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Submitted by kwils on Tue, 10/06/2015 - 10:01am

The Canadian Cancer Society has reported 1 300 new cancer diagnoses each year for children aged 0-18 years. Fortunately, the progress in treatments for childhood cancers has greatly improved cure rates, with 5-year survival now approaching 80%. This has led to more than 10 000 childhood cancer survivors living in Canada. However, three quarters of childhood cancer survivors have medical complications, up to 30 years after diagnosis. These side effects may include: impaired growth and development, cognitive dysfunction, compromised cardiopulmonary function, muscular sequelae, secondary malignancies, impaired physical fitness and decreased quality of life. Therefore, we must focus on improving the quality of life of pediatric cancer survivors by decreasing the impact of many of these negative side-effects. There is increasing evidence that regular physical activity is safe and feasible in different stages of cancer treatment, and can improve the overall health status, functional capacity and quality of life of patients and survivors of childhood cancer. Even in immune-compromised patients, exercise appears to be safe and feasible.

However, scientific evidence suggests that children with cancer are more sedentary than their healthy peers. Although the reason for lower activity levels is not entirely clear, some potential explanations have emerged in the literature. The first explanation suggests survivors are less active as a result of adverse side effects of chemotherapy and radiation. The second argues that childhood cancer survivors are subject to a “spectrum of disease” as a result of an overly cautious approach towards physical activity fostered by concerned parents, physicians, school teachers, and others. This overly protective approach could stem from a lack of knowledge of appropriate activities and may alter the child’s perception of their actual capacity for physical activity, resulting in a fear of over-exertion and lowered self-confidence (or self-efficacy). Another theory suggests that the timing of the diagnosis and length of treatment often coincides with a period of life when children are becoming more physically literate and being introduced to organized sports.

It is clear that several factors must be taken into account when developing strategies to improve the physical activity participation rates of childhood cancer patients and survivors. We feel that information about the benefits of physical activity in this population should be disseminated, along with practical recommendations that may reduce the fear for patients, survivors parents, health care providers, and educators.

In order to accomplish this, we have created evidence-based guidelines and resources outlining appropriate physical activity options for childhood cancer patients and survivors. These guidelines will not only serve as a tool for spreading the benefits of physical activity during the pediatric cancer journey, but will also establish a common criteria for exercise prescription in pediatric cancer populations. The current state of the research suggests there is a pressing need to provide evidence-based guidelines for those working with this population to promote physical activity participation.

*References

Increase awareness of the benefits of exercise during the childhood cancer journey

Provide allied health professionals, educators, and fitness professionals with evidence-based guidelines that will allow them to create specific exercise programs for childhood cancer patients and survivors

Provide tools that aid in the inclusion of cancer survivors in standard physical activity classes for healthy children

Provide oncologists and physicians with tools to allow them to start the conversation about physical activity with their cancer patients  and family and increase physician referrals to physical activity programs

Encourage childhood cancer patients and survivors and their families to engage in appropriate, safe, and enjoyable physical activity to counteract treatment side effects, reduce their risk of other chronic diseases, and improve their quality of life