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Exercise is Medicine -

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It must be noted that all health professionals featured in this segment are Accredited Exercise
Physiologists (AEPs). AEPs are 4-year university qualified allied-health professionals who
specialise in exercise therapy and lifestyle services for persons with chronic health conditions,
injury and disability. There are over 2,600 Accredited Exercise Physiologists (AEPs) nationally -
many of whom work in private practice. You can located an AEP in your area by going to the "Find an
Exercise Physiologist" search directory at www.essa.org.au. If you have a medical condition, please
consult your AEP or doctor before embarking on an exercise program.

NARRATION

Wayne is in his final weeks of chemotherapy for bowel cancer.

Clinical Prof David Goldstein

Chemotherapy as we use it today, is really drugs given to the highest doses that, from experience
and testing, people can tolerate.

NARRATION

To combat the severe side-effects of treatment, Wayne takes a range of other medications. But they
have limited effect.

Wayne Bell

After starting the chemotherapy, all my energy had gone. I was, I'd get out of bed and lie on the
couch and watch movies and read, and really had no energy. And this went on for weeks.

NARRATION

But Wayne's oncologist has prescribed another treatment, fast gaining recognition among cancer
specialists. It can fight Wayne's fatigue and nausea, lower his risk of developing secondary
diseases, and dramatically cuts the chance of the tumour returning.

Wayne Bell

I feel now much better than I did on the earlier part of the chemotherapy. I really feel that I'm
dealing with it much better.

Anja Taylor

It can treat the top ten chronic diseases in Australia. Yet the extraordinary thing is,less than
two per cent of GPs currently prescribe it. You might be thinking it's some new miracle drug, but
it's not.

NARRATION

It's exercise. We all know exercise is good for us. It makes us feel better, look better, and
function better.

Anja Taylor

It took all my energy to get up at six o'clock this morning and go training. And let's face it,

most of us only do it when we're feeling healthy or motivated. How Many of you exercise when you're
sick? I know I don't.

NARRATION

Neither did Wayne. Traditionally, cancer patients are recommended total bed rest.

Wayne Bell

I walked into the Lifestyle Clinic and I saw some weights there, and I thought, 'Oh no, I can't
even look at those weights.' But they, they got me on very light exercises - just walking. And I
couldn't believe the, the turnaround. Within a few days I was feeling much better.

NARRATION

The Lifestyle Clinic is no ordinary gym. Every patron here is a patient, being treated for a
serious medical condition.

Trainer

That's it, all the way back ...

NARRATION

Director Chris Tzar is part of a global campaign to get doctors to see exercise as medicine.

Chris Tzar

There is no medicine that can treat a range of chronic conditions like exercise can. We have many
medical practitioners that actually are if you like, exercise therapy naive, they're not familiar
with the role of exercise in a particular chronic disease, and the mechanisms underlying it, and
what impact it has as well.

NARRATION

The impact can be huge. Take Margaret. She was diagnosed with high-level diabetes at age
seventy-four. Standard medications didn't make a huge improvement to her blood glucose levels.

Margaret

After four years, you know, I didn't get the count down very far.

NARRATION

With nothing to lose, Margaret turned to exercise. She's been pumping iron three times a week.

Anja Taylor

Why strength training?

Chris Tzar

Strength training is an anaerobic activity. It requires muscle contractions, and that's a form of
activity that helps to treat diabetes, and primarily insulin resistance, to try and bring down
blood glucose levels.

NARRATION

And it's worked phenomenally well. In just eighteen months, exercise has achieved what medication
failed to: Margaret's blood glucose levels are now well within the normal range.

Anja Taylor

So Margaret's gone from a high-level diabetic to non-diabetic, essentially, at the age of eighty.

Chris Tzar

Essentially, yeah.

Anja Taylor

That's incredible.

Chris Tzar

It is, and it shows what impact exercise can have if you do it routinely and progressively, and you
can commit to it long-term. We find that it has a dose-response relationship. So there's a
particular type of exercise, done at a particular frequency, which poses significant benefits for a
specific condition.

NARRATION

Exercise works on different conditions in a myriad of ways. It alters the expression of genes,
changes hormonal responses, encourages the birth of new brain cells, lowers fat levels, decreases
inflammation ... the list is endless.

Chris Tzar

You're not just doing exercise to treat your type-two diabetes, but it's also helping to improve
your blood pressure, it's helping to improve your cholesterol levels, and tackle depression and
other symptoms. Because Many patients don't just present with one disorder, and that's the
uniqueness about physical activity and exercise.

Instructor

You okay there? Okay, just ten more seconds.

NARRATION

While the effects of exercise on some conditions like diabetes, osteoporosis and depression are
well-known, evidence is still coming in on its wide range of benefits for cancer patients. These
men have prostate cancer. The cancer thrives in the presence of testosterone, so treatment involves
the suppression of this hormone.

Assoc Prof Daniel Galvao

By withdrawing testosterone, there's a number of side effects, for instance the loss of muscle, the
loss of bone. Um, impairments in physical functioning and balance.

NARRATION

Patients on testosterone suppressants normally lose over four per cent of their bone density each
year. This trial is examining whether targeted exercise can prevent this loss.

Assoc Prof Daniel Galvao

We've shown in previous studies that exercise is an important role to reverse the loss of muscle.
Now we're taking it a step further, we're combining resistance training with high-impact loading
activity which is very likely to be beneficial for bone outcomes.

NARRATION

Jumping is not a normal activity for these men. Each time they land, their skeleton vibrates and
takes load. Over time, this leads to beneficial changes in the bones.

Anja Taylor

So this person's been on the trial for six months?

Assoc Prof Daniel Galvao

So what we can see here, this particular subject's actually preserving bone over time, which is a
fantastic outcome.

Anja Taylor

So that means he hasn't lost any bone at all?

Assoc Prof Daniel Galvao

Exactly.

Instructor

Difficult, isn't it?

Man

Oh, I reckon.

Instructor

Try and get your balance back.

NARRATION

Balance exercises lead to less falls and less fractures.

Instructor

If you have a look at the grey bar there

Man

Oh, I see, yeah.

Instructor

that's the average for someone your age. And so you're well above that.

NARRATION

Cardiovascular fitness lowers other risk factors. But best of all, exercise may even beat the
cancer itself. Large epidemiological studies suggest the right amount of exercise can achieve a
drop in mortality of around fifty to sixty per cent for a number of cancers.

Clinical Prof David Goldstein

Exercise is the only treatment I know of that can achieve this kind of result without any downside.
And in a sense, it's a rediscovery of something that's always been beneficial.

Wayne Bell

The idea that exercise will stop the tumour coming back, it makes me want to exercise more, and
anything I can do to stop that tumour coming back is great.

Assoc Prof Daniel Galvao

It means that patients have extended their lives, in terms of time. So it's a fantastic outcome,
it's very exciting for this area.

NARRATION

To encourage more GPs to prescribe exercise, the Lifestyle Clinic has developed a special patient
questionnaire. Expect your physical activity levels to be under scrutiny at one of your next
check-ups.

Anja Taylor

Surprisingly, the results from my questionnaire tell me I have to exercise more. But the upside is,
at least I'll be working on prevention, rather than cure.

Topics: Health, Others

Reporter: Anja Taylor

Producer: Anja Taylor

Researcher: Anja Taylor/Roslyn Lawrence

Camera: Julian Robins

David Collins

David Chia

Sound: Stephen Ravich

Gary Carr

Grant Roberts

Editor: Andrew Glover

Story Contacts

Clinical Prof David Goldstein

Medical Oncologist, Prince of Wales Hospital, Sydney.

Chris Tzar

Director,

Lifestyle Clinic, UNSW, Sydney.

Assoc Prof Daniel Galvao

Director, Health and Wellness institute, Edith Cowan University, WA.

Related Info

Exercise is Medicine for Cancer

Exercise is Medicine Australia

^ top

YOUR COMMENTS

>> Add a Comment

Michael Ace - 06 Jun 2012 8:01:23pm

Hi Chris,

I have trained & competed at a high level most of my life & am/was a PDHPE teacher. In 2000 I
discovered I had a malignant tumour in my right thigh which turned out to be a Synovial Sarcoma in
my Vastus Lateralis. After removal of the tumour & then removal of the muscle I had 6 all day
chemos of multi intravenous solutions every 3 weeks & then 5 weeks of intense Radiotherapy.
Throughout all this time I continued to train either weights or cardio, except for the immediate
2/3 days after my chemo. In 2010 I had a radical prostectomy & continued my training/way of life
after the obligatory 5 weeks of healing.

I train every day alternating weight training & cardio (walk/spin bike/rower). At the moment I am
receiving chemo again for CLL but find I can train thro this as it's not as intense as previouly.

Would be happy to discuss my regime etc & other facets that I utilised eg yoga/pilates, high
altitude trekking, with you if of use to you. regards mike

>> Reply

Cath Saville - 04 Jun 2012 1:42:16pm

Hi - great read - I was diagnosed with Bowel cancer in Feb 2012 but fortunately early stages just
needed surgery - in March 2012 I was also diagnosed with Breast Cancer (insitu) non invasive type
and have had surgery and will start radiation soon - I have book treatment at a clinic which
involves a 3 X 1K walks to get to - I figured this way no matter how tired I felt - even if I didnt
do normal excersize after getting home I would at least be walking daily.....It seemed like the
right thing to do but I was a little concerned - so reading your story just confirms that I am
right to continue trying to maintain and build fitness - thanks!

>> Reply

Chris TZAR - 06 Jun 2012 11:34:10am

Dear All - IMPORTANT !,

In the interests of public safety - & as one of the persons interviewed - I must emphasise that all
health professionals providing these services in the segment are Accredited Exercise Physiologists
(AEPs). AEPs are 4-year university qualified allied-health professionals who specialise in exercise
therapy and lifestyle services for persons with chronic health conditions, injury and disability.
There are over 2,600 Accredited Exercise Physiologists (AEPs) nationally - many of whom work in
private practice. You can located an AEP in your area by going to the "Find an Exercise
Physiologist" search directory at www.essa.org.au

>> Reply

Joshua Whittaker - 02 Jun 2012 9:49:02pm

Great presentation, however I'm confused as to why the title/occupation/profession (exercise
physiologist) of these professors, associate professors, clinicians and students was never
mentioned during the program?

>> Reply

Anja - 01 Jun 2012 5:07:51pm

Great program. I weight trained throughout my chemo and felt full

of energy and sailed thru chemo.

Had lung cancer. Elena

>> Reply

Karen - 01 Jun 2012 2:47:35pm

It was a great segment that really highlighted the work that Accredited Exercise Physiologists do
and the numerous benefits of exercise(despite failing to mention these allied health
professionals).

Accredited Exercise Physiologists provide specialist clinical exercise services for people living
with, or at risk of chronic illness, injuries and disabilities. This includes cardiovascular,
metabolic, musculoskeletal, neurological conditions as well as cancers, chronic pain syndromes,
chronic fatigue and mental illness.

As a practicing AEP, I see clients from all different backgrounds with a wide range of injuries and
conditions. I can certainly report that most of my clients get positive results from engaging in
appropriate and safe exercise that has been tailored to them and their circumstances.

>> Reply

Steven Turner - 01 Jun 2012 7:55:32am

Hi,

A great program

If your not already aware Doug McGuff M.D., and John Little have written a book called Body By
Science, Doug has included a chapter on "The Dose-Response Relationship of Exercise". I highly
recommend Body By Science (website) essential reading.

>> Reply

William - 31 May 2012 11:07:09pm

Dear Anja,

Thanks so much for your positive & encouraging Catalyst presentation about exercise.

It's been 8 years since my mum died from uterine cancer. My dad has twice recovered from prostate
cancer & was diagnosed with stage 3b bowel cancer in Oct 2010. There were days during his chemo
treatment when he couldn't move, but on his 'good' days, he used what strength he had to walk
modest distances close to home or do some pruning in the garden.

With a combination of surgery, chemo treatment, healthy diet, exercise & positive encouragement,
his recovery has been amazing!! At the age of 68, dad stepped back onto his windsurfer in January
this year. I can't even begin to describe my feelings of happiness; windsurfing on Port Phillip Bay
& looking over my shoulder to see my dad sailing next to me.

Appreciating the benefits of regular exercise, dad really enjoys his present weekly activities;
volunteer work helping others, walking, Tai Chi, Shibashi, stretch-n-flex, gardening & social
activities.

Thanks again for your encouraging presentation Anja. I hope you stay happy & healthy.

Kind regards,

William

>> Reply

Zac - 31 May 2012 10:27:40pm

Hey guy

Just wondering why there was no mention of exercise physiology or ESSA the peak profession for
exercise ??

>> Reply

Paul Davis - 31 May 2012 9:56:23pm

Wonderful Program. Possibly life saving advice.

Should be supplied on a disc or usb (boomerang) to every patient to take home with databases of
contact groups in local communities to help and support those who find it hard to get motivated.
Many men & women particularly find it hard to get going on their own when overweight. Stopping late
night ads where the food is the size of a table on the screen will help. With obesity increasing
the next 10 years will be critical in the managing to stop a health crisis wave hitting the health
system. Can there be proactive campaigns in the community that does not wait for these people to
land in their medical centre with problems. They need a group or club to go to or someone to get
them started. What about 1 morning off a week to be recorded as a physical routine, sponsored by a
private runner company of choice.?

Obesity tax? All health workers, physiotherapists in training must spend a month visiting suburbs
and identifying, enlisting, advising and encouraging physical exercise & or join a local get fit
group.. Maybe a study could be done on the savings of such a program. Rather than leave it up to
already expensive weight loss enterprises, who almost rely on peoples collapse into obesity and
anxiety. You would see a reflection I feel in mental health improvement also in this inclusion.

>> Reply

edward hawken - 31 May 2012 9:20:22pm

I was diagnosed with colorectal cancer september 2oo8,I have exercised most of my life especialy
army service.Since surgery I have realy got stuck into exercise. 3 annual colonoscopies have been
all clear.Surgeon only wants me to visit dec2012 and colonoscopy december 2013

>> Reply

Trudy - 31 May 2012 8:08:46pm

There are probably some conditions for which exercise makes the condition worse - like the one I
suffer from - Chronic Fatigue Syndrome. Every time I exercise I get sicker! This was not mentioned!

>> Reply

Anja Taylor - 01 Jun 2012 9:22:59am

Hi Trudy,

Chronic Fatigue Syndrome is actually a condition which the Lifestyle Clinic treats very
successfully with exercise. Time didn't permit going into details on the program. Please visit
their website for more details.

Anja

>> Reply

Bev - 04 Jun 2012 11:48:16am

Dear Trudy

It took years to regain my current health and manage CF and Fibromyalgia, effects of Lupus SLE, I
know exercise played a big role. I started small.

Just tiny moments here and there practising Yoga breathing, relaxation, meditation, slow qui gong
movements, self massage. I found it increased my energy, serenity and positive feelings. I still
place my hands on opposite shoulders, rock slowly from side to side to give myself a yoga hug, or
rub my face, head, neck, earlobes, under nose tip for a quick pickup.

Today people say I am very active walking, cycling, gardening etc, but I still must maintain
balance; adequate rest, relaxation, nutrition. Sometimes this is impossible due to life's demands,
or I say 'What the Heck' and suffer the consequences.

I can't know your circumstances Trudy, but what I am trying to say is that there is always hope.

Small steps, even just breathing well, can be beneficial and start of the journey to recovery.

Take care!

Bev

>> Reply

Marlee AEP - 04 Jun 2012 12:32:09pm

Actually studies show that chronic fatigue does respond well to exercise but it needs to be
professionally guided. Small, regular amounts gradually building up actually help most people to
regain energy levels and physical strength. Of course they cannot exercise at the level of a
healthy person but I have had good results with my clients.

>> Reply

Paul Harrison - 04 Jun 2012 8:19:19pm

Hi Trudy,

I sympathise as I also suffer with CFS. I find if I don't walk regularly and undertake light
exercise, I feel much worse! I am careful (mostly) not to over do it. Once you find the line
between the two extremes of too much and not enough, it is amazing how much better you can feel.
Good luck, I hope you can find it.

>> Reply