Survival Strategies

The articles below are to provide inspiration for your own positive survival strategies.

How important is exercise for cancer survivors? by Lexi Harlow, Physical Therapy, Seattle Cancer Care Alliance

Very important! The American Cancer Society recommends a physically active lifestyle, along with an appropriate weight and healthful diet, to prevent recurrence, second primary cancers, and other chronic diseases.1 Studies have shown that exercise improves cardiovascular fitness, muscle strength, body composition, fatigue, anxiety, depression, self-esteem, happiness, and quality of life in cancer survivors.2 Often, survivors tend to decrease their physical activity levels after being diagnosed with cancer and most continue lower levels of activity through treatment and beyond increasing their overall risk for a second cancer, obesity, diabetes, and/or heart disease.1 Most, if not all, cancer survivors would benefit from a consultation by a physical therapist to help develop a comprehensive exercise program. Physical therapists can make recommendations on the type, frequency, duration, and intensity of exercise. This exercise program should be individualized to your age, diagnosis, treatment, previous activity level, and other medical conditions. Physical therapists can evaluate specific needs in the following areas: strength, flexibility, cardiovascular re-training, scar tissue work after mastectomy/lumpectomy, fatigue, balance, incontinence and neuropathy disorder treatment and to teach lymphedema prevention and/or treatment education.

How can we help you start a safe exercise program?
The Seattle Cancer Care Alliance has physical therapists on staff with expertise in recommending specific exercise programs to cancer survivors with a wide variety of diagnoses and stages of treatment. If you are interested in meeting with a physical therapist at the SCCA, please discuss this further with your doctor, who can make a referral to our department. Survivors who are seen in the Survivorship Program's MOST Clinic can receive a comprehensive evaluation, which will include a discussions of the benefits of exercise and any possible risks. We can also refer you to one of our physical therapists for a consultation. We look forward to helping you meet your physical fitness goals and enhancing your quality of life as a cancer survivor.

For more information on the Fred Hutchinson Cancer Research Center Survivorship Program, or to arrange an appointment for yourself, a friend or family member, call 1-866-543-4272, e-mail us at survivor@fhcrc.org. We hope to hear from you soon.

References
1Doyle C, Kushi LH, Byers T, et al. Nutrition and Physical Activity During and After Cancer Treatment: An American Cancer Society Guide for Informed Choices. CA Cancer J Clin 2006; 56; 323-353.
2Courneya KS. Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 2003; 35: 1846-1852.

Employee Rights of Cancer Survivors by Dana Hess, Civil Rights Investigator, Washington State Human Rights Commission

One in three persons will be diagnosed with cancer in his or her lifetime. More than 10 million people in the United States are living with cancer. Additionally, more than 1.3 million persons in the U.S. will be diagnosed with cancer this year. Sixty-five percent (65%) of adults diagnosed with cancer today will be alive five years from now. And the large majority of these persons are employed when diagnosed, undergoing treatment, and after treatment ends.

As employees, a person with cancer (or who had cancer) is, in most cases, considered "disabled" under federal and Washington law and is protected by the American with Disabilities Act (ADA) and the Washington Law Against Discrimination (WLAD). An employer must accommodate an employee's condition when the impairment is "known or shown through an interactive process to exist in fact," and the impairment has a substantially limiting effect on one of the following:

the individual's ability to perform his or her job;
the individual's ability to apply or be considered for a job; or
the individual's access to equal benefits, privileges, or terms or conditions of employment; or
the employee puts the employer on notice of the impairment and medical documentation establishes a "reasonable likelihood that engaging in job functions without an accommodation would aggravate the impairment to the extent that it would create a substantially limiting effect."

The duty to provide reasonable accommodation is a fundamental statutory requirement because of the nature of discrimination faced by individuals with disabilities. Although many individuals with disabilities can apply for and perform jobs without any reasonable accommodations, there are workplace barriers that keep others from performing jobs which they could do with some form of accommodation. These barriers may be physical obstacles or they may be procedures or rules (such as rules concerning when work is performed or when breaks are taken). Reasonable accommodation removes workplace barriers for individuals with disabilities.

For more information see the newly released Breast Cancer Legal Resources Guide at: http://www.wsba.org.

January 2007