Get Up Get Moving

What’s one of the most common symptoms reported by patients with cancer? Fatigue. Regardless of what type of cancer their patients are experiencing, it seems that nurses are constantly looking for ways to help their patients fight against the symptoms brought on by their disease and its treatment.  

In the past, the most common recommendation for patients experiencing cancer-related symptoms was rest and recuperation. However, mounting evidence suggests that physical activity is the best way to decrease symptoms associated with cancer treatment—especially fatigue, depression, sleep disturbances, anxiety, and more.

Although that assessment is contrary to traditional practice, ONS Research Associate Deborah Struth, MSN, RN, says, “The most common complaint from people with cancer is regarding fatigue, and the evidence of strong studies across disciplines refutes the age-old advice of rest and recommends 150 minutes of exercise or physical activity weekly.”

Depending on a patient’s diagnosis and circumstance, certain restrictions and limitations to physical activity may have to be applied. However, most patients with cancer should be encouraged to participate in some physical activity. This is the cornerstone of ONS’s Get Up, Get Moving program

Beyond combatting fatigue, physical activity can fight against other symptoms such as anxiety and depression. It may improve sleep quality, manage lymphedema, maintain bone and muscle strength, and decrease the recurrence of future treatment-related symptoms.

Meeting the Goal to Get Up, Get Moving

A number of organizations have already backed incorporating physical activity into treatment plans, including the American Cancer Society, American College of Sports Medicine, National Comprehensive Cancer Network, U.S. Department of Health and Human Resources, along with ONS.

ONS created Get Up, Get Moving to encourage oncology nurses to break from the mold of traditional practice by recommending physical activity to their patients with cancer. The closer to the start of active treatment that oncology nurses encourage physical activity, the better for the patient. Having this discussion at the beginning of treatment encourages healthy, active habits in patients with cancer. 

According to ONS member, oncology educator, and 2014 Congress Get Up, Get Moving speaker Katrina Fetter, RN, MSN, OCN®, the program's goal is “to achieve a partnership between oncology nurses, healthcare organizations, and ONS that promotes quality cancer care by increasing the number of patients who receive safe and effective recommendations to participate in physical activity.”

Through Get Up, Get Moving, ONS aims to have oncology nurses recommend individualized physical activity plans to more than 100,000 patients. As part of your quality monitoring program, you can enter and track the number of patients given exercise recommendations using ONS Quality Measures. The testing of the ONS Quality Measures found that less than 10% of patients undergoing IV chemotherapy or within the first 12 months after treatment for breast cancer were encouraged to use physical activity as a way of decreasing treatment-related symptoms.  

Some patients may be hesitant to exercise, but Fetter said, “Nurses have reported that their patients were glad the topic was brought up, although there was reluctance to participate on the part of some patients as they did not feel good and were tired. But once they increased their activity, they reported feeling better!”

Resources to Help Your Patients

Interested in getting your patients into an exercise routine? ONS has prepared a patient education video that discusses the benefits of physical activity during treatment. Showing this to your patients will help them get a sense of what they can do to prevent symptoms like fatigue and depression through regular exercise. 

Although patients’ exercise plans will be dependent on their diagnosis and situation, Fetter said, “I always recommend walking and light weight lifting for the average person. For a person who is more chair- or bed-bound, I encourage them to use light weights or soup cans in the chair or bed for their arms and leg lifts as well.”

ONS also offers a comprehensive course, Incorporating Physical Activity Into Cancer Care, providing information, resources, and hands-on experience that will help you consistently recommend personalized exercise routines to your patients with cancer. 

A Simple Intervention

Although incorporating individualized exercise routines into a treatment plan was not typically recommended in the past, the evidence proves a clear benefit for patients with cancer. “I believe that physical activity is such a simple intervention with such wide-ranging benefits that it should be a priority for all of our patients,” Fetter says. “Get Up, Get Moving is designed as a catalyst for nurses to contribute toward better outcomes for our patients.”