Effects of Treatment on All Elements of Fitness
The elements of fitness include agility, speed, coordination, flexibility, strength, and endurance. Before clearing a cancer survivor for participation in a specific program or developing an individualized exercise prescription for that person, the fitness professional must understand what the exercise program will require of the survivor with regard to each of these elements, and whether the survivor is capable of participating in that component of exercise. For example, if a specific mode of aerobic exercise requires the ability to sustain an intensity level of 7 to 9 METS, but the maximal aerobic capacity of the client is 8 METs, it would not be appropriate to prescribe that particular mode of aerobic exercise. It is important to match the programming with the ability of the client.
One particular challenge in working with the cancer survivorship population is the interaction of aging with cancer. Cancer is more likely to occur in older people. Also, those who are diagnosed with cancer seem to experience an acceleration of functional aging. However, a healthy, fit 70-year-old diagnosed with early-stage cancer that requires minimal surgery, no chemotherapy, and a short round of radiation therapy could be ready to join a masters running club three months after treatment. By contrast, a sedentary, overweight, diabetic 40-year-old diagnosed with stage III colon cancer that requires extensive surgical resection, an external ostomy (e.g., a bag outside the body that stores waste), and a long bout of chemotherapy might need physical therapy just to return to functional mobility and independent living prior to beginning a basic walking and weight training program. The point is to evaluate survivors according to their current abilities and prescribe appropriate exercise programming according to the