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Exercise IS Medicine

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Mike AlpertMike Alpert

For those of you who are familiar with Jim Collins' book Good to Great, you are familiar with the Fly Wheel Concept. Specifically, it takes time and patience to create meaningful change (I refer to Improvements vs. Change), but once it begins to be incorporated, it is like a Fly Wheel. It begins slowly, and then, as it gains more recognition and acceptance, it picks up speed and accelerates. It is my opinion that this is what is happening in healthcare today as it applies to exercise being accepted as part of the adjunctive standard of care for people affected by cancer and other chronic illnesses. And, this will mandate insurance reimbursement for exercise and nutrition programs offered at health and fitness clubs nationwide.

I recently read an important state-of-the art review on the care of breast cancer survivors from the Mayo Clinic in Rochester, Minnesota.

From the Abstract: "Breast cancer survivors may experience significant aftereffects from diagnosis of breast cancer and cancer-directed therapies. It describes the side effects of chemotherapy and endocrine therapy and evidence-based strategies for the management of such effects, with particular attention to effects of therapies with curative intent. It includes strategies to promote health and wellness among breast cancer survivors, along with data to support the use of integrative oncology strategies. The strategies outlined in this review are paramount to supporting breast cancer survivors' quality of life."

In the body of the review:

"Integrative Oncology approaches to breast cancer survivorship - Exercise"

"Exercise is one of the most important lifestyle interventions patients can engage in to prevent recurrence and decrease symptoms associated with breast cancer treatments. Research has shown that exercise reduces both recurrence of and death from breast cancer; one meta-analysis reported that meeting recommended physical activity guidelines (at least 150 minutes of moderate intensity aerobic exercise a week) after diagnosis was associated with lower risk of breast cancer-related death during average follow-up periods ranging from 4.3 to 12.7 years. Exercise has also been shown to improve fatigue, anxiety, depression, quality of life, physical function, strength, sleep and bone health. Resistance training is safe in patients with lymphedema and should be encouraged. Unfortunately, most breast cancer survivors do not meet the recommended goals of 150 minutes of moderate aerobic exercise a week and twice weekly strength training."

So, what is Integrated Oncology, and what will it do to make the fly wheel accelerate? Integrative Oncology is the use of complementary, or integrative, therapies along with conventional medicine. These therapies work together with standard treatment methods (surgery, chemotherapy, radiation) to treat the patient's body, mind and spirit. Read on!

City of Hope received a transformative $100 million gift from the Panda Charitable Foundation to create a first-of-its-kind national Integrative Oncology program. Peggy and Andrew Cherng are entrepreneurial philanthropists who co-founded and own Panda Express and the Panda Restaurant Group and have grown it to $5 billion in annual sales. According to City of Hope's press release, "they intend to change the way we look at cancer care."

An estimated 40% of cancer patients use integrative therapies. Studies show that integrative therapies can support better health, improve quality of life and optimize clinical outcomes. City of Hope says that they plan to use the Panda Charitable Foundation gift to make Integrative Oncology an evidence-based, interwoven standard of care that supports optimal cancer treatment and survivorship.

Once Integrated Oncology is accepted as a standard of care in treating cancer, then insurance will have to reimburse for it. And, I am sure that will lead to other chronic conditions as well. It is one more step towards third party reimbursement. Think of the millions of people who will need exercise-based services to help treat these chronic health conditions. And, your club will be able to apply for and be reimbursed for these exercise-based programs. Is your club preparing for this huge opportunity?

If you are interested in participating in a beta trial with exercise oncology, contact me at and remember, Exercise IS Medicine!

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