Q: Tell us about your career so far?
A: I’ve been a physiotherapist for over 20 years. I’ve spent almost all that time working with children and I have a lot of experience working with children and young people with cancer. I co-lead the recently established international SIOP Rehabilitation and Physical Medicine Special Interest Group which aims to bring professionals together to increase global collaboration in areas such as physical activity in childhood cancer.
Q: Tell us about the role of a children’s physiotherapist
A: We help prepare children for treatment and surgery through prehabilitation, and rehabilitate them following surgery or the effects of cancer, working on areas including strength, balance and mobility. We play a key role in promoting active and healthy lifestyles and helping to keep children physically active during and after their treatment.
Q: What are the benefits of active lifestyles?
A: In children and adolescents in general, being physically active has many benefits including being associated with better cardiorespiratory fitness and muscular and bone health. On the other hand, higher levels of sedentary behaviour are associated with increased body fat, and poorer cardiometabolic health and fitness, so it’s something we advise against! The evidence we have for children and adolescents with cancer shows physical activity is safe, feasible and beneficial and can effectively mitigate some of the side effects of cancer treatment. It can improve physical factors, such as cancer related fatigue and fitness, and psychosocial factors, such as mood, anxiety and quality of life.
Q: How do you see physical activity and exercise in childhood cancer care evolving in the coming years?
A: I remember when the evidence for exercise in adult care started to emerge, and there was barely anything specific to childhood cancer at that time. This is definitely not the case anymore as the research is rapidly expanding with many innovative exercise and physical activity interventions being delivered in childhood cancer care. We do, however, need much larger and higher-quality studies.
In recent years we’ve started to see international collaborations that will undoubtedly take this field forward. The FORTEe Project and the International Pediatric Oncology Exercise Guidelines (iPOEG) are just a couple of examples of wonderful current international collaborations. They’re bringing together global expertise to produce guidelines, conduct clinical trials and promote exercise therapy in childhood cancer.
Q: Are the challenges with physical activity similar across the world?
A: Physical inactivity is a global problem! The World Health Organisation estimates that more than 80% of adolescents globally don’t meet recommended physical activity levels. Whether it’s in the UK or the other side of the world in Australia, children and adolescents aren’t active to levels recommended to benefit their health.
Despite the encouraging evidence emerging in paediatric exercise oncology, there are unfortunately gaps in evidence elsewhere. There is less evidence about physical activity from low-/middle-income countries and resource-limited settings. We already know there is a huge gap between children with cancer in high-income and those in low-/middle-income settings in relation to survival and access to care. With developments in exercise oncology, it’s vitally important as a community that we aim to reduce health inequality and, where we can, ensure research findings are applicable to all children with cancer.
Q: Do you have a message for children and their families affected by cancer?
A: Physical activity and exercise is hugely beneficial to children and young people at every stage of the cancer journey, whether during or after treatment. It can improve so many things including physical health, self-esteem and confidence, and can help with many of the side effects of cancer treatment Any activity is better than none, so do what you can, do it when you can, and make it fun!
From Contact magazine issue 99 - Summer 2023
