Presentation title which may run over two lines Name Title Date

Evidence of reduced risk from physical activity Convincing Colon Probable Breast (post-menopausal) Endometrium Limited but suggestive Lung Pancreas Breast (pre-menopausal) Conclusions of World Cancer Research Fund (WCRF) expert report (2007) and continuous update project (CUP)

Pre-diagnosis (prevention) Pre-treatment (prehabilitation) Treatment (symptom control) Survivorship (health promotion) Post-treatment (rehabilitation) End of life (palliation)

Physical activity and survival Emerging evidence of physical activity post-diagnosis as an independent predictor of survival time/disease progression Cancer Studies Risk reduction Breast 4 >20% cancer mortality/progression Colorectal 6 >30% cancer mortality/progression Prostate 2 >50% cancer mortality/progression Lung 1 >30% total mortality Brain

Exercise is safe both during and after most cancer treatments Patients are advised to avoid inactivity and return to normal daily activities as soon as possible after surgery, and during adjuvant cancer treatments The standard age appropriate guidelines are also appropriate for cancer patients

Safety considerations Potential risk Precaution Exacerbate symptoms Avoid high intensity; modify based on site of treatment Immune suppression Avoid high intensity/volume & public places while white blood cell counts are low Bone fractures Avoid high impact/contact with bone metastases/osteoporosis risk Falls Avoid activities needing balance with dizziness/frailty/peripheral neuropathy

Department of Health. Improving Outcomes. (2102). A Strategy for Cancer. Second Annual Report. London: Stationery Office.

Macmillan Cancer Support/ICM. (2011) Macmillan Cancer Support/ICM. (2011). Online survey of 400 health professionals who deal with cancer patients (100 GPs, 100 practice nurses, 100 oncologists, and 100  oncology nurses, of whom 52 were oncology nurse specalists). Fieldwork conducted 23 May-12 June 2011. Survey results are unweighted.

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Patticrew M Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Patticrew M. Developing and evaluating complex interventions: new guidance. Medical Research Council; 2008 Sep pp. 1–39.

Michie S, van Stralen MM, West R Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science. BioMed Central Ltd; 2011 Apr 23;6(1):42.

Michie S, van Stralen MM, West R Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science. BioMed Central Ltd; 2011 Apr 23;6(1):42.

Michie S, van Stralen MM, West R Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science. BioMed Central Ltd; 2011 Apr 23;6(1):42.

Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions. ann behav med. Springer US; 2013 Mar 20;46(1):81–95.

Health care professional responsibilities: if you have only 60 seconds about current physical activity levels and if they are aware of the benefits of moving more ASK of the benefits of physical activity to people living with and beyond cancer ADVISE signpost on for more help and support ACT

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Patticrew M Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Patticrew M. Developing and evaluating complex interventions: new guidance. Medical Research Council; 2008 Sep pp. 1–39.

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Patticrew M Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Patticrew M. Developing and evaluating complex interventions: new guidance. Medical Research Council; 2008 Sep pp. 1–39.

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“To ensure everyone living with and beyond cancer is aware of the benefits of physical activity and enabled to choose to become and to stay active at a level that is right for them.”

Physical activity the underrated wonderdrug ‘Keeping active has helped me, and my family, through a really difficult time. It’s helped me return to a more normal way of life and has given me a real sense of achievement’. Ted Poulter,

Presentation title which may run over two lines Name Title Date