Exercise may reduce risk of cancer returning, study shows
An international cancer study has found that exercise can have huge benefits for cancer patients and can even reduce the risk of the disease returning.
The results were presented at the American Society of Clinical Oncology annual conference in Chicago at the weekend, and published in the New England Journal of Medicine.
Among those attending the expert gathering was Professor Janice Walshe, medical oncologist at St Vincent's University Hospital in Dublin.
She called the study an "incredibly strong finding", saying "it adds to the literatures that suggests that exercise is really important in keeping ourselves well."
The study examined nearly 890 patients who had high risk colon cancers (stage 2 or stage 3) and was completed in 55 locations, including in countries such as the US, France and Australia.
All patients had completed chemotherapy treatments and were put into one of two groups.
One group was given structured, supervised exercise sessions with a personal trainer and the other was just given a booklet outlining the benefits of a healthy lifestyle.
The first group did 45 to 60 minute walks three or four times a week and could do more if they chose.
Twice a month they worked with a personal trainer and then later once a month for a total of three years.
After eight years, the patients in the first group had a 37% lower risk of dying than those in the second group.
Prof Walshe said it was important to note that all these patients had already received chemotherapy.
"So, this intervention is not a substitute for drugs that we know already reduce the risk of people dying from different various cancers," Prof Walsh said.
Speaking to RTÉ's Morning Ireland, Prof Walshe said she felt that some newspaper headlines about the study were "misleading."
"I think what they're trying to say is that the magnitude of benefit we have seen with this intervention, of an exercise programme, is the type of reductions we've seen with many of our new drugs.
"But this is not a drug substitute," Prof Walshe said.
"This is on top of you receiving the best drugs in the market to reduce the risk of disease recurrence."
Prof Walshe said there is a "huge amount of Irish research" at this year's American Society of Clinical Oncology conference.
"The consultants who travel here are all networking with various research groups to bring these trials home to Ireland and obviously the best approaches in terms of managing our cancer in our Irish patients," she said.
"We already have exercise programmes ongoing in various parts of the country that are free of charge, because we believe exercise is really important in terms of, one, reducing risk of disease recurrence and, two, increasing people's confidence," she added.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Irish Times
3 hours ago
- Irish Times
Admissions to Portlaoise nursing home halted due to ‘significant concerns'
Admissions to one of two nursing homes facing allegations of abuse and neglect were halted earlier this year by the Health Information and Quality Authority (Hiqa) due to 'significant concerns'. The Residence, Portlaoise, featured alongside Beneavin Manor in Glasnevin, north Dublin, in an RTÉ Investigates programme showing instances of alleged abuse and neglect of frail, elderly residents. The programme includes older people allegedly being manhandled, 'forced' down into chairs, being left in incontinence pads for so long their clothes were soaked, and being ignored when they pleaded for help to go to the toilet. The centres are operated by Emeis, previously known as Orpea, the largest provider of private nursing home beds in the State. READ MORE Following the RTÉ broadcast on Wednesday night, Hiqa has said it identified several 'significant concerns' through previous inspections of the services and, as part of escalatory action, it stopped admissions to the Residence, Portlaoise. The health and safety watchdog halted admissions after an inspection in February, a spokeswoman said. This condition came into effect in April following a notice period. Such 'restrictive conditions' are implemented when there is persistent noncompliance with the regulations or where there is risk to residents' safety, it said. Overall, the centre was found to be non-compliant with 10 regulations following the February inspection. It found staff were not appropriately trained to deliver effective and safe care and were not appropriately supervised, which was noted as being a repeated noncompliance. While most centres can expect one or two inspections each year, Hiqa said it carries out more inspections at centres where there are concerns or where there is repeated noncompliance. The Residence, Portlaoise, had three inspections last year and one in February. Beneavin Manor was also among the 36 nursing homes to receive three or more inspections in response to persistent noncompliance. Other enforcement steps available to Hiqa include cancelling the registration of a centre. However, it noted such action can cause 'significant upset and distress' to residents and their families. Following 840 inspections in total last year, the authority either refused to renew registration or cancelled the registration of 10 nursing homes. Hiqa said it was conscious the RTÉ Investigates programme is 'very distressing viewing' for nursing home residents, their families and friends. It said further inspection reports on both of the centres are being finalised and will be published in the coming weeks. 'However, we are very concerned about the practices described in the programme and we have engaged directly with those responsible for the operation of the nursing homes,' it said. Hiqa said it will be taking necessary actions with Emeis to ensure safe and effective care for all residents.
Irish Examiner
4 hours ago
- Irish Examiner
We need to talk about our nursing homes
I was recently invited by RTÉ to review images taken surreptitiously by an undercover worker in a nursing home setting. In general, I'm not in favour of such approaches as clandestine 'fly on the wall' filming will often capture moments in time that may not be representative of the culture of a place or an individual's performance. We all have moments when we are not at our best. That said such an approach must be weighed up against public interest especially when the subject matter relates to vulnerable people. This is such a situation. Ever since the Leas Cross report by Professor Desmond O'Neill in 2006 highlighted the poor standard of care of older people in a residential setting it became obvious that nursing homes required not only a greater regulatory focus but also greater societal attention. There is no doubt that the resultant formation of the Health and Information Quality Authority (Hiqa) led to greater standards in residential settings but regulation in isolation does not guarantee standards of care. The expert report and recommendations into the care of residents in nursing homes during covid-19 highlighted our continued collective blind spot around vulnerable older adults in residential settings. The report identified not only, the now well recognised, lack of planning and provision of protective equipment to nursing homes by the State during the pandemic, but a system-wide lack of medical and nursing governance and gerontological training in the sector. Many of that report's recommendations have not been implemented and Hiqa have not reported on our response to that report. The Leas cross report had identified staffing as a core issue, summarising that the inadequate staffing and training amounted to the "institutional abuse of older people". In all the cases of substandard care that I witnessed in this documentary, there was a significant staffing factor, most often unavailability of staff members and on a few occasions a very evident lack of training. An inability to supervise or attend to a person's care, answer a call bell, appropriately handle a person's positioning or continence needs, all reflected to my eye a lack of personnel and training. There were distressing moments to watch, older frail people being poorly or roughly handled, left sitting on toilets, or left in their own urine and without the basis of a sheet. In some instances worryingly there was a shortage of resources as bad as any we witnessed during covid-19, and in most cases in these snapshots there was an absence of any aesthetic or joy in resident's lives. As we celebrate the greatly improved life expectancy we have achieved over the last century, I was moved having watched these vignettes of care, to again reflect on the gerontological dilemma and ask "what is the point of adding years to life if we cannot add life to years as well?" Although almost all the care I have witnessed personally in nursing homes has been good, I do wonder how much joy of being alive the almost 30,000 vulnerable adults in nursing homes actually experience. We have approximately 32,000 nursing home beds in Ireland with over 90% occupancy. Four in five beds are made available by private providers. Our demographic trends forecast almost 1.25 million people over the relatively young age of 65 by 2040, and 300,000 over the age of 80. During the cost-of-living crisis many smaller nursing home businesses struggled, folded or were unable to undertake structural improvements mandated by the new era of concern around infection control. Not all will age healthily, 25% will have at least one chronic disease by the age of 50. The 2022 census showed 23,500 people were resident in our 557 nursing homes, up from 22.300 in 2016. While the shifting emphasis of our health service is concentrating on maintaining people at home, many of us will need residential care and in many cases it would be preferable or it should represent a richer possibility than to be to living isolated and alone with a call for half an hour three times a day. In any case we are likely to need 1,500 extra residential care beds per annum over the next 25 years or so. How is this to be funded to scale and to what model? It is unlikely after years of closing down institutions that the State is coming back to become a provider of long-term residential care on any significant scale - though this needs discussion. The State has a role, in my opinion, to provide training and expertise through a 'teaching nursing home' model and is currently de facto the guarantor provider in very complex case needs declined or 'returned' to hospital by the private sector when it is determined by their evaluation that care needs cannot be met, or at least not without substantially more funding. In addition, the public health system has considerable real estate through its community hospital network that often provides more complex longer term care in people's communities such as in my native town of Kinsale. Nevertheless, the cost of providing this care through public services has been seen as more prohibitive than commissioning through private providers. Private providers themselves complain they get significantly less capitation per bed than that given to public residential facilities. Currently our private providers are a mixture of Irish family-owned businesses and small companies and larger nursing home chains funded through foreign investment funds. Both models need to be profitable to build capacity and provide care, but it is clear from talking with providers that their view points and cultural mores may differ. There is the motivation to provide excellence in care juxtaposed to a requirement for a guaranteed investment prospectus to fund new developments to scale. Fair Deal One root of the problem evident in this documentary lies in the current nursing home support scheme or 'fair deal' which provides State funding, by means of a 'mortgage' loan on the person's estate, that covers the bare costs of residential care. It does not cover 'hotel luxuries' such as cable TV, or newspapers, access to activities and there is limited continence wear provision. These costs, as well as access to chiropody, physiotherapy, speech and language therapy must be met as additional charges to the resident and their families. What ostensibly should be an automatic right to assessment and treatment through our community structures does not exist either through local policy or lack of resource. The model of 'basic' funding rather than 'reasonable' funding of the lifestyle and care needs of residents creates a culture of 'skimping' on our vulnerable older person's quality of life and care. During the cost-of-living crisis many smaller nursing home businesses struggled, folded or were unable to undertake structural improvements mandated by the new era of concern around infection control. This created its own crisis for residents and families as people who had lived in a nursing home for many years were compulsorily forced to move, a stress that should always be avoided and surely has a rights-based argument. I am aware of one family whose relative was on their third move due to nursing home closure, moving more times in the last two years of her life than she had in her entire adult life. 'Aging in place' is a relatively modern but important concept. In its fullest realisation, it should mean being able to live an enriched life in an environment that enables you to enjoy life and realise your later life goals. That may or may not be best achieved in your adult home. A proper personalised and supportive assessment of this, such as currently provided through the Healthy Age Friendly Homes Initiative by Age Friendly Ireland, is a great example of how we need to engage with later life planning. But 'rightsizing' our accommodation needs alone does not address the inevitability of needing more support as we age. We need more developments in our communities that integrate age friendly design in residential accommodation with integrated structures that allow for escalation of care needs if we get frailer, so we can truly age in place and in our communities rather than moving several postcodes away to solely congregational settings. This will need planning and funding but examples like Macauley place near Kildare town, are emerging in Ireland, emulating the 'green house' approach to residential design, so evident in Phoenix, Arizona, a city that has taken the business of aging seriously. Caring skills Caring for older adults is complex challenging and hard work. It can be very rewarding and full of joy but it is also often hard work, physically mentally and intellectually. Looking after patients with dementia, multiple medical problems, on 13 medications and with poor mobility, needs highly developed interpersonal skills, empathy, clinical acumen and mental resilience. How do we value such skills in our society? How is pay determined and what are the terms and conditions of such employments? What are the opportunities for training, continuous learning and career progression? Many of the clips I watched seemed to show staff under stress, poorly motivated and lacking training. Compounded by a basic lack of supplies at times there was a helplessness to the situation bordering on burnout, the phenomenon by which repeated inability to deliver a standard care creates moral injury, stress and eventually a reduced empathy in healthcare workers. What then is the solution to our repeated nursing home scandals? How do we best meet the challenge of our needs in this area as we age? The Irish Society for Physicians in Geriatric medicine (ISPGM) in its paper Responding to the needs of Residents in long Term Care in Ireland highlighted a number of important principles worthy of more focused consideration. We have approximately 32,000 nursing home beds in Ireland with over 90% occupancy. Four in five beds are made available by private providers. Included among its many common sense recommendations was that all residential nursing homes needed a clearly defined system of governance, with an identified medical and nursing lead who had appropriate gerontological training. Nor is it enough that we should just expect our care staff to have the necessary training, but that they also should have a career opportunity to operate at the highest licence of achievement. We must attract talent by developing talent in the nursing home sector through promised career opportunity. Allied to that must be a linking of salary and conditions to equivalent HSE staff grades, both to attract and retain staff and stabilise manpower across the sector to reduce the risk of significant staff shortages. Regulation must be linked with scientific development and research so what we are inspecting is relevant and matters to the care and lives of older people. That regulation must be encouraging and well informed but it must also have a 'stick'. We cannot have residential care homes operating despite repeated serious failures of regulatory inspections as was alluded to in this documentary. What does that say about the importance we ascribe to the care of us all as we age? The right response How then should we - and minister O'Donnell, who has responsibility for older people - respond to this latest documentary? Let's start by recognising that we have had recurrent exposés of poor care in our nursing home sector and a number of expert reports highlighting systemic problems that need remedy but go unresolved. The citizens assembly in 2017 brought focus to the challenges for aging in Ireland but we now need a proper authoritative commission on residential long-term care in Ireland. This commission needs to involve older people and their advocacy agents Like Age Friendly Ireland, the department of health and Health Service Executive, multidisciplinary gerontological expertise and the providers of nursing home care. Such a commission needs to set out the future framework for residential and nursing home care in Ireland, to include a forecasted need by geographical area, the model of this care and how this development should be funded. It needs to describe the model of governance, training and career development and employment conditions of healthcare workers in the sector. It must define the funding per residential care home bed and what services this must statutorily. The model of a safer staffing framework to determine staff levels on an hours per resident per day must be defined, funded and implemented. Regulation of the sector must be informed by scientific research, digital technology and a cycle of meaningful audit with the power and intent to withdraw or transfer licensing where serious recurrent breaches are evident. We all want to feel the security that a loved one and that we ourselves would be treated with dignity and care if and when we need residential care. It's time to properly discuss our need for residential care and what this should look like. Professor Rónán Collins is a consultant physician in geriatric medicine Read More Investigation shows dire practices at privately-run nursing homes
The Journal
4 hours ago
- The Journal
HIQA 'very concerned' over scenes at nursing homes at the centre of RTÉ investigation
NURSING HOMES REGULATOR HIQA carried out additional inspections at two care facilities featured in an RTÉ Investigates programme as a result of previous non-compliance orders, the authority has said. The Health Information and Quality Authority (HIQA) said it is 'very concerned' over the 'distressing' scenes pictured in RTÉ Investigate's programme into two privately-owned care facilities in Co Dublin and Co Laois. It has engaged with the owner of the two facilities, Emeis Ireland, formerly known as Orpea. RTÉ Investigate's programme aired last night and highlights poor treatment and practice within two of the homes under the chain's brand. Emeis operates 27 nursing homes across the country after entering the Irish market in 2022. Two RTÉ researchers worked undercover in two different homes; one in The Residence Portlaoise, and one in Beneavin Manor in Glasnevin. Undercover reporters saw understaffing leading to older people being in pain while waiting to go to the toilet. HIQA has this morning revealed that the nursing homes featured in the programme were subject to additional inspections, as a result of previous non-compliance orders. It has asked all residents in all Irish nursing homes, and their friends and family, to maintain confidence in its ability to regulate care and nursing homes and to come forward with anything they deem concerning at other facilities. Multiple residents at the facility suffered falls after being left on their own, staff moved people inappropriately without using a hoist, and in one case, a man who asked to be taken to the toilet being told directly by a staff member to pee in his incontinence pad. Advertisement In a statement yesterday, Emeis apologised 'unequivocally' to residents and their families . It said the investigation's findings are 'deeply distressing, wholly unjustifiable, and entirely unacceptable'. 'We express our deep concern, as the wellbeing, dignity, and safety of residents in our care will always remain our foremost priority,' the company said. Overnight, HIQA, the national regulator for nursing homes and care facilities, said it will be taking the necessary actions with the provider to ensure safe and effective care and support to all residents. A recent report by the authority highlighted that a small number of nursing homes fail to meet compliance regulations. It said the 'vast majority' of operational nursing homes in Ireland meet mandated standards Where issues are persistent, HIQA said its chief inspector takes necessary enforcement steps, such as placing restrictions on a centre's registration. In 2024, HIQA refused to renew registration or cancelled the registration of ten nursing homes. It said the chief inspector, in taking these decisions, is 'mindful that cancelling registration of a centre can cause significant upset' for residents and their family. A total of 840 inspections were carried out last year, it said, with 84% of them being unannounced reviews. 'Inspections are a core component of the regulation of nursing homes and aim to improve the lived experiences of residents, and allow us to meet with residents on inspection and hear directly from them,' it said. It has engaged with the owner of the two facilities, Emeis Ireland, formerly known as Orpea. Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
