Physical therapists at the heart of the global battle against cancer

This September the United Nations will hold its first ever summit on non-communicable disease - only the second such meeting to focus on global disease. The summit, involving heads of state, is an official recognition that non-communicable diseases (cardiovascular diseases, chronic respiratory diseases, diabetes and cancer) are an increasing global health challenge.  They already claim 35 million lives a year – around 60 per cent of deaths. For physical therapists, the official recognition that a global strategy is required to reduce this burden of disability and deaths is highly significant. The profession of physical therapy, known in some countries as physiotherapy, helps millions of people every year to prevent these conditions and their risk factors – most importantly obesity. They also manage their effects, along with the effects of aging, illness, accidents, and the stresses and strains of life. Physical therapists specialise in human movement and physical activity, promoting health, fitness, and wellness. They identify physical impairments, limitations, and disabilities that prevent people from being as active and independent as they might be, and then they find ways of overcoming them. They maximise people’s movement potential. So when the World Health Organization points out that physical inactivity is one of the leading risk factors for global mortality, causing 3.2 deaths annually, and that physical activity can reduce non-communicable diseases, it is clear that the profession has a major part to play. In any global actions that emerge from the UN Summit on Non-Communicable Diseases in New York on 19th and 20th September, physical therapists must be central to plans and implementation.

That is why World Physical Therapy Day, held every year on 8th September, is particularly important this year. It is a day when physical therapists can publicise their work, educate the public and policy makers about what they do, and try and ensure that the public benefit from their skills.   Many people do not recognise the contribution physical therapists make in keeping people healthy and independent. This year on World Physical Therapy Day, WCPT is particularly drawing attention to physical therapists’ role in reducing the risk of cancer, and helping people recover from its effects. The World Health Organization has this year drawn attention to the role of physical activity in reducing cancers – 150 minutes a week of moderate physical activity can reduce the risk of breast and colon cancers, according to WHO’s new Global Recommendations on Physical Activity for Health.  But the physical therapy contribution in cancer goes wider than that. Studies have also indicated a relationship between higher physical activity levels and lower mortality in cancer survivors. One recent meta-analysis reported that, post-diagnosis, physical activity reduced breast cancer deaths by 34% and disease recurrence by 24% (Ibrahim EM, Al-Homaidh A. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol. 2010 Apr 22). Another meta-analysis found that exercise brings people with breast cancer improved peak oxygen consumption and reduced fatigue (McNeely ML, Campbell KL et al. Effects of exercise on breast cancer patients and survivors: a systematic review and metaanalysis. CMAJ. 2006 Jul 4;175(1) 34-41). I conduct workshops around the world, demonstrating how adults with chronic health problems can improve their health by learning how to exercise safely under the guidance and instruction of physical therapists. Activity has to be introduced carefully if a person is overweight, unfit, older, or has a chronic disease. Physical therapists do this by examining the person, recommending exercises that are safe and appropriate for them, and educating them about how to look for signs of trouble. This makes them the ideal professionals to prescribe exercise programmes for cancer. According to the World Health Organisation, cancer is a leading cause of death worldwide and accounted for 7.6 million deaths (around 13% of all deaths) in 2008. Deaths from cancer worldwide are projected to continue to rise to over 11 million in 2030, yet more than 30% of cancer deaths can be prevented. Physical therapy doesn’t just mean more healthy people, but more productive people who can contribute to countries’ economies. Their services are provided in an atmosphere of trust and respect for human dignity and underpinned by sound clinical reasoning and scientific evidence. These are important messages that physical therapists want to convey to the world every day, but especially on 8th September, World Physical Therapy Day. The message is clear: physical therapists are the movement, physical activity, and exercise experts and a resource in the battle against non-communicable disease that should never be overlooked.

Written by Marilyn Moffat, President of the World Confederation for Physical Therapy