Swiss Junior Doctors and Undergraduate Perspective on Sport and Exercise Medicine Blog Series
By Lauranne Bazin and Justin Carrard
For our final blog in the exercise oncology series, we spoke to Dr. Didier Jallut, who, for over 20 years has worked as an oncologist at an out-patient setting dealing primarily with breast cancer patients in Lausanne, Switzerland.
What drew your interest to exercise oncology?
Four years ago at the American Congress of Oncology, I learnt that exercise could reduce the adverse effect of the aromatase inhibitors1. To my surprise, this was presented at the end of the conference, which reflected my colleagues’ lack of enthusiasm towards the topic. Since this congress, I have been reading the latest research which time and time again shows the benefits of physical activity on both the quality of life and improved survival rate for patients with breast cancer. That is why I am devoted to promoting this research. In 2016 we organised a ‘Pink Challenge’ during the 2016 Lausanne Marathon, which asked participants to walk for breast cancer, followed by a conference explaining the benefits of physical activity.
Is the scientific evidence strong enough to support physical activity prescription?
Yes, it is. It would be dishonest of me to not acknowledge the evidence! It’s common to hear oncologists say that we shouldn’t make patients feel guilty if they do not partake in physical activity. However, I think the key is to choose the appropriate way for a patient to be physically active, and this is why I am an advocate for medical schools to teach physical activity prescription.
How do you prescribe physical activity?
When I first meet a patient, I ask about their usual physical activity habits. If the patient does not meet the WHO guidelines, I suggest that they start an endurance activity such as nordic walking, aquagym or spinning at least three times a week. If the patient prefers to exercise in a group, I refer the patient to a group managed by physiotherapists or sports scientists specialized in adapted physical activity.
From an oncological perspective, in your opinion, does every patient benefit by exercising?
Other than the very rare exceptions (such as a patient with acute decompensated cardiac heart failure), the answer is definitely yes. Again, I will reiterate, the key is to adapt the physical activity prescription to each patient. Most of my patients are 50+ years old and some have several co-morbidities. Many patients are also completely inactive and I consider it as a part of my job to inform them that they will benefit from exercise and motivate them to do so. I am proud of the effort my patients make to be physically active – they are top athletes to me!
Do you monitor your patients’ level of physical activity?
Unfortunately, not as much as I’d like to. At each consultation, I ask patients how active they are and document it in my files. Moreover, I advise them to use a pedometer to capture their daily steps. This is a great way to motivate patients to maintain a certain level of movement and help them work towards the 10’000 step WHO recommendation.
Do you notice any improvement in the patients who choose to be active?
Patients are really satisfied with themselves when they become more active. Unfortunately, I don’t have the capacity to conduct a prospective study to look at this question from a scientific perspective.
Do you want to share any thoughts regarding the future of exercise oncology?
I hope to see more evidence supporting the preventive and therapeutic benefits of exercise for breast cancer, and more evidence that shows that exercise contraindications are extremely rare. Through my work, I hope to convince more oncologists to prescribe exercise to their patients. Finally, I would like to see health care systems recognize the therapeutic value of exercise and implement it appropriately in the modern health system.
Read part 1 of the series: Exercise oncology part 1/3: Let’s get moving, exercise helps in preventing AND treating cancers!
Read part 2 of the series: Exercise oncology part 2/3: Let’s put it into practice!
Lauranne Bazin is a 4th year medical student at the University of Geneva (Switzerland), member of Students and Junior Doctors SGSM/SSMS. She regularly practices sport and has a keen interest for exercise physiology and sports medicine. Email: Lauranne.Bazin@etu.unige.ch
Justin Carrard is a SGSM/SSMS board member, president of Students & Junior Doctors SGSM/SSMS and coordinator of the BJSM Swiss Junior Doctors and Undergraduate Perspective Blog Series. He is currently working as a second-year internal medicine resident in Biel/Bienne (Switzerland). Email: firstname.lastname@example.org Twitter: @Carrard.Justin
- DeNysschen CA,Burton H, Ademuyiwa F, Levine E, Tetewsky S and O’Connor T. Exercise intervention in breast cancer patients with aromatase inhibitor-associated arthralgia: a pilot study. Eur J Cancer Care (Engl). 2014 Jul;23(4):493-501.
Newspapers article about Dr. Didier Jallut (in French)