Getting back on the bike, post cancer

Professor Melanie Keats takes the exerbikeout for a test drive. A study by fourth-year student AbbyJakob showed participants enjoyed playing the gaming systems andwere so keen that they wanted to keep playing. Her researchalso showed that they were having so much fun that they didn'trealize how hard they were working. (Nick PearcePhoto)

As a two-time survivor of cancer, Melanie Keats is convincedthat being a fit and active person is what saved her life.

At the age of 12, she was diagnosed with spinal cord cancer,with a nasty tumor sitting at the very base of her spinal cord andgetting entangled with spinal nerves.

It was serious. The girl who ran, shot hoops, blocked herbrother’s slapshots, dribbled soccer balls and just loved toplay was facing major surgery and the knowledge that she may notfully regain function of her lower extremities. Worse, she learnedthat she may not live to celebrate her 14th birthday.

Dr. Keats was facing a tough road of surgery, radiationtreatment and physical therapy. But six months after difficulttumor debulking surgery, she was learning to walk again. Beforelong, she was running and jumping and back trying to keep up withher older brother.

“I went into my surgery being very, very active,”says Dr. Keats, 38, assistant professor in the Department of Healthand Human Performance. “I am convinced that is the reasonthat I am as strong and as healthy as I am now.”

On track to become a nurse—just one course shy of herdegree—the Calgary native was again diagnosed with cancer,this time bladder cancer. Although this time surgery and recoverywas a “piece of cake” in comparison with the firstgo-around (which subsequently involved more surgery to fuse andstraighten her spine) she had spent enough time in hospitals toknow she didn’t want to work in one. Her focus changed tokinesiology and she found her niche in an exercise psychology classinvestigating the value of exercise for special populations, namelyyoung cancer survivors like herself.

“C’mon, seriously?” says Dr. Keats, who was 19at the time of her second diagnosis. “I don’t drink. Idon’t smoke and I’m active. I’m not even 20 andI’ve had cancer twice.”

MILESTONES

Arriving at Dalhousie in 2008, Dr. Keats has embarked on a majorresearch initiative called MILESTONES. The primary goal of theresearch is to optimize the quality of life of childhood cancersurvivors by getting them active, whether they were active orinactive prior to their diagnosis.

Over the past 30 years, there has been a dramatic decline in thenumber of childhood cancer-related deaths. But as the population ofpediatric cancer survivors continues to grow, a new set of healthconcerns, commonly referred to “late-effects,” hasemerged. Ranging from physiological to psychological, there is anincreasing need for supportive interventions that target riskreduction and promote healthy behaviors from diagnosis and beyond.As cancer survivors are more susceptible to long-term healthproblems than their “healthy” peers, health riskbehaviors, such as physical inactivity and poor diets, prove to beof even greater significance.

“The treatments for cancer are very intensive and they canhave long-term implications,” she explains, in her office inDalplex. “Chemo, for example, can reduce muscle mass, bonemass; it can impair the hearth and lungs; it can affect balance,all kinds of things. Then there are the emotionalproblems—you’re suddenly different from yourfriends.

“As a childhood cancer survivor, it’s always a partof you. It’s always there.”

'Exergaming'

The key to recovery and a good quality of life, she believes, isearly intervention, right in the hospital. With the help of a grantby the Canadian Foundation for Innovation (CFI) and matching fundsthrough Nova Scotia Research and Innovation Trust, she wants to getkids on bikes: having races, smashing vehicles and steering throughcongested corridors at breakneck speeds. So to speak. The bikespower video-games; pedaling controls the action on the screen.

“With the CFI money, we can bring the bikes right to theirrooms in the IWK,” she enthuses. “And, if the childdoesn’t have the strength, they can stay in bed and pedalwith their hands. It’s a start.”

The other part of MILESTONES is a community component and thatinvolves setting up an “exergaming” fitness centre atDalplex where kids can come to play and regain strength andconfidence once they’re out of the hospital. The centre willbe set up with interactive activities such as exercise bike gameconsoles, the music video game Dance Dance Revolution, and dozensof Wii units, to use at the centre or to borrow and take home.

“The equipment they’re coming out with now, is, asthey kids say, sick,” she says with a laugh. “We wantto get people excited about activity so that they’remotivated to start being active, and once they get active, tosustain that physical activity, to move from a virtual bike to areal bike.”