Cedars Geri-CARE Program at the MUHC

Helping Older Cancer Patients Improve Their Physical and Emotional Health

No matter how gracefully we wish to age, getting older almost always leads to some degree of physical and mental decline. Of course, it’s not all bad, and there are lots of things that seniors can do to stay physically and mentally fit! However, if a cancer diagnosis strikes, things that naturally accompany ageing, like a loss of appetite, strength and balance, can make the cancer journey more difficult and slow down the recovery process.

Dr. Justin Sanders – Director of the Division of Supportive and Palliative Care at the MUHC

That’s where the MUHC’s Division of Supportive and Palliative Care steps in. Its aim is to meet the physical, psychological, informational, and spiritual needs of seriously ill patients. It employs a variety of healthcare professionals and encompasses a variety of healthcare programs and services. Although not exclusively available to cancer patients, the latter make up the majority of its clientele.

“There is a lot of distress involved in a cancer diagnosis, but we now have so much knowledge and experience that we can anticipate the issues that patients are going to face, and we can proactively alleviate their suffering and meet their needs, right from the start,” explains Dr. Justin Sanders, Director of the Division of Supportive and Palliative Care at the MUHC.

Dr. Antonio Vigano – Director of the Cancer Rehabilitation Program at the MUHC (CAREPRO)

The Cancer Rehabilitation Program (CAREPRO) is one of the Division’s programs. It’s headed by Dr. Antonio Vigano, a palliative care physician specialized in cancer rehabilitation. Since 2015, CAREPRO has been caring for cancer patients who experience malnutrition and a decline in functional status (the ability to look after one’s daily needs). CAREPRO’s clinics are located in the Cedars Oncology Supportive Care Centre, on de Maisonneuve Boulevard, just a few minutes walk from the Cedars Cancer Centre.

Most of the older patients referred to CAREPRO have below average muscle mass and strength, moderate malnourishment, and impaired appetite. Many also report suffering from depression and anxiety. The CAREPRO team, which consists of a physician, a nurse, a dietitian, a physiotherapist, and an occupational therapist, conducts a thorough assessment of each patient’s needs and comes up with an individualized treatment plan. The plan might include medication to alleviate cancer treatment side-effects, nutrition advice and supplements, referral to meal services, walking aids, and therapy to improve cognitive and physical function.

As of January 2024, a brand-new service will be  added to CAREPRO. Called the Geriatric Cancer Rehabilitation (Geri-CARE) Program, it is designed to specifically address the issue of decreased physical function in older cancer patients. “The goals of Geri-CARE are to increase muscle mass, balance and strength, which improves a patient’s ability to look after their needs. It may also reduce cancer treatment side-effects,” explains Dr. Vigano.

Resistance exercises help to gently and safely build muscle strength

In a nutshell, Geri-CARE provides patients with a fully personalized, professionally designed, do-at-home, exercise program that’s developed by a team of two clinical exercise physiologists (CEPs) and a physiotherapist. The program takes into account the patient’s functional limitations and focuses on resistance exercises, using the patient’s own body weight and resistance bands (which resemble giant elastics). The exercise programs are meant to be done twice a week and are always done under the supervision of a CEP, either in-person or via Teams. Occasionally, a patient will do their exercises in the CAREPRO/Geri-CARE clinic.

“Cancer treatments can be extremely hard on the body and can be especially debilitating for seniors,” says Dr. Vigano. “By following their exercise program, our patients improve their ability to perform essential daily tasks and, therefore, are better able to look after themselves. Plus, the regular interactions with the CEPs help reinforce our patients’ connection with our team, which reduces social isolation and the risks that it poses to people’s health,” he adds.

“This is part of our new ‘whole person’ approach to caring for cancer patients, which aims to provide the best possible care from the moment of diagnosis, by looking after the whole person, not just their disease,” explains Dr. Sanders.

The Cedars Cancer Foundation is a big supporter of Dr. Sanders’s whole-person approach to supportive care and has been instrumental in establishing the Cedars Oncology Supportive Care Centre as well as the Geri-CARE program. “Geri-CARE is perfectly aligned with our mission,” says Cedars’ President and CEO, Jeff J. Shamie. “It’s helping to improve the physical and mental health of some of our most vulnerable oncology patients, and providing supportive care that helps patients navigate their cancer journey.”

Visit www.cedars.ca to learn how the Cedars Cancer Foundation helps ensure that MUHC cancer patients and their loved ones receive the supportive care they need, at every step of their cancer experience.