Development prototype — NOT FOR USE

Talking Points for Healthcare Providers

Breast cancer may affect an individual’s beliefs, motivation, and ability to exercise. Focusing on these can be a useful way to introduce the topic.

Using a respectful and non-judgmental way to get a conversation about exercise started can keep the woman actively engaged in the conversation and decision making.

Reference: Cancer - Moving Medicine

The health care professional talking points below are intended to help you integrate the personalized estimates of benefits and risks of exercise into a clinical discussion.

How to engage breast cancer survivors in discussions about exercise

It is important that you:

  1. You may start a conversation about exercise by asking, “Would it be OK to spend a minute talking about something many cancer survivors find really helpful?”
  2. You could also say, “Cancer survivors find moving more helps them manage their symptoms and improve their general health and well-being. I wonder what you make of that?”
  3. You may also start a conversation by briefly getting your patient’s perspectives about warning signs, diet, or exercise.
    1. You can use open ended questions like “Your weight seems to have changed from our last appointment, what do you think of that?” or
    2. Use affirmations to encourage conversation. E.g., “You are doing a great job walking your dog every day after work.”
  4. Discuss Goals for Exercise: Encourage patients to take one step at a time.
    1. Use open ended questions like “What changes would you want to make?”
    2. You can also use an “Elicit-provide-elicit” technique as follows:
      • Elicit: What do you know about the benefits of exercise?
      • The patient may say that exercise helps reduce weight.
      • Provide: That’s true. Reducing weight could also reduce your risk of cancer coming back or avoiding breast cancer death.
      • Elicit: Would you be interested in talking a little more about how exercise might help with your health?

Using the tool with breast cancer survivors

  1. When sharing estimates from the tool it is important to tell the women that…
    • Everyone is different, and it is impossible to know the future, but the information you provided was obtained from simulated women their age and in similar health.
  2. Current exercise guidelines recommend:
    • 150-300 minutes of moderate (or 75-150 minutes of vigorous intensity) activity each week.
    • Resistance training exercise at least 2 days per week.
  3. But different levels of exercise may offer different levels of benefits (and risk).
    • Even a small increase in exercise could reduce a woman’s risk but
    • More exercise is not always better.
  4. How to discuss breast cancer death and life-years gained
    • Exercise may help a breast cancer survivors’ live longer.
    • Talking points for estimates generated by the tool:
      • Breast Cancer Death: “based on risk calculators, out of 1000 adults your age with similar health problems, around 50 could die from breast cancer in 10 years without exercise while 950 would not (OR you have a 5% chance of avoiding a breast cancer death with exercise).”
      • Life-years gained: “Based on information from others your age and in similar health (and based on available risk calculators), I would estimate that you could gain around 25-years with exercise. Of course, everyone is different, and it is impossible to know the future.”

Refer

If the patient needs more help or guidance than you can provide in a few minutes, please consider providing the following referrals:

  • Exercise Professionals
  • Registered Dietitians
  • Community Resources