Exercise and Cancer
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Forward Progress
“You have cancer” are three words no one wants to hear. Receiving a cancer diagnosis can come with an overwhelming impact, more so on the mind than the body. Patients experience a range of emotions, from shock to numbness, disbelief, fear and crippling anxiety.
However, with a little self-belief and resilience, you can bounce back stronger. Wondering how? With the right tools, resources, and support, of course — all offered to you in the form of integrative cancer care.
There are many types of integrative therapies, from acupuncture, naturopathic and holistic therapies to diet and lifestyle modifications. We would like to introduce you to a really potent therapy — exercise. That’s right! A prescribed addition of specific exercises can help reduce fatigue, stress, and improve physical function.
Let’s delve deeper into the integration of exercise and cancer, more formally referred to as exercise oncology.
Let’s delve deeper into the integration of exercise and cancer, more formally referred to as exercise oncology.
An Introduction to Exercise and Cancer
While great strides have been made on the clinical side of cancer treatment in the past few decades, oncology care has also evolved to become more patient-centric. Everyone who has had to deal with a cancer diagnosis now has a wide variety of adjunctive care options to support recovery, not the least of which is exercise.
Research has identified exercise as one of the essential components of every cancer treatment program. Regular exercise can significantly enhance both physical and mental health during all stages of treatment, according to an increasing body of evidence. In fact, an exercise program tailored to your specific needs can help you resume an active lifestyle, even if you were not moving your body much before your cancer diagnosis.
You must consult your physician before beginning any fitness regimen. They can assist you in determining whether you have any health issues that can limit the types of workouts you can perform. They might advise you to see an exercise specialist or get a medical examination. This can be a personal trainer, physical therapist, or cancer rehabilitation specialist. Before starting an exercise regime on your own, talk to your primary care physician, oncologist or exercise physiologist.
Moving through Cancer: Watch now!
Filmed over two years and at major cancer centers in Ohio, Pennsylvania, Texas, California, Virginia and Denmark, MOVING THROUGH CANCER chronicles innovative programs that emphasize exercise throughout the cancer journey, with experts and patients providing first hand testimonies.
What are the Benefits of Exercise for People with Cancer?
The benefits of exercise are abundant, irrespective of age, gender, or health status. Exercise can be transformative for people struggling with cancer and the effects of treatment. In fact, exercise is one of the finest things cancer patients can do to revitalize their well-being even while undergoing their cancer treatment.
People who exercise regularly handle their cancer therapies with fewer and more mild adverse effects. Exercise routines recommended by an oncology exercise specialist will be ideally tailored to individual abilities and goals.
Enhance the Effectiveness of the Treatment
Regardless of the type or stage of cancer, exercise can often enhance the body’s reaction to treatment. Frequent exercise has been demonstrated to:
Lessen fatigue from cancer treatment
Lower the chance of co-occurring diseases, including diabetes and heart disease
Keep up your athletic prowess, strength, and vital organ performance
Enhance the quality of life and lessen stress, depression, and anxiety
Reduce recovery time
Decrease side effects in patients undergoing chemotherapy
Exercise has been linked to higher survival rates for specific diseases.
Lower the Likelihood of Further Malignancies and Co-Existing Disorders
Co-existing conditions refer to additional health issues you may be experiencing in addition to cancer. Frequent physical activity may:
Lower the chance of co-occurring diseases, including diabetes and heart disease
Assist in managing any current co-existing disorders you have
Lower your chance of getting further malignancies
Boost General Health Conditions
Boost your balance to lower the risk of falling
Improve digestion and regularity
Increase flexibility and range of motion
Stop muscular atrophy and increase strength
Improve bone density and lower the risk of osteoporosis
Enhance sleep quality and overall well-being
Better weight management
Increase lung function and improve endurance
As evidenced by the benefits cited above, exercise during and after cancer can bring a transformative change to your recovery process. Combining exercise with a balanced diet will help establish a healthy lifestyle and return to daily life.
Exercise Guidelines for Cancer Patients and Survivors
Before you build your exercise program as a cancer patient or survivor, there are a few things you must keep in mind.
It is important to discuss any necessary precautions with a qualified healthcare provider. This includes your general practitioner (GP) and any of your cancer treatment physicians. Your individual exercise program should be designed with a certified oncology exercise specialist or a licensed physical therapist with cancer patient expertise. Both cancer patients and survivors are advised to start cautiously and increase gradually if they haven’t been active in a while or if they don’t have a high fitness level. It is critical to pay attention to your body. While exercising demands effort, you shouldn’t push yourself if you feel pain or extreme discomfort.
You may need a modified exercise program if you have any conditions, such as pain, lymphoedema, moderate-severe fatigue, anemia, significant shortness of breath, low platelet count, compromised immune system, radiation therapy burns, damage to nerves (peripheral neuropathy), or primary or metastatic bone cancer.
If you are a cancer survivor, it may take some time to get back to your pre-cancer level of fitness after treatment. Consult your medical staff about the best fitness regimen for you. They may approve you to begin exercising independently, recommend a cancer rehabilitation program, or refer you to a trained cancer exercise specialist who can create the ideal fitness regimen for your particular circumstances. You might need to collaborate with the cancer exercise specialist or cancer rehabilitation clinician for a while, or you might be able to follow the plan independently.
Your personalized workout regimen will be based on the kind of cancer you have, the therapies that are employed, the adverse effects that you are feeling, how fit you are, and any further health issues you may be experiencing post-treatment.
Exercise Recommendations During and Following Cancer Treatment
Based on research, American Society of Clinical Oncology ASCO recommends that cancer patients mainly participate in aerobic and strength-training exercises during cancer treatment.
An overview of exercise guidelines that have been demonstrated to enhance overall health in cancer patients and survivors is given below.
Stretching Exercises
Regular stretching can help with posture and flexibility. It can assist your body in healing itself by improving the blood and oxygen flow to the muscles. If you have not been active while recovering from cancer treatments, stretching is usually beneficial.
For instance, radiation therapy can cause your muscles to stiffen and reduce your range of motion. However, mobility and flexibility can be enhanced by regular stretching before, during, and after radiation therapy. Stretching after surgery can help you return to your regular daily activities by restoring your range of motion and breaking down tight scar tissue.
Exercises for Balance
One of the negative effects of cancer and its treatment is balance loss. You can safely resume your every day activities by using balance exercises to help you restore the function and mobility you require. Keeping your balance well also helps you avoid injuries like falls. Find out more about post-cancer exercise for balance.
Aerobic Workouts
This sort of exercise, which increases heart rate, is often referred to as cardio. It can make you feel less exhausted both during and after treatment and strengthens the body’s heart and lungs. One simple approach to acquiring aerobic exercise is to walk.
Strength Training
A person who is less active throughout cancer treatment and recovery frequently experiences muscle loss. There are medications that also weaken muscles. Resistance training, often known as strength training, aids in the maintenance and development of strong muscles. Increasing muscle mass can ease daily tasks, lessen fatigue, and help you balance better. Moreover, it can aid in the fight against osteoporosis, a condition where certain cancer treatments can weaken the bones.
The current exercise guidelines for adults to maintain overall health, as detailed in the Physical Activity Guidelines for Americans, 2018 resource, dictate that —
Cancer patients and survivors should moderate aerobic exercise for at least 150-300 minutes per week OR vigorous aerobic exercise for at least 75-150 minutes per week. They can even combine both, accompanied by resistance exercises twice a week.
Research also indicates that even lower amounts of exercise can help improve symptoms like cancer-related fatigue, physical function, anxiety, depression, sleep, lymphedema, and bone health and generally lead to a better health-related quality of life.
Here is a chart of proposed exercise routines and the symptoms they can manage —
Aerobic Exercise
3x per week
30-60 minutes
Cancer-related fatigue, physical function, anxiety, depression, and sleep
It can also elevate the health-related quality of your life.
Resistance Exercise
2x per week
2 sets / 8-15 reps
Cancer-related fatigue, physical function, lymphedema, and bone health
It can also elevate the health-related quality of your life.
Aerobic Exercise
2-3x per week
20-40 minutes
+
Resistance Exercise
2x per week
2 sets / 8-15 reps
Cancer-related fatigue, physical function, anxiety, and depression
It can also elevate the health-related quality of your life.
To reinforce your confidence in cancer fitness and its many benefits, here are some success stories I have gathered from my esteemed colleagues and partner institutions.
Patient Success Stories
I did experience fatigue, cognitive impairment, and pain. And I found with all three that exercise was the best medicine I could give myself. My personal training plan was a godsend. The exercise gave me energy and cleared my thinking when I felt groggy and out of it.
What amazed me was how fast the pain would disappear with exercise. Following my chemotherapy regimen, every bone in my body ached. It was the worst pain I had ever experienced in my life. I couldn’t fathom the idea of walking, let alone working out."
- Arthur, Liver Cancer Patient
| Flexibility | Lower Body Muscular Endurance | Upper Body Muscular Endurance | Cardio respiratory Fitness |
|---|---|---|---|
| 21.4% | 60.9% | 30.7% | 21.3% |
| Increase | Increase on average | Increase on average | Increase |
- Erin
- Rebecca, Breast Cancer Survivor
| Flexibility | Cardio
respiratory Fitness |
|---|---|
| 20% | 12.8% |
| Increase | Increase |
- John
- Sara, Breast Cancer Survivor
| Cardioresp -iratory fitness |
Lower body muscular endurance | Upper body muscular strength | Upper body muscular endurance |
|---|---|---|---|
| 7.1% | 69.7% | 10.1% | 15% |
| Increase | Increase on average | Increase on average | Increase |
- Dena
Wondering how to get started?
This is what we will cover in this last section.
How To Get Started?
Daunted by the thought of starting to exercise during or following your cancer treatment? It does not have to be a big deal. In fact, you may incorporate the ideal amount of exercise into your life in various ways. Little things add up, and taking action, no matter how small, will benefit you far more than lying on the couch.
Begin by doing what you can and then seek out opportunities to do more. Start out cautiously if it has been a while since you’ve been active. Build up your activities by performing them more frequently and for longer periods of time after a few weeks or months.
You can increase your level of exercise by walking. Start by going for ten minutes of daily walks a few days per week. Spend the first two weeks doing this. Following that, begin to walk a little bit farther. Instead of ten minutes, try fifteen. Next, go for more weekly walks.
Try walking more quickly once you can easily stroll for fifteen minutes several days a week. Continue walking at a fast pace for several months. For a change, consider starting to ride a bike on the weekends.
Besides this, you can also try to participate in exerting activities that are part of a daily routine, such as mowing the grass, scrubbing your bathroom, washing your car, playing active games with your family or friends, dancing in your room, or riding a bike.
Furthermore, you can also add some changes to your habits, including taking the stairs instead of the elevator, setting phone reminders to take a 10-minute walking break after every hour, joining a walking club with friends, and using a treadmill or doing squats, arm curls, or lunges while watching TV.
Last but not least, here are some more tips to support you in your cancer fitness journey:
Work Out in a Secure Setting
Stay away from locations where germs can readily spread if your immune system has been compromised by therapy. Exercise indoors or outside in pleasant weather.
If you don’t feel like exercising, change the length of time or intensity until you do. Do not force yourself toward exhaustion.
To prevent dehydration, you should be well-hydrated throughout the day and while working out. Consuming wholesome meals, particularly those rich in protein, can help your body recuperate from physical activity. You can also contact a cancer nutritionist to make a diet plan suited to your lifestyle.
Your state of health may alter both during and following treatment. During your routine checkups, discuss any significant health indications, such as your blood count, with your doctor to determine whether it is still safe for you to exercise.
There is a place for adjunctive care therapies like exercise in all stages of cancer care, whether your goals are to prevent cancer, support recovery and survivorship, or are actively undergoing cancer treatments (chemotherapy, immunotherapy, surgery, anti-hormonal agents, target therapies). Thus, do not wait and begin your cancer fitness journey as soon as possible.
Frequently Asked Questions (FAQs)
Before you begin exercising during or following your cancer treatment, you should consider posing the following questions to your medical team (physicians, physical therapists, oncology exercise specialists).
– What kind of fitness regimen would you suggest for me?
– Do I have to avoid any particular kind of activity while receiving cancer treatment? What happens when my treatment is over?
– Could this fitness regimen evolve over time?
– Does my cancer treatment need me to stay away from the gym? Can I perform any exercises at home? Any routine activities that I can consider as exercise?
The intensity of your exercise regime is the amount of effort your body puts out during a workout. It measures how challenging physical activity is for you at the moment. There are three different levels of exercise intensity: mild, moderate, and intense.
Try practicing light-intensity workouts first if your team advises it is safe for you to begin exercising. Once you feel comfortable performing such exercises, you can go on to more difficult moderate-intensity workouts. When performing light-intensity activities, you generally should not feel breathless, start to sweat, or take breaks to speak or sing. When engaging in moderate-intensity exercise, on the other hand, you generally should not be breathing heavily, yet your breathing is rapid, start to sweat a little bit, and be able to speak but not sing.
Yes, even if you have never exercised before, it can be helpful to start right after receiving a cancer diagnosis. Work with your medical team to create a customized and safe plan. Start with two to three sessions of 10 to 20 minutes a week of exercise. Select low-intensity workouts like walking, balancing exercises, and stretching. Gradual low-intensity exercises can support a healthier lifestyle by enhancing energy levels, reducing stress, and enhancing general well-being both during and after treatment.
Keep in mind that it is all about variety. Change up the length and intensity of your workouts. Exercise for a longer period of time at a lower level on some days, as opposed to exercising consistently at the same length of time and intensity. When you are feeling especially terrific, work out for a shorter amount of time but at a slightly higher intensity. You will get the most out of your training if you mix things up.
It is completely feasible to continue your fitness regimen after receiving a cancer diagnosis. However, you should modify it according to your condition and treatment plan. Check with your medical team for tailored guidance on what your exercise plan should look like and the diet to help support your body needs.
You can also exercise on days you receive treatment (except surgery). This means you can work out post-chemotherapy, immunotherapy, or targeted drug therapy sessions. Think about doing less strenuous things and pay attention to your body on treatment days. While adjustments might be required, regular exercise can still have positive effects on one’s physical and mental health. Work together with your medical team to find a balance between maintaining your level of activity and modifying your regimen to suit your demands as a cancer patient.