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Exercise During Treatment May Give You a Boost

Doctors point to various studies showing exercise during cancer treatment may provide physical and psychological benefits for survivors.

Deciding which activities are safe to engage in during and after cancer treatment starts by having an open discussion with your doctor. Don’t be surprised if they recommend exercise as a part of the treatment process.

In a report released in the April/May 2012 publication of CA: A Cancer Journal for Clinicians, a group of experts in nutrition, physical activity and cancer survivorship at the American Cancer Society (ACS) evaluated the scientific evidence of exercise. The group concluded “exercise is not only safe and achievable during cancer treatment but can also improve quality of life in many ways”.

Possible Psychological Benefits of Exercise for Cancer Survivors

Gary T. Kimmel, MD, founder of Cancer Foundation for Life in Tyler, Texas, says there is compelling data on the benefits of exercise during cancer treatment. He notes some of the most important benefits may be psychological. 

Mood Boosting

“A major factor during and following chemo, demonstrated repeatedly, is the influence the cancer experience has on your mood and perspective,” Kimmel says. Exercise can be “just as effective as drug therapy in elevating mood and managing that aspect of the experience.”

Getting Back a Sense of Control

“When someone gets a diagnosis of cancer and begins that journey, it’s all about what others are going to do to you,” Kimmel explains. “You depend on others to treat you and get you well.” But when people hear they can participate in their care through exercise, they begin to perceive themselves as survivors.

“Being active gives you a sense of self-control,” says Colleen Doyle, a registered dietitian and director of Nutrition and Physical Activity for the American Cancer Society. “It is great to have control over something during a trying, difficult time when there is such a sense of loss of control over so many things.”

Anxiety and Depression

Anna L. Schwartz, PhD, a researcher at Idaho State University and a family nurse practitioner who specializes in oncology and pain management, says exercise also helps with body image, self-esteem and anxiety, as well as depression during treatment. “Exercise boosts endorphins. It’s recommended for healthy people who have mild to moderate depression and is known to decrease mild depression. It has the same effect in cancer patients.”

Potential Physical Benefits of Exercise

An American College of Sports Medicine roundtable on exercise guidelines for cancer survivors also concluded, “exercise during cancer treatment is safe and can improve physical functioning, quality of life and cancer-related fatigue."

Dr. Kimmel notes this is one of the most significant benefits because fatigue affects 70 to 80 percent of patients receiving cancer treatment. Exercise also helps control weight gain, which he says sometimes happens during treatment and may increase the chance of recurrence of certain cancers.

Other side effects of treatment that may be favorably influenced by exercise include:

  • Nausea
  • Deconditioning of heart and lungs
  • Loss of muscle mass
  • Bone strength 

“When you start exercising, you eat better and you feel better,” Kimmel says. “You may be able to tolerate chemo better. Your bones fare better. Your immune system is stimulated. Exercise treats everything, including the acute and chronic adverse effects of other comorbid diseases. To me, it is a panacea.”

Dr. Schwartz agrees, adding exercise maintains or improves aerobic function, even during treatment. “Those who exercise can get stronger muscle-wise, which has benefits,” says Schwartz.

Exercise May Reduce Cancer Risks

According to Dr. Schwartz, a growing number of studies show exercise may help reduce the overall risk for breast, colon and some other types of cancer. It may also reduce recurrence as well. “Exercise is one of the most important things healthy people can do to prevent cancer,” she says, “and to tolerate treatment better and increase chances for long-term survival.”

Overcoming the Hurdles of Exercising During Cancer Treatments

While there are plenty of reasons to exercise, some people may need guidance and motivation, Schwartz says. One challenge is learning how to deal with treatment-related physical limitations. Ironically, another is healthcare providers who may be hesitant to prescribe exercise, since it wasn’t encouraged in the past.

Expense can be a major hurdle for those who aren’t ready or able to exercise independently, says Kimmel. This is why Cancer Foundation for Life doesn’t charge and doesn’t set a time limit for their programs.

People who didn’t exercise before they had cancer may also need a structured, individualized program to get motivated, Kimmel says. Having cancer and being told the benefits of exercise often will be motivation enough to start, and once patients start an exercise program and see the benefits, they are empowered to continue.

For Dr. Kimmel the biggest challenge is getting people on board and reassuring them they can handle the physical activity. He says, “The first few visits, we just want them to leave saying, ‘I can do this.’ They leave knowing any exercise is beneficial, and it’s based on whatever they want to do.”

Exercise Considerations for Cancer Survivors

Any kind of activity helps, explains Doyle, referring to a study that showed a significant benefit from simply walking three to five hours a week at an average pace. But it’s important to keep a few general precautions in mind before exercising during cancer treatment.

  • Fitness level prior to diagnosis. Doyle suggests you should consider how active you were before treatment and adjust accordingly. Someone who was already active may have to slow down a bit during treatment and perhaps not exercise as intensely as they had before. People who were sedentary before should start slowly, adding more intensity and frequency as they are able.
  • Current fitness level. Doyle also recommends cancer survivors assess how they feel currently, and avoid pushing themselves too hard.
  • Side effects of treatment. Side effects of treatment can determine the most appropriate type of exercise. For example, someone with neuropathy may have numb toes, which would make riding a stationary bike a better choice than walking on a treadmill.
  • Immune functionality. If you’re undergoing frequent chemotherapy treatments, you may have lower immune function and should avoid working out in public places, such as gyms.
  • Presence of open wounds and catheters. People who are having skin reactions from radiation treatments and those with open wounds or catheters, should avoid swimming in chlorinated pools. An upper-body catheter may also necessitate temporarily avoiding upper-body strength training.
  • Pain and discomfort. Pain or discomfort should be used as a general guide for what type of activities to avoid. 

It’s important for you to communicate with your healthcare providers about your activities. “Let them know what you’re doing,” Doyle says. “Exercise should be a very individualized approach, based on age, previous level of activity, type and stage of cancer and type of treatment you’re receiving. With smany things going into the picture, it’s a good idea to talk to your healthcare team about your plans and what you’re currently doing.”

Exercise can increase your chances at getting through treatment successfully, avoiding recurrence and reducing the chance of developing another cancer. The experts all agree—exercise can make a huge difference in your health and wellbeing if you’re a cancer survivor.