We all know exercise is good for our health, however it is rarely used as medicine. Exercise has extensive benefits for cancer survivors, even if they have never been active before. This research is advancing leaps and bounds to encompass survivors of all different types of cancer, from all around the world. This is my area of study, so please excuse my enthusiasm on the subject.
Based on reviews of all the studies done on cancer survivors during treatment, it has been concluded that exercise is not only safe and feasible during cancer treatments, but it has the potential to improve physical functioning, decrease fatigue, and positively influence many aspects of quality of life.
The recommendations for people undergoing cancer treatment are to maintain exercise as much as possible. If you have been inactive before treatment, it is recommended to engage in low intensity exercise (i.e., slow walks, stretching, yoga) and build up slowly.
One very exciting result was an increased chemotherapy completion rate in breast cancer survivors. In this study, breast cancer survivors would come into a fitness centre for an aerobic workout three times a week during the length of their chemotherapy (usually for about three months). At the beginning of the study, breast cancer survivors were divided into three groups: a resistance-training group, an aerobic group, and a usual care group. The usual care group did not receive any exercise training.
When patients are diagnosed with cancer, a treatment plan is made up. For example: Six rounds of X drug, every three weeks. This plan can be interrupted by many circumstances, such as drug side effects or low white blood cell count. The study showed a significant positive effect of exercise on the women’s ability to complete their treatment plans: 78 percent of those in the resistance-training group and 74.4 percent in the aerobic exercise group completed at least 85 percent of their recommended chemotherapy. In the control group receiving usual care, 65.9 percent completed at least 85 percent of their recommended chemotherapy prescription. Essentially, women in the exercise groups were given more of their drugs on time.
A very common side effect for cancer survivors after treatment is fatigue. This fatigue is so much more than “being tired.” There is not a particular event that causes fatigue, and it will not be resolved with sleep. Fatigue is full body lethargy and excessive tiredness that affects your daily living activities and diminishes quality of life.
For people suffering from cancer-related fatigue, exercise is one of the treatments that has demonstrated the most promise. I realize that it may seem counterintuitive, and that the natural response to fatigue is to rest. McNeely and Courneya released a review of literature and physical activity guidelines for cancer survivors experiencing fatigue. After treatment, it is recommended to return to activity as soon as possible. Just as for anyone starting to exercise again after a period of inactivity it is important to start slowly and progressively build up to guidelines. Cancer and cancer treatment side effects may remain for months, years, or indefinitely after treatment. Exercise may fit into your life differently than before cancer treatment. For example, if you have peripheral neuropathy, falling may be a new concern, so it may be easier and safer to ride a stationary bike instead of walking on a treadmill.
Studies in cancer survivors post treatment have demonstrated many positive outcomes, including better quality of life, cardiovascular fitness, self-esteem, and lower anxiety and stress. There have also been studies demonstrating lower risk of cancer recurrence and improved overall mortality among breast, colorectal, prostate, and ovarian cancer survivors.
How Much Physical Activity Should Survivors Be Doing?
The American College of Sports Medicine has determined that exercise is safe and beneficial for cancer patients and survivors. The exercise recommendations they put forward for cancer survivors indicate that survivors should be working their way up to 150 minutes of moderate exercise a week. The American Cancer Society provides the same guidelines. Some studies have shown a dose-response relationship: the more exercise you do, the more benefits you will receive. Remember though, it is important to build up slowly and listen to your body and engage in activities you enjoy.
Moderate exercise is when your heart rate is elevated, you are sweating lightly, and are breathing heavier than normal. If you can keep up a conversation but cannot sing (physically unable to catch your breath, not because you’re tone deaf) while you are working out, you are working at moderate intensity. If you cannot keep up a conversation, you are working at a vigorous intensity.
The key is to form a habit of exercise you enjoy. Exercise in itself is not an enjoyable activity. People don’t go to the basement turn off all the lights and run. The trick is to pick an activity, or elements to an activity you truly enjoy. For example if you enjoy exercising with others you could join an aerobic class, walking group or curling. If you prefer to be alone to enjoy your walks or runs in beautiful scenery, listen to your favorite music or an audiotape.
IMPORTANT: If you have not been exercising regularly or are still going through treatment, please consult with your physician before engaging in exercise. People who are going through radiation should avoid chlorine exposure because it may irritate the skin. Survivors with severe anemia should delay activity until anemia improves. Survivors with compromised immune systems should avoid public gyms until their white blood cell counts return to normal.
A passion for preventative medicine has been a theme running through Lisa Bélanger’s career. Naturally curious about why some people engage in health behaviors she completed her undergraduate degree in Human Kinetics at St. Francis Xavier University. After the passing of her best friend from cancer, her interests shifted to the powerful effect health behaviors could have on cancer survivors. She is currently completing her PhD at the University of Alberta, her research focuses on the impact that physical activity can have on cancer survivors. Inspired by the survivors she was working with through her graduate school she created the national charity Life into Days as well as her business, Exceed Wellness. Her latest venture is Knight’s Cabin, a retreat for cancer survivors to be built in the Rocky Mountains. Recognizing a deficiency in the way that the Canadian medical system addresses cancer survivorship, Lisa hopes to create a environment that focuses on healing, practical implications of health behaviors and strategies to make the best of the rest of their live.
Lisa was one of Edmontonian’s Top 20 under 30 and has received the YMCA Woman of Influence—Local Hero Award. She has co-authored Inspire Me Well: Finding Motivation to Take Control of Your Health.