Exercise is key both in terms of prevention and in terms of the treatment of cancer as it helps to improve the quality and life expectancy of patients.
The benefits of exercise as a means to manage the effects of cancer and even as a preventative measure are innumerable: exercise has been shown to help prevent cancer; reduce the seriousness of the side effects often associated with chemotherapy and radiotherapy; decrease cancer recurrence; improve vital energy required for mobility and balance and reduce fatigue; maintain muscle mass; improve self-esteem and sleep quality; decrease anxiety, depression and stress etc.
Neolife medical management
Numerous scientific studies have shown there are multiple benefits to exercise both in terms of cancer prevention and improving the prognosis for those who have already been diagnosed.
No one doubts the importance of physical activity, exercise and sport in maintaining our overall health or the prevention and even the treatment of numerous diseases. Amongst these diseases is cancer. There are more than 10,000 scientific publications that have studied the relationship between exercise and cancer and almost all of them have shown positive results in terms of the prevention of numerous types of tumors, the reduction of cancer recurrence and ensuring the best prognosis for the patient if you exercise.
It has been scientifically proven that properly prescribed physical exercise can be by patients without risk during and after chemotherapy and radiotherapy treatments. However, it is necessary to adjust the intensity, duration, weekly frequency and type of exercise in accordance with the patient’s condition. Physical exercise will improve the quality of life of the patient, as well as reduce fatigue and improve the mood of the cancer patient during treatment. Furthermore, exercise is likely to improve the disease prognosis, the predicted quality of life and the final life expectancy of the individual concerned.
In summary, physical exercise has the following benefits when we refer specifically to cancer:
- Decreases the risk of cancer.
- Reduces/alleviates known side effects caused by chemotherapy and radiotherapy, such as nausea, constipation, fatigue, decreased libido and the risk of thromboembolism.
- Decreases the likelihood of cancer recurrence.
- Increases the quality of life and life expectancy of the patient.
- Exercise improves ‘vital energy’ (life-force) and decreases fatigue.
- Improves mobility and balance in general.
- Helps to maintain muscle mass and the ability to perform day-to-day activities.
- Exercise maintains the mineral density of bones.
- Improves self-esteem.
- Decreases dependence upon third parties / encourages independence.
- Improves social relationships.
- Improves quality of sleep.
- Decreases anxiety, depression and stress.
- Exercise helps to control weight.
When can you resume or start exercising?
The key in answering this question is to remember that exercise must not involve any risk of injury, that is to say, when the surgeon allows you to resume exercise (in cases where you have undergone surgery) and/or when the oncologist considers that your general condition in relation to the chemotherapy and/or radiotherapy is sufficient to enable you to resume exercise.
In general terms this tends to be, in the case of post-surgery patients, when the postoperative period has elapsed (removal of chest tubes, healing of the surgical wound, postural habit and normal joint mobility); in the case of chemotherapy patients, this time will likely be when the digestive symptoms allows you to resume exercise; and in the case of radiotherapy when the possible wounds and tissue weakness are no longer pose an issue to your recovery.
It is also important that you start gradually and progressively increase the amount of exercise, without causing cardiovascular or muscular fatigue. Pain is a warning sign that cannot be ignored. The pain you feel warns of a potential problem and should be investigated. It is also important for you to allow for a recovery period between two sessions of physical exercise: you should not force your body; if you feel fatigue for example then you should not exercise or put your body through additional stress.
Which professional can help me start to exercise?
This answer depends on a number of factors including whether you exercised regularly before the diagnosis and were in shape, the type of cancer and the type of treatment you are currently undergoing. If the impairment caused by the cancer itself or surgery-chemo-radiotherapy is significant and your physical condition is poor, then we recommend that you consult a physiotherapist, at least at the outset. If your physical condition prior to the cancer was good and the impairment caused by the cancer or the associated treatment is not too restrictive then a doctor duly licensed in the physical activity sciences with knowledge of pathology may be the most appropriate professional to consult. If you are in good physical shape and have prior knowledge of how to prepare an exercise plan then you could manage this on your own. In any event, our recommendation is that you seek advice from an exercise and health professional.
Can I exercise during chemotherapy and radiotherapy?
In principle there is no problem with exercising during treatment but this will also depend on your physical condition prior to being diagnosed with cancer, the type of cancer and the type of treatment you are having. Exercise is beneficial for you as it mitigates the side effects caused by chemotherapy and radiotherapy and improves your quality of life, mood, energy, self-esteem and the effectiveness of the cancer treatment. However, some important aspects should be taken into account before we go further:
- In the case of chemotherapy, the mucous membranes of the mouth and digestive tract, skin, hair, nails and bone marrow are all affected by treatment. These are all tissues which constantly regenerate and do so quickly. This fact must be taken into account when exercising as you could suffer from anemia and fatigue, leukopenia and be predisposed to infections. You will also notice that your skin damages more easily including bruising. Therefore we strongly advise against exercise where there is any risk of bruises or falls, locations with poor hygiene or that pose a risk of infection because they are overcrowded, water areas etc. In addition to the above, chemotherapy can be cardiotoxic and have a serious impact on your cardiovascular capacity. Some chemotherapy drugs have been known to cause arrhythmias, so it may be advisable to avoid exercise on the day of your chemotherapy session and for a period of one or two days after.
- In the case of radiotherapy, there may be damage to the skin and other soft tissues such as muscles, tendons and ligaments near the treated area. This may predispose you to injuries and infections in the affected area during your exercise session. Like chemotherapy, there could be heart complications and the treatment may impact on your cardiovascular capacity.
- In the case of bone metastases (metastatic bone disease), the risk of a stress fracture should be taken into account and not overlooked.
What kind of exercise can a person diagnosed with cancer participate in?
Basically there are three physical qualities that we must discuss:
- Cardiovascular capacity or aerobic capacity; refers to the bodies resistance during physical exercise such as walking, running, cycling, swimming, dancing etc.
- Muscular strength; refers to the bodies ability to overcome a certain resistance like when you lift a weight, push, pull etc.
- Flexibility; refers to the range of movement or range of motion of our joints and our ability to flex the muscle as wide as possible.
Any person with cancer should aim to exercise in such a way so as to improve these three qualities. In reality – this is the same advice as any person would receive but you must remember to exercise at a lower intensity and for shorter periods:
- Types of aerobic exercise: walking, hiking, Nordic walking, jogging, cycling, swimming, dancing, group gym classes, aerobic exercise machines at the gym (treadmill, stationary bike, elliptical, rowing machine etc.), sports with an emphasis on aerobic capacity like tennis, basketball, golf etc.
- Types of muscle toning and muscle strength exercises: weight machines, dumbbells, disc bars and kettlebells, resistance elastic bands, muscle toning exercises performed using one’s own weight such as push-ups, pull-ups, squats etc.
- Types of flexibility exercises: set of stretching exercises, body-mind gymnastics such as yoga, tai-chi, or Pilates. In reality these type of gymnastics not only help maintain flexibility, they also increase muscle tone and to a lesser extent aerobic capacity.
The location of the cancer (lung, breast, prostate, colon etc.) must be taken into account when prescribing the most suitable type of exercise to undertake due to the involvement of muscles in the area near to the surgery or radiated area. For example, you should limit the number of chest exercises if you are being treated for breast cancer or reduce the number of abdominal exercises in cases involving colon cancer or limit the number of pelvic floor exercises in cases involving prostate cancer. This is something that should be personalized and your treatment should be taken into account. In addition, we recommend that you always warm-up prior to exercise and do not forget to warm-down or cool-down after your exercise session.
How to maintain consistency when exercising?
It is often said that it is easier to change your religion than your life habits and this is because our habits are acquired throughout childhood and adolescence and do not develop later in life. Maintaining consistent and regular exercise may seem like an arduous task but we have some tricks that will help you achieve your goal:
- Be clear to yourself that exercise is one of your priorities, just like feeding, sleeping or showering.
- Try to exercise even if you are tired. The session will make you feel better and rejuvenated.
- Measure your strength. Nothing bad will happen if you skip a day as long as you are clear that you will make it up.
- Find a comfortable place to exercise. The gym, sports center, park or any place can be used to exercise – but make sure it is close to home or work.
- The exercise session should be fun. Try to find an activity that entertains you; dancing, walks in the park, whether in a group or alone.
- Change activities if you do not like the exercise you have attempted.
- Try to make your exercise a social activity. Doing it with more people improves levels of adherence, perseverance and is more pleasant for everyone involved.
- It is better to exercise in the morning, when you are more rested and there are fewer excuses to postpone the session due to a lack of time.
BIBLIOGRAPHY
(2) https://www.curadosdecancer.com
(3) PALS for Life
(6) Dr. Susan Love Research Foundation: Getting Strong With Exercise After Breast Cancer
(7) https://www.cancer.gov/cancertopics/factsheet/prevention/physicalactivity
(8) https://www.mayoclinic.com/health/breast-cancer-prevention/WO00091