Exercise and Chemo

Exercise and Chemotherapy

Although statistics show that one of the biggest risks for cancer is obesity there are loads of us out here who are keen exercisers and not unhealthy (ironically).

Its not unusual to lose your way a bit with exercise when you get told you have cancer – I know I did, transforming from a keen runner to someone who really couldn’t be bothered overnight!

During this time it is quite normal to question many aspects of your life as you knew it including exercise. It is important to remember there are still benefits to exercise but it may be that you don’t feel up to doing your usual class etc

Different types of exercise may be better at different points in treatment and recovery.

The Benefits of Exercise

It used to be thought that cancer patients (and those with other long term diseases) should not use unnecessary physical energy on things like exercise. Things have moved on a lot and it is now recognised that exercise is a good thing for current cancer patients and for those in recovery.

There was a large study carried out last year (2017) looking at the effects of exercise on physical function and quality of life in cancer patients. This was a ‘meta-analysis’ which means the researchers looked at the results of many different trials on the subject (in this case 34) and correlated the findings. (Effects and moderators of exercise on quality of life and physical function in patients with cancer:An individual patient data meta-analysis of 34 RCTs, Buffart LM, Kalter J et al; Cancer Treatment Reviews, Vol 52, 91-104, Jan 2017)

There were several interesting findings:

  • There were significant benefits of exercise on quality of life and physical function.
  • The effects of exercise on quality of life and physical function were the same no matter what the patient’s age, BMI, education level or marital status.
  • Exercise benefits were significantly larger for supervised than unsupervised interventions (eg classes).
  • The actual type of exercise did not make a difference on these findings.
  • The benefits were the same no matter what the stage of cancer.

So What Are These Benefits?

The benefits of exercise for people with cancer include:

  • Improved physical function
  • Improved quality of life
  • Reduced fatigue
  • Reduced depression

These are the same whether you currently have cancer or are recovering from the treatment of cancer.  Exercise will help your mood and improve your positivity about the outcome.

Exercise can also:

  • Help with weight control (which can be a problem if you have had steroids or been plunged into the menopause)
  • Decrease sickness
  • Help with stress and anxiety (these can be quite common all through cancer and its treatment)
  • Improve balance (many chemotherapy drugs can affect the nerves in your feet and make balancing more difficult)
  • Decrease your chances of osteoporosis (unfortunately this can be an effect of some of the medication used in treating cancer.  Weight bearing exercise is good at helping with bone density)

What Type of Exercise Should I do?

You may find that you cannot go back immediately to the type or intensity of exercise you did before diagnosis or treatment. You may be someone who didn’t exercise before this all happened. Either way now is a good time to look at fitting exercise in to your life. You’ve seen the benefits so get cracking!

It doesn’t really matter which type of exercise you are doing, being active is the key. An exception to this is exercise to improve bone density needs to be weight bearing – in other words running, jogging or walking.

You may also be limited if you still have a line in (for example a PICC line) as swimming is not advisable unless the line can be adequately covered.

Now may be a good time to explore exercise you have never tried before.  As mentioned above supervised exercise is more beneficial in terms of improving quality of life so consider joining a class – it doesn’t have to be expensive.  There are so many different classes available, some are even based outside in local parks for example and these can be really quite inexpensive. Classes are a good way to meet others and make friends too.

How Much Exercise Should I do?

There has been a lot of discussion about this but current guidelines for adults aged 19-64 (www.nhs.uk) suggest at least 150 minutes of moderate aerobic activity (eg cycling or brisk walking) every week and strength exercises (working all the major muscle groups – legs, hips, back, abdomen, chest, shoulders and arms) on 2 or more days a week.

Or – 75 minutes of vigorous aerobic activity (eg running) every week plus the strength exercises.

Or – A mix of moderate and vigorous aerobic activity adding up to about 150 minute every week plus the strength exercises.  One way to achieve this would be by doing 30 minutes a day for 5 days a week.

Having said this it is important to be sensible and listen to your body – this is not a good time to get injured.  If in doubt check with your doctor. It is really important that you find the right activity for you at the right level. You may find you become tired more easily or feel more short of breath, this is not unusual.  Take a break and then try again.

Exercise After Surgery

There is specific advice available from a variety of different sources tailored towards specific cancer operations. One that is close to my experience is the information published by www.breastcancercare.org.uk which looks at arm exercises to reduce swelling following lymph node removal.

Your surgeon should be able to advise about the length of time you should wait after any operation before you start exercising again.  It is important that your body is given time to heal, you may have drains or stitches which may hamper your efforts or you may be anaemic. Sometimes a physio will come and see you in hospital prior to discharge and be able to tell you how much and when you can get on with exercising. This can be variable depending on your case and your preoperative fitness level.

Odd Bits and Pieces

There are some specific situations when you need to be aware about exercise for example if you are on Herceptin which can potentially affect heart function. Just be sensible and if in doubt ask your oncologist.

Where to next?

related post: Alcohol and Chemo





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