Physical Activity and exercise is important for everyone, perhaps even more so for people with cancer. Research is showing that in addition to all the well known health benefits of exercise such as increased muscular strength, improved bone health and cardiovascular fitness, weight control and improved mental health to name a few, regular exercise for someone with cancer can actually help you make it through your cancer treatments and recover faster and better following treatments. Research is also showing a very important protected effect of physical activity and exercise as it has been shown to decrease the rate of recurrence for some cancers and in some cases, help to reduce the risk of cancer. There is even a group of researchers who are looking at the exact amount of exercise that is needed that could actually be part of your cancer treatment regime. For example, for your specific cancer and stage of disease, you may one day be told by your oncologist that you will require surgery, chemotherapy and well….a specific dose of exercise! But we are not there yet. However, what we do know is that people who exercised before receiving their diagnosis are more likely to continue to be active throughout their treatments and those who were inactive, are more likely to continue to be inactive. However, those who were not active prior to receiving their cancer diagnosis may in fact have the most to gain from increasing their physical activity!
Exercise is also one of the most studied management strategies for cancer related fatigue (CRF). Approximately 90 percent of people with cancer will experience CRF either during their treatment and/or following treatment, even years later and there are a number of reasons why you may be experiencing CRF (link to a definition). There are many aspects about cancer and cancer treatments that you cannot control; however choosing to maintain or become more physically active is something you can do and can control and the possibilities for improving your cancer outcomes, including improved quality of life are worth giving it a shot!
Unfortunately, many people stop exercising once they receive their diagnosis and many do not return to their regular physical activity and exercise levels after they are done treatment. The reasons for this are varied. Some believe it is not safe to exercise during treatments, which for the most part, it is. Other’s feel that they simply do not have time or energy as they try and manage family, work all while attending many cancer related appointments.
However, even when there seems to be more barriers to exercising than not, there is always some easy way to incorporate physical activity and exercise into everything else that you have to do (and want to do). We generally recommend that people with cancer follow the age specific Canadian Physical Activity Guidelines where are seen here:
In most cases, moderate intensity (a fast pace walk) is most appropriate and health benefits can be achieved with even low to moderate intensity. Also, higher amounts of physical activity may in fact reduce cancer risk. What is very important is that you make sure you are exercising regularly and stick to a routine, and make sure it is something you like and will keep doing. When patients ask me what is the best form of exercise, I always respond by saying “the exercise you will do!” Walking programs alone have been shown to be extremely beneficial and easy to incorporate into your daily life. For example, you can park the car 10 minutes down the road from the cancer centre and walk briskly to your appointment. Adding this to the return walk to the car and you has already accumulated 20 minutes of exercise for the day. Perhaps you decide to take the stairs instead of the elevator in the cancer centre. Now you have met your 30 minutes per day target!
Exercise and physical activity is not a one size fits all. An exercise program should include the following components: aerobic (increasing your heart rate), strength training for muscles and bones, and finally stretching to keep your muscles and joints flexible. Start small, see how your body responds and then don’t be afraid to add a little more next time, keeping in mind that there may be times during your treatment that you need to make some changes to your usual routine based on your body’s response to treatment. Exercising during treatment is safe, but there will likely be situations in which you may need to modify your choice in activity or intensity level or even perhaps the location of where you exercise. For example, people with advanced disease and/ or metastatic disease affecting the bones may need to avoid certain types of activities such as heavy weight lifting. Those who are receiving chemotherapy will experience changes in their blood counts and therefore may need to participate in lower intensity aerobic activity. If you are undergoing radiation and your usual activity is an aquafit class, you will need to switch to a land-based aerobics class. Those who have nerve injury related side effects from chemotherapy can sometimes be at an increased risk for falls and therefore may benefit from exercising in a more supervised environment (see resources below for programs in your area). It is best to obtain medical clearance from your oncologist before exercising and to inform them about your current physical activity levels at each follow up visit.
