Exercise? Now?

The notion of exercise, when a person is in the middle of chemotherapy or radiation, or recovering from surgery, may sound pretty strange — and yet there is mounting evidence to show that exercise, even just a little, while undergoing cancer treatment can help you feel better and have a better quality of life.

The Benefits of Exercise

While there is no scientific evidence to prove that people with cancer who exercise have a better chance of beating the disease, there is ample evidence that exercise can help you feel better in a number of ways. You'll feel less tired, have more strength, and usually feel less depressed and stressed. Of course exercise will have different effects on people, but in general the results are positive.

Your body works better. Exercise improves your circulation, getting more blood moving into your legs and arms. In turn, your muscles regain or retain their strength — and your flexibility of movement improves. Moderate exercise helps reduce your risk of developing osteoporosis and heart disease. Your immune system strengthens, and most people sleep better. In general, cancer patients who exercise feel less fatigued.

Fatigue, so much a part of life for the majority of people being treated for cancer, is one of the most aggravating of side effects. The impact of ongoing exhaustion hampers the quality of life — which in turn seems to breed even more fatigue at times. Exercise, even a little or moderate exercise, appears to interrupt this downward spiral.

Your spirits revive. Exercise helps reduce stress — something every cancer survivor can appreciate. You feel more relaxed, a bit stronger and more confident, and part of the world around you. This can lead to an sunnier mood and brighter outlook on life. You may not need as much help from other people as you had before. Yes, the cancer is still part of your life — but exercise may help you feel a bit more able to cope with it.

Creating an Exercise Program

If you are a cancer survivor still being treated for your cancer, or if you have just recently ended treatment, it's important that you understand that the exercise program you develop should not be equal to the exercise you may have done before cancer.

Your body has been under siege — by the cancer and by the treatments you have taken to overcome it. Acknowledging this and planning accordingly can help you create a plan that will be manageable and rewarding.

Where to begin?

• First, let your health care team know that you plan to begin exercising and ask for their advice and assistance. Your team may want to monitor your blood and other vital signs a bit more frequently. They will reinforce to you that you should NOT exercise when you are at risk of infection, are in pain, or experiencing other side effects that are not well-controlled. Ask if the treatment you are receiving or any other factor in your physical condition might restrict your exercise plans.
  
  
• If possible, consider working with a physical therapist or an exercise physiologist who has experience working with cancer patients and can design a program just for you. Sometimes hospitals and treatment centers have staff members like these who can help, and some communities have facilities and programs just for cancer patients. The program developed should help accomplish three basic objectives:
  
  
  • Moderate aerobic exercise to maintain your stamina as much as possible;
    
    
  • Maintaining or improving your flexibility
    
    
  • Improving your muscular strength
    
    
• It is not a requirement to work with an expert to begin exercising, so if this service isn't available to you, it's simple to proceed on your own. The best concept to keep in mind is listening to your own body, to its limits and reactions. Many people begin, and enjoy, just walking a bit, every day if possible, for as long as walking feels comfortable. Walking can be gradually increased as stamina increases.

A good start. As with every other important activity in life, taking reasonable precautions makes sense. Here are few common-sense guidelines:

• Begin slowly. This is safe and smart. Increase the amount you do gradually, as is comfortable for you without strain. Start with just a few minutes if need be, and each time you exercise add a minute or two more. If you experience side effects that are troubling — such as nausea, dizziness, sudden extreme fatigue, headaches, increasing pain or blurred vision — stop exercising and contact your health care team.
  
  
• Make your exercise something you enjoy in a setting you like. This will increase the odds that you'll continue to exercise.
  
  
• Protect your body. This means clothing that is warm enough, or cool enough, and shoes that are comfortable and supportive.
  
  
• Remember there is no contest, and there is no race. This applies particularly to people who exercised regularly and vigorously before cancer and are, perhaps, concerned that they cannot now do what they once did easily. Anyone who has been treated for cancer will need time and patience to regain former strength.

Program Components
Ideally, your exercise plan will have three key components:

1. Exercise that works your heart. Aerobic exercise (exercise that uses the large muscles of the body to elevate the heart rate), even if you begin with just five minutes, will accomplish this. Aerobic exercises include walking (outside or on a treadmill), swimming, jogging/running, cycling and dancing. Gardening can be aerobic, as well. Ideally, if you can, work toward maintaining some level of aerobic exercise for 20-30 minutes, three times a week.
   
   
2. Exercise that helps strengthen muscles. Lifting weights or doing resistance exercises fits this category. Remember that the goal is to maintain muscle strength — and use just enough weight to do that. There is no need to lift heavy weights to maintain strength.
   
   
   • If you've never lifted weights, get help and advice before doing so. A physical therapist or trainer can help.
     
     
3. Exercise that helps you remain flexible. Periods of inactivity and less-than-usual movement can lead to stiffened joints and discomfort. Flexibility exercises might include knee lifts, shoulder shrugs and gentle stretching.

Warming up helps, too. Before beginning any exercise, start moving slowly, using gentle motions like lifting your arms up and down and walking around a bit. If you've worked up a sweat, you should also cool down following exercise, using similar movements as you did warming up.

Everyday Opportunities for Exercise

There are many small ways to increase the amount of activity you have in a day, even if you don't have a regular exercise program. Of course the amount of activity you add in will depend on how you're feeling. As cancer patients know very well, what is fine to do on one day may prove too difficult the next. Here are some suggestions:

• Play with young children.
  
  
• Take a stroll around the inside of a mall you like.
  
  
• Visit a museum — there is always a lot of walking involved.
  
  
• When you're watching television, do gentle exercise motions, such as leg lifts, lifting light weights, and stretching.
  
  
• Take a bike ride to a nearby store, instead of driving.
  
  
• The classic: take the stairs instead of an elevator.
  
  
• Park farther away from a building you're going to.
  
  
• Take a stroll with a good friend every few days as part of the time you spend together.
  
  
• Clean the house — or maybe just a room or two.
  
  
• Take a walk around the block.

Alternative Approaches

There are a number of forms of exercise, beyond the usual walking, swimming, jogging, cycling approaches, that can prove enjoyable for people with cancer. A few of these include:

• Yoga
  Yoga is not aerobic, but it involves using movement, breathing and meditation to help a person find a unity of mind, body and spirit.
  There are a number of different forms of yoga, and to learn, it is best to attend classes. Some communities have special yoga programs just for cancer patients or people with chronic illness. Ask your hospital's physical therapist for a recommendation. Yoga can improve overall physical fitness.
  
  
• Tai Chi
  This ancient Chinese martial art is a mind-body system that, like yoga to some degree, integrates movement, timed breathing and meditation. It helps reduce stress and provides a greater sense of wellness. While Tai Chi does not require much physical strength, a sense of balance is important in learning. Classes with a Tai Chi instructor are the best way to learn.
  
  
• Dance Therapy
  This approach to movement also seeks to connect mind and body to improve health, strength and spirit. Dance therapy is taught by specialists who observe you and design a program tailored to your needs. Sometimes dance therapists, who are highly trained specialists, work with individuals, but often there are groups available as well.

Questions to Ask Your Health Care Provider

1. I want to begin to exercise a bit. Is there any reason why I should not?
   
   
2. Will you need to do any special monitoring of my condition because I am exercising?
   
   
3. What exercises do you recommend for me?
   
   
4. Is there any form of exercise that I should avoid?
   
   
5. Are there any warning signs that I should inform you of once I begin exercising?
   
   
6. Can you refer me to a physical specialist or other exercise expert to help me get started?

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