The Healing Power of Movement


How to Benefit from Physical Activity During Your Cancer Treatment

When people think of personal trainers, they envision a world of hard bodies and calorie counting, of spandex outfits and mirrors in the gym. While there is a place for that in our society, the kind of personal training I've been involved with for the last ten years is another world entirely. For many years, I've been an exercise physiologist for a very special group of clients whose motivation is not vanity, but survival. The clients who make up my business may not be able to do even one push-up, and their victories are measured in inches instead of miles. They are all ages and from all professions, but they have one thing in common-cancer stole a part of their life, and they want it back.

Today the medical profession is calling cancer a chronic disease. The National Cancer Institute estimates about 8.2 million Americans are living with cancer in various stages of treatment, remission and cure. Just as they're changing their perception of the disease itself, health professionals are starting to change their ideas about how much activity a cancer patient can handle while in treatment or soon after.

HOW MUCH SHOULD I EXERCISE?
There is not one ultimate exercise prescription for cancer patients at various stages of the disease. Right now there aren't even explicit standards for the type, frequency, duration, intensity or progression of exercise for people in cancer treatment. However, we can make confident recommendations drawn from the growing body of research studies of the last ten years. Above all, studies conclude that exercise is safe, feasible, and beneficial to anyone's quality of life at almost any stage of cancer therapy. Of course there are considerations if you have a severe physical impairment, a condition such as anemia, or a particular part of your body that is limited because of surgery, but they are just that-considerations-not reasons to avoid activity.

Although the focus of The Healing Power of Movement is to perform physical activity, there may be mitigating factors that make exercise unwise or dangerous for a few. Some patients may benefit from a supervised exercise program, and close medical supervision may even be required for others.

There may be times during your treatments that you don't feel like exercising. These down days are different for each person and may vary from cycle to cycle. The key is to listen to your body and modify the frequency, intensity or duration of any of your exercise. As you go through treatment, you will get used to hearing a lot of numbers associated with your condition. You will have your blood counts and heart function checked regularly in addition to receiving nutritional guidance. As for the numbers below, they should only be used as a guideline and should not be substituted for a physician's supervision.

The American College of Sports Medicine (ACSM) has set guidelines for the general population, and people in cancer treatment may closely follow the same suggestions. The guidelines call for exercising three to five days a week, twenty to thirty minutes per session.

WHAT KIND OF EXERCISE?
Mountain climbing, running, playing tennis? The most important point is that the exercise feels right to you. You have to use your instinct as to which activities you want to perform. While you're in cancer therapy you probably won't take up a sport you've never attempted before, and any activity you attempt has to be modified for the treatment effects of surgery, chemotherapy, or radiation.

Let me start by saying that walking and cycling are the two activities recommended most often because they are safe and tolerable for the majority of people. Doctors who have studied cancer treatment and exercise have concentrated on exercises for the large muscle groups, and concentrated on exercises that are easily measured. Walking is a natural choice because it relates to all of the activities of daily living that anyone recovering from a disease looks forward to doing.

Most of the medical studies concerning cycling were done in a hospital setting, and cycling proves to be a good choice for most recovering patients. Some studies were even done while the patients were bed-ridden and only able to move their legs. Swimming has proven to be another safe aerobic activity that promotes cardiovascular and overall fitness. However, if your cancer therapy includes catheters or nephrostomy tubes, swimming may not be appropriate for you. Good sense would tell you that if you are recovering from primary or metastatic bone cancer, high-impact or contact sports are out of the question.

CAN I EXERCISE TOO MUCH?
There is some evidence that repeated, high intensity exercise could lower your immune system and therefore be unsafe if you are recovering from surgery or chemotherapy. You will want to keep your heart rate under 75% of maximum (Subtract your age from 220 to get your maximum heart rate). On the other hand, unless you have been a professional athlete, it is unlikely that you will want to push yourself to this extreme during cancer treatment. Once you've rebounded from treatment, however, and returned to your normal workload and lifestyle, there is no evidence that high intensity exercise isn't appropriate.

CAN I VARY THE EXERCISE?
Many researchers in this field recommend intermittent or interval training. This means short bouts of exercise coupled with rest. If you are in the first stages of recovery from chemotherapy or bone marrow transplants, this intermittent exercise throughout the day is a good way to accumulate your thirty minutes.

As for weight training, studies on the efficacy of this type of exercise are only beginning to come to light. It is likely that the optimal exercise regime for most cancer patients will combine aerobic activity and weight training. The exercises I've recommended in this book offer that combination.

The key to The Healing Power of Movement is not just to focus on walking or cycling, but to add specific muscle conditioning to help you maintain the optimal level of function at any given time during your treatment. From my years of experience working with all different kinds of patients and survivors, I've seen that walking alone simply doesn't cut it. Just as for healthy adults who aren't fighting cancer, you will need to combine aerobic activity with muscle conditioning and strengthening, and add stretching as well.

The clinical studies suggest that the sooner you begin to exercise, no matter how feeble the attempt, the sooner you will regain your normal level of functioning. If you allow yourself only rest, you will contribute to further decline of your agility, your energy level and ultimately to your quality of life. Your question really isn't "Can I exercise too much?", but "How can I exercise enough?"

Written by: Lisa Hoffman, M.A.
Excerpts from her book: The Healing Power of Movement: How to Benefit from Physical Activity During your Cancer Treatment