Authored By: Janette Powell (Physical Therapist, Orthopedic Certified Specialist, Sports Certified Specialist, MHSc) and Brian D. Lawenda, MD (Radiation Oncologist, Integrative Oncologist, Medical Acupuncturist)
There are many reasons why you might not be able to exercise like you used to:
- Mobility Issues: Decreased range of motion, strength, balance
- Cancer or treatment-related side effects: neuropathy, lymphedema, pain, fatigue
- Other health problems: cardiovascular health, respiratory health, joint health (arthritis).
Nevertheless, exercise is still very important to your health and cancer treatment outcomes. Learn more about the importance of exercise on cancer outcomes in “Exercise and Cancer 101”
The U.S. Centers for Disease Control and Prevention and the American College of Sports Medicine both recommend that you “should be as active as your abilities and conditions allow” and, overall, “avoid inactivity.”
If your range of motion is limited, your strength is decreased, your fitness is less than ideal, or your balance is not optimal participating in an exercise program can substantially improve all of these. If you have challenges with your joints (such as arthritis or pain), your heart, your lungs or other issues that limit your ability to participate in normal activities of daily living, an exercise program can substantially improve these. Start wherever you can.
Every Little Bit Adds Up:
Move as much as possible during the day, even if it is simply from room to room, or in and out of the house, or in the community (park the vehicle further way from your destination, push the wheelchair for some of the distance rather than just ride in it), stand rather than sit, use the stairs rather that the elevators or escalators, wash your car, mow your lawn, prepare your meals.
Every little bit of activity adds up and leads to improvements in your function and in your health. Choose activity (rather than a short cut) repeatedly through the day and consistently day after day. You might be surprised at what you can achieve within one week, one month or one year.
Exercise During Treatment:
If you already participate in a fitness program and you are currently undergoing cancer treatment try to keep up your usual physical activity. You may need to reduce the duration or intensity, or both depending on how you are feeling. You may have reduced tolerance for exercise on specific days (e.g. the day of treatment or the days immediately following a treatment session). Don’t be hard on yourself if you are feeling tired. It’s perfectly okay to temporarily modify your routine on these days. Quite often, as cancer treatments progress, your exercise tolerance can decrease as a result of the cumulative effects of treatment.
Exercise After Treatment:
Following cancer treatment you may want to get back to your previous fitness activities quickly. Just recognize that regaining fitness takes time. Restart your physical activity program slowly (starting with 10-15 minutes per session) and aim for consistency (three to five days per week).
Physical activity levels, along with cardiorespiratory fitness and functional capacity levels (quality of life), tend to decrease during cancer treatment. During treatment, the overall goal of exercise should be to maintain cardiorespiratory fitness or functional capacity. After treatment is over, you can focus on improving your fitness.
Allow adequate time to heal after surgery, chemotherapy or radiation therapy. It’s important to talk about your activity goals with your cancer care team. They will be able to advise you on how much time your body needs to heal and at what pace to restart (or start) your exercise routine.
If you do not feel confident beginning certain activities, or you want specific direction on exercising, ask your doctor for a referral and/or recommendation to a healthcare professional who can help (such as a physical therapist, fitness trainers with cancer experience, physical medicine & rehabilitation physicians). These specialists are able to guide you on how to modify your exercise routine based on your abilities and limitations.
Seek medical attention if you have any of the following signs:
- Unusual tiredness or unusual weakness
- Fever or infection
- Difficulty maintaining weight
- Sever diarrhea or vomiting, sudden onset of nausea during exercise
- Leg pain or cramps, unusual joint pain or bruising
- Irregular heartbeat, palpitations or chest pain
- Flare of lymphedema symptoms
- Change in the appearance or feel of your cancer site
- Lump in the breast or groin, change in your skin color or texture
- Significant changes in your coordination, vision or hearing
Remember chemotherapy can suppress your immune system and increase your risk of infection, so remember to wash your hands and face after exercise. This is an easy way to reduce the risk for infection. If you have any fevers or chills or you begin to feel sick in the days following chemotherapy talk with your medical team.
Cancer Prehabilitation (“Prehab”)
After your cancer diagnosis, but before cancer treatment, we recommend that you look into cancer prehabilitation. Cancer “prehab” is about getting you in the best possible shape for cancer treatment. These programs aim to prevent or lessen the severity of anticipated treatment-related problems that could lead to later disability. They aim to identify any current impairments you might have, and provide targeted treatments and strategies to reduce the risk and severity of future impairments.
Not only does cancer prehab focus on aerobic & strength conditioning, but research shows that it can improve outcomes in those with specific cancers:
- Swallowing exercises before surgery for head or neck cancer
- Smoking cessation to improve breathing function before lung cancer surgery
- Pelvic floor exercises to reduce problems with urinary incontinence after surgery for prostate cancer.
Consider Cancer Rehabilitation (After Treatment)
After cancer treatment you may want to consider and talk with your medical professionals about cancer rehabilitation. This is an area of increasing interest in cancer care. In a recent Wall Street Journal interview, cancer rehab was highlighted for being able to help cancer patients avoid long-term physical disability and complications after treatment ends. Read more here.
Historically, after undergoing cancer treatment, most patients receive little to no help returning to their normal life. Increasingly, hospitals & outpatient clinics are starting to offer programs to provide cancer patients and survivors with comprehensive rehabilitation services amid mounting evidence that they help speed recovery, shorten hospital stays and improve quality of life.
More Video News Segments on Cancer Rehabilitation:
Additional Helpful Resources:
- Cancer And Exercise (National Center on Health, Physical Activity, and Disability)
- Exercise And Cancer (Oncology Nursing Society)
- Exercise For Cancer Patients: Fitness After Treatment (WebMD)
- Exercising During Cancer Treatment (National Comprehensive Cancer Network)
- Exercises After Breast Surgery (American Cancer Society)
- Eat Healthy And Get Active (American Cancer Society)
- Physical Activity And Cancer (U.S. National Cancer Institute)
- Fitness For Cancer Survivors (IDEA Health And Fitness Association)
- Exercise For Breast Cancer Survivors (American Council On Exercise)
Find Cancer Exercise Trainers In Your Area:
- Cancer Exercise Training Institute
- American College of Sports Medicine (search for “certified exercise trainer”)
Cancer Rehabilitation Programs:
- Oncology Rehab Partners (STAR Program)
- The Rocky Mountain Cancer Rehabilitation Institute (University of Colorado)
**If you want your cancer rehab program listed here, contact us.
Exercise DVDs And Books:
- Essential Exercises for Breast Cancer Survivors II (Cancer Exercise Institute)
- The Breast Cancer Survivor’s Fitness Plan: A Doctor Approved Workout Plan For A Strong Body And Lifesaving Results (Harvard Medical School)
- Cancer Fitness: Exercise Programs For Patients And Survivors (Anna L. Schwartz)
- Exercise For Cancer Patients DVD (Recovery Fitness)
- Strength And Courage: Exercises For Breast Cancer Survivors DVD
We hope this 4-part series on “How To Begin An Exercise Routine (For Cancer Patients And Survivors)” has been a useful resource for teaching you about the importance of staying as fit as possible during and after cancer treatment. You have been introduced to a wide variety of exercise approaches, tips and safety information that should serve our readers well as they get started in their exercise routines. Remember, exercise is supposed to be fun. As long as your enjoying it, you’re more likely to stick with it. Exercise is an essential component of the ‘anticancer lifestyle’, so get started today!