Benefits of Exercising

In the past, people being treated for a chronic illness were often told by their doctor to rest and reduce their physical activity. This is good advice if movement causes rapid heart rate or shortness of breath but too much rest can lead to loss of body function, muscle weakness and reduced range of motion. Approximately 70% of patients experience fatigue during chemotherapy and radiation. An increasing number of studies have examined the benefits of exercising during cancer treatment. Some studies show that it can help to speed up recovery after cancer treatment. Exercise has been shown to help people cope with many of the side effects of cancer treatment, including:

• Fatigue
• Loss of appetite, body weight and composition changes
• Muscles wasting
• Nausea
• Anemia
• Poor blood flow to your legs and higher risk of blood clots
• Osteoporosis
• Poor balance, increased risk of falls and broken bones
• Heart disease
• Depression and anxiety
• Dependent on others for help with normal activities of daily living, lower self-esteem
• Loss of social contacts

Exercise can be a great way to feel better about your health. Keep yourself energized and have fun. It also helps control weight – a crucial factor, as studies have shown that gaining weight during and after treatment increases the risk of cancer recurrence, particularly for breast, colon and prostate cancers.

Exercise precautions:

Although exercise is an effective intervention for cancer patients undergoing treatment, it is important to recognize there may be factors that make it unwise to exercise. In these cases, exercise may be still beneficial; however, the risks may brighter and close medical supervision may be required. Individuals undergoing cancer treatment should:

• Obtain approval from their oncologist before starting an exercise program.
• Have vital signs monitored regularly. If participating in moderate-to-vigorous exercise, have their blood pressure and heart rate monitored before, during and after exercise to ensure that participation in exercise is appropriate and safe.
• Exercise with a partner, caregiver or exercise professional for safety reasons
• Scale back and possibly avoid exercise if the red blood cell count is low. The body’s ability to carry to the tissues is redacted
• Avoid exercise if the white blood red count is now. The body’s ability to fight infection is reduced, especially if there is a fever above 38c
• Avoid public fitness facilities and activities (e.g., swimming) where there may be an increased risk of exposure to viral and-or bacterial infection
• Avoid contact sports or activities with high risk of falling if platelet count is low. There are increased risks of bruising and bleeding. Report any unusual bruising or symptoms, such as nose bleeds, to a doctor
• Take care to reduce your risk of falling or injuring yourself it there is tingling in your hands or feet from chemotherapy.
• Avoid swimming if they have an indwelling catheter or are undergoing radiation react with skin.
• Check with a doctor before exercising if there are side effects such as vomiting and diarrhea and symptoms such as swollen ankles, unexplained weight loss/gain or shortness of breath with low levels of exertion. These may make exercise unsafe.

Aerobic exercises:

If an individual is not regularly active and wishes to start an exercise program during cancer treatment, they may need to start with low-intensity exercise for a few minutes a day:

• Walk around your neighbor after dinner
• Ride your bike
• Scrub your bathroom
• Wash and wax your car
• Play active games with kids and the games you played when you were a kid
• Walk a dog which can be controlled
• Dance
• Use an exercise bike or treadmill or do arm curls, squats, lunges and crunches while watching TV
• Use the stairs instead of the elevator or escalator
• Get off the bus several stops early
• Wear a pedometer every day and try to increases your steps

In the long run, aim for 30 minutes of low moderate intensity, on most days of the week. This can be continuums or you can combine a few shorter sessions of around 10 minutes each, allowing a change to rest and recover. These kind of aerobic exercises use large muscle groups and cause your heart rate to increase during the exercise. If improves heart and lung fitness. And makes strenuous tasks easier. Always begin with a light warm-up including 5-10 minutes of low-intensity aerobic work mixed with some light stretching. Walking outside or using the indoor equipment are good warm up activities. If you are going to do some weight, it is a good idea to use light weights in your warm-up. A couple of lighter sets prepare the muscles and joints for the exercises to come. Warming up helps to get you going and reduces your risk of injury. Individual’s care is potentially different in their responses to cancer treatment. Exercise programs may need to be modified to allow for “down” days in the treatment cycle. If they will be receiving chemotherapy, it may be wise to wait one chemotherapy cycle to see the response to treatment prior to stating an exercise program. When side effects from treatment are more pronounced, they may avoid or scale back exercise. In the case of aviation therapy, exercise may need to be reduced, or in some cases avoided, toward the end of treatment and/or in the early weeks following treatment. When you feel up to it, take a walk around the block. Do what you can and remember that rest is also important to your recovery. Don’t feel that you always have to do more than yesterday. Even doing a small amount of exercise has benefits. There will be times when you feel you are able to do some type of activity and have more energy than others. Then you could add back some physical activity to your daily routine.

Resistance training:

For example of hormonal treatments, it either reduces the amount of oestrogen in the body or blocks the effect of oestrogen on cells. This may increase the risk of developing osteoporosis. You can help your bones strong and reduce the risk of osteoporosis by doing:

• Weight-bearing exercises, such as walking, dancing and stair climbing
• Resistance training, such as press-ups against the wall or letting light weights

In general, resistance training, like weight lifting, is useful not only in strengthening bones but also maintaining muscle mass through weight loading. So try to pick physical activity that uses the muscle groups of the arms, legs and trunk to keep the musculoskeletal system in shape. Each set training should include 6-12 repetitions of the movement. Rest for 60-90 seconds between sets. It should be performed 1-3 a week, on alternative days. Perfect form is better than doing more reps or holding a stretch longer exercise. Make sure your form is excellent, even if it means doing less. If you have a catheter, be careful not to do exercises using muscles near the catheter, which may cause it to dislodge. People with stomach or other digestive system cancers or cancer that has spread to the bone should bot do heavy weight training.

Stretching exercise:

Therapies may cause pain and joint stiffness. This can often be helped by stretching exercises which lengthen muscles and tendons. Good flexibility can help case stiffness and to do just about any movement more comfortably. Try to stretch 3-4 times a week, especially after exercise. Complete 2-4 sets of 4-6 different stretches including arm, leg and trunk. Hold each stretch for 15-30 seconds. Muscles stretch more easily when they are warm, so do some easy warmup if the session is only on flexibility.

Stop exercise and contact doctor it any of the following symptoms occurs during exercise or after an exercise session:

• Disorientation, dizziness, blurred vision or fainting
• Sudden onset of nausea, vomiting
• Unusual or sudden shortness of breath
• Irregular heartbeat, palpitation, chest pain
• Leg/ calf pain, bone pain, unusual joint pain or pain not caused by injury
• Muscle cramps or sudden onset of muscular weakness fatigue

Tips to help stick to exercise program

• Set short-term and long term goods
• Focus on having fun
• Do something different to keep it fresh
• Ask for support from others or get friends, family and co-workers to exercise with you
• Use charts to record exercise progress
• Recognize and reward achievements

330 Tips provided by:  Dr. Forrest Yau  (Health/ Fitness Specialist, Centre for Nutritional Studies, School of Public Health and Primary Care, Faculty of Medicine, CUHK)

Date: 2016-07-01