Nutrition

The Importance of Exercise

Exercise is an important aspect of improving and maintaining overall health. It can be started at any time with little or no previous experience, and it can offer benefits to people before, during and after cancer treatment. According to the American Cancer Society’s Nutrition and Physical Activity Guidelines for Cancer Survivors, survivors should aim to engage in regular physical activity and exercise for at least 150 minutes a week, including strength training twice a week.

Being as fit as you can be will better prepare you to manage your treatment. It may be helpful to think of exercise as a key way you can actively participate in your treatment plan.

The benefits of exercise and physical activity are wide ranging. It can help lower your risk of developing cancer, heart disease and diabetes, help you stay healthier and tolerate treatment better, maintain mobility and flexibility, improve overall well-being and self-esteem, reduce the risk that cancers may develop in the future, boost your immune system, lower anxiety and depression, build strength, release tension and help reduce body weight before, during or after treatment ends.

Research has shown significant evidence that exercise may be linked to lower risks of colon cancer, breast cancer and endometrial cancer specifically, but exercise is thought to have a positive influence on the body overall. Scientists have found that exercise may reduce your risk for cancer by lowering hormones that may encourage cancer development, preventing or decreasing obesity, reducing inflammation and improving the immune system, metabolism and digestion.

Next to smoking, obesity is considered a large risk for developing cancer because having extra body fat increases the amount of inflammation in the body and insulin resistance, which may contribute to increased cell production and the development of cancer cells. When an obese person’s body is inflamed due to extra weight and fat, damage may occur to DNA, which may lead to cancer.

How to Get Started

Before beginning any exercise program, it is recommended that you consult your doctor, who may suggest specific exercises, the amount of activity you should do and at what level depending on your unique circumstances. Your doctor’s recommendations may depend on your fitness level before diagnosis, any physical limitations and your stage of treatment. Once your doctor clears you for physical activity, start off slowly and build up your endurance, even if you’ve been a life-long exerciser. It is recommended that adults get at least 150 minutes (two and a half hours) of moderate activity or 75 minutes (one hour and 15 minutes) of vigorous activity each week.

Physical activity levels can be light, moderate or vigorous.

Light physical activities:

• Cooking
• Making the bed
• Slow walking
• Washing dishes

Moderate levels of physical activities:

• Bicycling
• Dancing
• Gardening
• Golf
• Walking
• Water aerobics

Vigorous levels of physical activities:

• Aerobics
• Basketball
• Heavy yard work
• Running
• Swimming
• Tennis

Other ways to add exercise include using the stairs, riding a bike to work, walking at breaks or on lunch hours, or getting up to stretch during the day for 20 minutes.

Components of an Exercise Program

A good exercise program is made up of several components.

Breathing changes while exercising. Most of the time, we breathe very shallowly. Paying attention to your breath allows you to adjust the intensity level of your exercise. Deep breathing, also known as relaxation breathing, reduces stress and helps calm your body and mind, which may assist in dealing with the stress of a cancer diagnosis.

Aerobic exercise is what most people think of when they start an exercise program. Any physical activity that increases the heart rate and the body’s use of oxygen can help improve a person’s physical fitness. The goal is to gradually increase the length of time that you spend exercising aerobically each day, several times a week. Even short bursts of activity, such as five to 10 minutes a few times a week, are better than no activity.

Stretching can be done any time, but it’s typically done before and after exercising. Stretching allows you to slowly and safely increase your range of motion and flexibility, improve your posture, restore joint mobility and break down scar tissue. Before you begin exercising, it is recommended you do at least five to 10 minutes of stretching, particularly the muscle groups you plan to work. For example, stretch calves and hamstrings before walking. Stretches should be done slowly and only to the point that you feel tension in the muscle. You don’t want the stretch to be painful. You may have to work up to doing some stretches.

Strength training may be used to build strength, if your doctor approves. It can be done with or without weights to accommodate your capabilities. The goal is to improve your balance and posture, make everyday activities easier to perform, strengthen your core muscles and improve your overall quality of life. Increasing your muscles doesn’t mean you’ll become a weight lifter, but it can increase your metabolism, help you adjust your weight and build stronger bones. You may want to only do strength training every other day to give your muscles a day to recover. Pay attention to the quality of the motion and move slowly through each repetition.

Balance exercises may be particularly helpful after surgery or other treatments to improve side effects, such as fatigue, neuropathy, lymphedema, balance issues and weakness. They also allow you to return to normal functioning and mobility and prevent falls and other injuries. Examples include yoga, Tai Chi or Pilates.

Drinking plenty of water is a key part of your exercise program. Because dehydration is always a concern during cancer treatment, make sure you are drinking the recommended amount of water (10 cups of water per day for men and eight cups for women) along with enough to replace the fluid you lose through sweating.

What to Expect With Exercising

If you are new to exercising, be prepared for the following.

• Expect to sweat, especially when doing moderate to vigorous activities. Sweating is the body’s way of regulating its temperature. Be sure to have water or another drink readily available to replenish any liquid you lose during exercising.
• Wear comfortable clothes that do not restrict your movements. Some people prefer loose-fitting clothes, while others prefer tight materials that cling and wick moisture away as you sweat. Wear shoes that are slip-resistant and that fit your feet to lessen foot pain, cushion your joints and keep you stable while exercising.
• Consider the weather, including snow and ice as well as summer heat. Wear sunscreen while exercising outdoors.
• Expect soreness. You may feel a little sore because you may be using muscles that haven’t been used before or you’re working muscles in a new way. Be mindful that your discomfort does not become painful.
• Exercising takes energy, and it may make you hungry. It’s a good idea to bring high-protein snacks for an after-workout snack.
• Monitor your heart rate. As you exercise, your heart rate is likely to increase and your breathing may be more challenging. If you feel you cannot catch your breath or feel like you are gasping, slow down and take deep breaths in through your nose and out through your mouth to slow your heart rate down.
• Mix up your routine. Some people get bored if they do the same thing over and over. Consider doing something different each day, as long as your doctor approves. It may be helpful to make a weekly plan of when to exercise, for how long and what to do. Having a plan helps you set a routine, which makes it easier to create a healthy habit.
• Get a buddy. You may find it easier to stick with an exercise plan if you find a friend to join you. You can keep each other motivated. Many websites are available to find groups for like-minded people to get together, exercise and support each other. Check Facebook and Meetup.com for groups near you.
• Add your own soundtrack. To make exercising more fun, it may be helpful to play upbeat music, create your own playlist or listen to music that puts you in a good mood. Music can impact your mood and can be a powerful tool to employ in keeping you motivated.

Ideas to Keep in Mind

Your exercise plan should be tailored specifically for you. Ask your doctor for a recommendation of a qualified exercise provider that specializes in fitness plans for people with cancer. They will take into consideration your fitness level, abilities and your unique situation.

You may feel discouraged when you begin because you may not be able to do as much as you did before or that you expect to do now. Here are some ideas to keep in mind as you begin or resume an exercise plan.

• Be kind to yourself and don’t beat yourself up if you get a slower start than you’d like.
• Set goals to keep you motivated.
• Be flexible with your routine. Some days you may not feel well enough to exercise. Only do the level of activity your body can handle.
• Exercise when you have the most energy. It may be helpful to keep a diary and note how you feel as you go through the day. Include your pain levels because they can change daily. You might plan for less strenuous activities on days when you are recovering from treatment.
• One of the easiest exercises you can do is walking. You can build up from 10 minutes a day or increase your speed or distance as you develop strength and stamina.
• Go slowly. Overdoing it can cause pain and possibly a setback in your progress.
• If you feel severe fatigue or experience side effects of treatment, such as diarrhea or nausea, stick with simple activities and stretching.
• Keep in contact with your doctor and share your progress and setbacks. Your doctor may recommend changing your activities or suggest a physical therapist for specific issues.

Taking a Necessary Break

You may need to avoid exercise if the following occur.

• You are neutropenic or have a fever.
• You are experiencing symptoms of the cancer or its treatment.
• Your exercises have not been approved by your doctor or physical therapist.
• You experience chest pain, dizziness, blurred vision or fainting.
• You are anemic, have bone issues or take medications that affect your balance or muscle strength or that make you dizzy.

Your fitness plan will need to work for you and your specific needs. Your abilities and goals are likely to change as you start exercising. Work closely with your doctor or physical therapist to address side effects, worsening pain or other challenges that develop as you continue to exercise.