Guest Columnist: Janet Caputo, PT, OCS
In support of the Race for the Cure this upcoming weekend, this two part series on exercise and cancer is intended to raise the level of awareness and attempt to empower people to make their illness an opportunity for wellness.
In the past, people being treated for a chronic illness, like cancer, were often told by their doctors to rest, conserve their energy and reduce their physical activity. Recent research has shown that exercise is not only safe and possible during cancer treatment but it can improve your function and quality of life.
Fatigue, one of the most frequent side effects of cancer treatment, affects up to 70% of patients receiving chemotherapy and radiation therapy. Treatment-related fatigue is severe and imposes limitations on daily activities. To reduce fatigue, patients may avoid physical exertion and down-grade their level of activity. The resulting physical inactivity causes muscle atrophy and weakness, reduced endurance, and loss of function. Current studies show that people recovering from cancer treatment should increase their physical activity to reduce fatigue and improve physical performance.
Cancer, as well as cancer treatments can increase the risk of blood clots. You are at high risk for a blood clot if you have undergone surgery for malignancy. If you are less active because of treatment-related fatigue, this would also increase your risk! Physical activity and graded exercise improve blood flow and lower the risk of blood clots.
Steroids, which are often given with chemotherapy and radiation therapy can increase the risk of developing osteoporosis. Osteoporosis weakens bones and places them at a high risk for breaking. Weight-bearing exercises, such as walking and resistive exercises using weights, help keep your bones strong and healthy. You can break a bone if you fall, especially if you have osteoporosis. Balance training, a form of weight bearing exercise, can prevent falling by improving your balance which would lower your risk of breaking a bone. Also, steroids can also cause muscle weakness called steroid-induced myopathy. This muscle weakness, increased by the physical inactivity from your chronic fatigue, can further impair your balance responses which would increase your risk for a broken bone from a fall. The harmful side effects of steroids can be delayed or reduced by weight bearing exercise such as walking and strength training using weights or resistive bands.
Many people will gain weight from the steroids and from physical inactivity due to chronic fatigue. This weight gain can further reduce your physical abilities especially if you are already experiencing muscle weakness and fatigue. Regular exercise can reduce your risk for gaining weight by increasing caloric expenditure with aerobic exercise and increasing lean muscle mass with strength training.
Nausea can be a problem with some cancer treatments. Not eating properly because of nausea can contribute to your muscle weakness, bone loss, and fatigue. Your physical performance can further diminish making you dependent on others for help during normal daily activities. Physical activity and exercise can lessen nausea and improve your appetite. Eating better will not only provide the nutrients that are necessary for strong bones and healthy muscles but also the energy for physical activity and exercise that are vital for life.
Cancer and chemotherapy can suppress your immune system which would increase your risk for developing infections and possibly other cancers! Exercise can enhance your body’s natural defense mechanisms to prevent illness. Although there are very few absolute guidelines for exercise prescription, moderate exercise and physical activity has been shown to enhance immune function and reduce your susceptibility to disease.
When you live with a chronic illness like cancer you may develop anxiety, depression, and sleep disturbances. Regular physical activity and exercise can not only reduce your symptoms of anxiety and depression but also improve your ability to sleep. Although the exact mechanism is unknown, researchers hypothesize that these benefits are experienced because exercise releases endorphins, reduces levels of cotisol, and increases sensitivity of serotonin receptors. Overall, you experience improved mood, sense of control, and self-esteem. When you feel better about yourself, you will want to socialize. Interacting with friends will enhance your physical activity which will further improve your mental and physical well-being!
Before initiating any exercise program, consult your doctor! Exercise cautiously when you feel extremely fatigued. Keep your exercise program fun and fresh! Consult a medical professional, like a physical therapist, to tailor a program that can precisely suit your needs!
Read Part 2 of this series, about exercise and cancer prevention.
SOURCES: American Cancer Society; Friedenreich, CM, Orenstein MR. Journal of Nutrition
CONTRIBUTING AUTHOR: Janet Caputo, PT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic and sports physical therapy. She is currently a Doctor of Physical Therapy student at the University of Scranton.
MEDICAL EXPERT REVIEWER: Christopher A. Peters MD, Oncologist, Radiation Oncologist, Northeast Regional Oncology Centers (NROC), Dunmore, PA. Dr. Peters is a clinical associate professor of medicine at the Commonwealth Medical College.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
