How to exercise with cancer?



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Exercise and Cancer

Almost four years ago, my mother was diagnosed with cancer. She underwent surgeries and chemotherapy, only to develop another form of cancer requiring radiation and surgery. She is thankfully in remission with respect to cancer, but she battles the residual effects from surgeries, medications and radiation. Her journey, like so many others, is one of frustration, gratefulness, fear, appreciation, and hope. As a mom of a family of health focused individuals, she has been inundated with information from diet, supplements, meditation, and exercise. She is appreciative of the information, however, it is often too much information and too many “to dos” leaving her feeling overwhelmed versus encouraged. In an attempt to help navigate and streamline the information and “to dos,” we have delegated such activities as grocery shopping and meal preparation, while encouraging meditation and exercise. Recognizing that exercise is important to health and vitality, she would like to participate in her walking, stretching and stabilization program but she often times has been lost as to what to do and what she can do…a common feeling expressed with my clients who have cancer. To help her and others navigate the exercise journey, a greater appreciation of factors influencing energy and exercise recovery is warranted prior to suggesting exercise.

 

1. SLEEP

Medications and stress can alter sleep patterns and quality. Poor sleep can heighten nausea, contribute to poor memory, inhibit immune function, and impair muscular strength and balance. If sleep is impaired and fatigue is constant, the RIGHT exercise can help one feel better. The right exercise is client dependent in respect to how one overall feels will suggest if the exercise should be high energy or restorative. In other words, exercise can be divided into two categories, catabolic or restorative. Both categories are intended to enhance well-being. Running can be a catabolic exercise in that you are depleting the energy stores. Walking or gentle stretching can be restorative in that you may be using energy but you are focusing more on the breath and relaxation.

When you have a poor night’s sleep, focus more on restorative/gentle exercise like stretching. Poor sleep can lead to poor balance, so choose exercises in which you are supported. If moving through a weight routine, then lower your weights this day and focus on your form and breath. The key is to move on this day and not succumb to the couch. Movement that restores the body up can help you sleep better.

 

2. STRESS

Stress…who is not stressed in some shape or form. Remember stress does not have to be just mental, it can be environmental, chemical, hormonal or physical. The body can interpret both good and bad stress the same. For example, have you ever had an amazing weekend with friends and/or family but feel exhausted come Monday morning? Have you ever had a weekend spent at home reading or just putting around but keep thinking about work and all you have to do, so come Monday morning you still feel exhausted. Studies have shown exercise can help with stress management. The key again is the recognizing if you need a more restorative/anabolic routine or a more catabolic routine. For example, are you the personality that a run or a hard workout makes you feel better? OR are you the personality that exercise because you feel you have to not because you want to? Cancer is a catabolic state in that your body is fighting itself, and this breaks down the immune system. A person who continues to exercise hard because that is his or her only outlet may eventually have to stop exercising at this intensity because it is too stressful on the system. However, if the person incorporates more anabolic activities to counteract the high intensity workouts, then the client might be able to continue exercising without deleterious effects.

 

So what is high intensity versus low intensity exercise? That too becomes more individualized. A yoga class can feel high intensity to one individual and low intensity to another… who is right? Neither. This is the learning process for you as an individual. Learning to define your high intensity is helpful in recognizing what exercises to include and exclude. Maybe walking 3 miles is low intensity because you have had a great night sleep, feeling mentally alert and happy. Maybe 3 miles on another day is “high intensity” because you had a bad night’s sleep, nausea is greater, and/or just feeling more anxious today. I wish there was a magic percentage, but there is not. The magic lies in you learning how varying lifestyle factors can influence how you feel and function, and being open to changing your exercise routine accordingly. If this feels daunting, having a health coach can help you navigate your way through your wellness. And be patient, this skill takes time.

 

3. DIET

There are multiple diet recommendations which claim to prevent or cure cancer. The type of diet is a personal choice. The same diet can respond differently in people, thus it is important to be open to trying various one which work for you and your lifestyle.  Make sure you let your MD know any supplements you are taking, because even they can have negative effects. For instance, fish oils can increase bruising after a surgical procedure.

Diet also includes hydration. Nausea, fatigue and loss of balance can be side effects of medication, as well as, dehydration. If you do not like water, try adding a slice of lemon or add some coconut water.

 

4. MOVEMENT

One of the keys to vitality is to keep moving. The first step to movement is redefining movement. Movement may be walking down a driveway to grab the mail, walking for 5 miles, or running. In other words, workouts need to be based on how you feel physically and emotionally. There is fine balance between not exercising enough and exercising too much, both of which can have side effects of muscle weakness, poor balance and fatigue. A simple routine of squats, pullovers, chest press, rows, biceps can be done at a higher level on days you are feeling energized and well, and low levels with just a few reps on days where fatigue is greater. Be open to changing the time of day you like to exercise. Recently, I have had a client change from her late morning walk to an evening time because the mornings and afternoons were too hot and/or she tended to not feel well until the evening. She kept missing her walks, which led to frustration and the sensation she was moving backward not forward. Albeit a small adjustment, it allowed her to return to her ½ mile walk and feel more in control of her health.

 

In sum, cancer is a journey from diagnosis, treatment, and post treatment. Side effects, emotional struggles, and triumphs can present differently in a day, week, month and person to person. Honor your journey and those around you, seek support to help you stay moving and motivated, and keep breathing.

Elizabeth Leeds, DPT

Elizabeth Leeds, owner of Seaside Fitness and Wellness, combines her background in physical therapy, personal training, and Pilates in her practice and teaching. As a pelvic floor physical therapist working at Comprehensive Therapy Services in San Diego, her passion for pregnancy and postpartum is seen in her mission to empower women with knowledge and understanding of their physical changes, and how to address them to prevent future issues.Additionally, Elizabeth is a Master Trainer and developer for Total Gym’s GRAVITY education.

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