Exercise before, during and after cancer treatment
Being active can build strength, decrease recovery time and improve coping skills
If you were diagnosed with cancer in the last decade, your doctor likely recommended resting as much as possible and avoiding most activities. But the last 30 years have seen an explosion of research showing the undeniable benefits of exercise after a cancer diagnosis — research that is still making its way to the front lines of care.
A recent analysis of 26 studies, involving more than 40,000 patients, found exercise reduced cancer-specific mortality in some cancers by up to 37 per cent. The facts Routine physical activity can reduce your risk of developing cancer by up to 30 per cent, especially for breast, colon and endometrial cancer. For other cancers, the data is still emerging, but indications are that exercise as part of an overall healthy lifestyle can also reduce their incidence.
During treatment, oncologists will take you to the brink of survival to ensure they kill as many cancer cells as possible. This process can be gruelling, but exercise can help you deal with the negative side effects, both physical and emotional. It’s safe and improves your overall health and quality of life.
The top side effect of cancer treatment is fatigue; routine exercise can actually help you feel more energetic. It can also improve your mental concentration, body composition and quality of sleep, and reduce pain and depression.
But the relationship between exercise and cancer extends beyond functional outcomes and quality of life — laboratory research shows it can slow tumour progression. Exercise reduces some cancer-causing hormones and proteins and can decrease uncontrolled gene replication, which is the cause of cancer. When should patients exercise? Exercise is important at any stage during the cancer journey. But we’re now discovering that even exercise prior to treatment can help you build up strength, decrease your recovery time and improve your coping skills. This is known as prehabilitation — in contrast to rehabilitation that occurs following a course of treatment. Resources In 2015, Cancer Care Ontario developed standard exercise guidelines for cancer care centres across the province. The Princess Margaret Cancer Centre uses these guidelines in the Cancer Rehabilitation and Survivorship Program, which offers an eight-week group program on site and is developing a similar home-based program for those who can’t attend in person.
In addition to hospital programs, other programs can help you transition to exercising on your own. One such program is offered at U of T’s Faculty of Kinesiology and Physical Education. It pairs Master of Professional Kinesiology students with patients for one-on-one consultations. Other community programs include Gilda’s Club and Wellspring’s Cancer Exercise Program. And online resources such as ActiveMatch help women diagnosed with cancer connect with an exercise partner.
The key to all of these programs is that they are individualized and can accommodate each patient’s abilities and needs. Some patients go through chemotherapy, radiation, surgery, hormone therapy, targeted therapy, or multiple therapies, and reactions to treatment may fluctuate — one day you might feel fantastic while on another day you might feel exhausted. Adjusting to daily, weekly or monthly fluctuations will help ensure the program is safe and effective. Simple ways to get active
Set personal goals that you can attain — take small steps and do a little bit more tomorrow than you did today and decrease sedentary behaviour. In general, some physical activity is better than none.
Find simple ways to get active — from walking down the hall in your condo, to using the stairs and standing more during the day.
Find social support — having someone to keep you accountable is a known strategy for successfully sticking to an exercise routine.
Keep track of what you do throughout the day — acknowledge small successes and achievements to increase your confidence.
Choose physical activities that you enjoy. You can gain tremendous benefits in mental and social health from lighter intensity exercise.
Remember, the best exercise is the one you enjoy and are willing to do. Staying active will help you gain a sense of control over a situation that often makes people feel powerless. Daniel Santa Mina is a professor at U of T’s Faculty of Kinesiology and Physical Education and in the Faculty of Medicine’s Department of Surgery. He is also a scientist in the Cancer Rehabilitation and Survivorship Program at the Princess Margaret Cancer Centre. Catherine Sabiston is a professor in the Faculty of Kinesiology and Physical Education. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine. Email doctorsnotes@thestar.ca.