In 2011, Cancer was the leading cause of disease burden in Australia (1), and has a profound and damaging toll physically, emotionally, psychologically and socially for the sufferer and their family. Exercise, as is well known now, has profound positive effects on us physically, emotionally, psychologically and socially. This article aims to briefly summarise just how critical exercise is throughout the process of treatment.
Cancer is a group of diseases that is characterised by the body’s cells becoming abnormal and multiplying at an uncontrolled rate. These cells can invade surrounding tissue, then the blood stream, which can then spread to vital organs within the body. We previously wrote “Cancer Care: A New Approach” touching on the benefits of exercise within this pathology. Research has shown that undergoing an exercise program during treatment can boost certain physiological processes that include blood flow, immune system response and chemicals within our muscle that help fight the tumour cells directly, but what form of exercise is best and during what phase of treatment can you undertake exercise? With research still being conducted in this area, hopefully by the end of this we have given you some starting guidelines to what form of exercise can be done through the various stages of the disease. Please note, exercise is an additive support mechanism, there are many types of cancers requiring varying approaches, and your treatment and management should always be guided by a specialist.
The Benefits of Exercise on Cancer
This image below provides a nice little summary on the simple benefits of exercise for cancer patients.
Exercise Prior To Cancer Treatment:
Chemotherapy and Radiation therapy for cancer pathologies involve flooding the body with a highly toxic substance aimed at killing of the tumour cells. As a side effect, people undertaking this form of treatment can often experience:
- Sarcopenia (loss of muscle mass)
- Loss of bone mineral density which can increase the onset of osteoporosis
- Loss of exercise capacity
- Fluctuations in weight
The goal of an exercise intervention during this phase of treatment should be viewed like that of a “pre-hab” program before musculoskeletal related surgeries. Research has shown that performing a pre-hab program can improve the outcomes post-surgery. Because of the side effects of chemotherapy and radiation therapy, an exercise program that aims to improve strength, aerobic capacity, balance, flexibility and mobility is vital. By preparing your body to the highest levels of physical capacity as possible pre-cancer treatment, will assist your ability to counter the effects of chemotherapy and radiation, and if required, to be able to handle higher dosages and survive.
During Cancer Treatment:
Can I undertake exercise while going through my treatment cycles?
Research into aerobic and strength training modalities has not only proven that exercise is safe, but also beneficial in helping the body improve its own ability to help fight the cancer. As the tumour begins to grow, the cells become highly abnormal regarding their vascular nature. What this means is that some cells are exposed to a sub-optimal blood flow, causing a poor delivery of the body’s own immune defenses to help fight the tumour. Additive to this issue is the environment becoming hypoxic (deprivation of oxygen at a level that affects bodily tissue), which has been associated to cellular changes that enhance tumour growth.
Strength & Aerobic Exercises have been found to:
- Increases in physiological processes such as blood flow. An increase in blood flow allows more blood with oxygen to diffuse into the site of the tumour which can offset the current hypoxic environment
- Improvement in immune function through physiological processes, in combination with increased blood flow, allow more of the body’s immune system to flood the infected area
- Help offset the effects of fatigue, sarcopenia, osteoporosis and cardiovascular fitness parameters.
Post Cancer Treatment
Like the pre-hab program suggests above, the focus of an exercise intervention post treatment should be to regain overall exercise tolerance, by gradually improving muscular strength, aerobic capacity, functionality and quality of life. This in turn may lead to a decreased rate of re-occurrence, which has been outlined by some research (2).
Some Extra Gems From Us
With symptoms varying between days, during the day and during the treatment cycle. Here are some tips to consider when undertaking an exercise program pre, during & post treatment.
- Seek the advice of a qualified health professional – Numerous program variables must be considered including intensity, sessions per week and time of day, as symptoms are different between patient to patient
- MAINTENANCE IS OKAY!!! – Maintaining current levels of exercise is completely normal during treatment, there is no need to exhaust yourself. Your aim is not to be hitting personal bests during this time.
- Nutritional support for your treatment is vital, while appetite levels can fluctuate throughout, seeking guidance from a qualified Dietician will make the whole process that much easier for you.
- It’s not just therabands, Yoga and Pilates. In fact, proper strength training, guided by an experienced Coach, Exercise Physiologist or Exercise Scientist, will be the single most beneficial form of training for you to be doing. The stressed state which the body is under when it is suffering from diseases such as cancer, imposes a greater demand for amino acids from muscle protein breakdown, so your lean tissue is critical (3). Muscle is so important that your ability to heal wounds from surgery, recover from disease, and increase life expectancy from cancer and associated infections is so intimately linked to the amount of lean tissue you have, needing it to be able to supply the increased demand of amino acids (4,5,6).
To find out more on what you should be doing for your particular case, come on in and see the expert team at Absolute. A multidisciplinary team of highly skilled clinicians here to work alongside your oncology specialist.
From Exercise Physiologist & Performance Coach Adam Luther and Exercise Scientist & Head Performance Coach David Smith.
- AIHW 2017. Cancer in Australia 2017. Cancer series no. 101. Cat. No CAN 100. Canberra: AIHW
- Moore SC, Lee IM, Weiderpass E, Campbell PT et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176:816–825.
- Wolfe, R. The underappreciated role of muscle in health and disease. Am J Clin NutrSeptember 2006 vol. 84 no. 3 475-482
- Zhang X-J, Chinkes DL, Wolfe RR. The flow phase of wound metabo- lism is characterized by stimulated protein synthesis rather than cell proliferation. J Surg Res (in press).
- Pereira CT, Barrow RE, Sterns AM, et al. Age dependent differences in survival after severe burns: a unicentric review of 1674 patients and 179 autopsies over 15 years. J Am Coll Surg 2005 (in press).
- Kadar L, Albertsson M, Arebert J, Landbert T, Mattsson S. The prog- nostic value of body protein in patients with lung cancer. Ann N Y Acad Sci 2000;904:584 –91.
ABC’s “World First” call for exercise to be prescribed to all Australian cancer patients. Published on May 6th 2018.