Beauty tip #12: exercise during chemo will help you feel in control again
Today’s blog is based on a lovely chat with Associate Professor André La Gerche, a cardiologist, exercise specialist and my colleague at the Baker Institute – if you haven’t started your chemo yet, you can join his clinical trial on breast cancer and exercise here. His top 2 tips to exercise during chemo are:
Plan an exercise regime and if needed look for help from an exercise practitioner –know you will face some challenges but it is possible to exercise during chemo.
Be realistic! Exercise when you are feeling well, and when you are unwell try to stay active without pushing the limits.
I have been getting a writing blockage lately when it comes down to writing about cancer and chemo. I have several ideas and then I either procrastinate, finding excuses not to sit down and put it on paper, or I just can’t find the words. My excuses come from a long day in front of a computer screen writing grants and papers at work, or just feeling too tired. But the reality is that I am probably too scared. Too scared to ‘think cancer’ when I finally feel like myself again, almost 3 years after my diagnosis and treatment. Too scared to remember everything I went through (and if you are reading this, probably everything you have been through to). And it is hard to keep my blog relevant when I am too scared to put my heart on it.
But something changed this week. I am not any less scared than I was – I just decided to allow myself to feel that I have been through a lot, but that writing about it is not going to bring it back. I have decided to be in charge of my life again by doing a big step – joining a gym.
What pushed me was a chat with A/Prof André La Gerche, a cardiologist, exercise specialist and my colleague at the Baker Institute. His research was all over the news recently showing that exercise during chemo protected breast cancer patients from heart damage.
Cancer and heart disease have several over-lapping risk factors, such as ageing, smoking, lack of exercise and carrying some extra weight. We know that several drugs used to treat breast (but also other types of) cancer can result in damage to our hearts. This includes, for example, doxorubicin, tamoxifen, trastuzumab, cisplatin and paclitaxel. With more long-term cancer survivors, including myself, heart disease is now the most common cause of their death.
We all have heard that exercise is good for our overall health, but the concept that exercise is beneficial during chemotherapy is quite new. André told me that his trial was designed to understand if exercise could predict people who would have issues with chemo, and to see if exercise would attenuate damage to the heart caused by chemo. His team found that breast cancer patients who underwent a regular exercise program (3 times per week) for 3 months during chemo had a small loss of their fitness capacity (only 2%), while the group that didn’t exercise lost 16% of their exercise capacity, which is equivalent to 16 years of normal ageing! Not only that, the exercise capacity (measured as VO2max) of one third of the breast cancer patients (8 out 29) in the non-exercise group was so low after chemo that they would struggle to do their normal daily activities such as going up the stairs, while in the exercise group only one patient ran into the same issues. Before patients started chemo, they also did an exercise MRI testing in André’s laboratory to determine their heart function. His team found that having low level of fitness and heart capacity were strong predictors of those that would have trouble with their hearts at the end of chemo. This means that now they can identify women at higher risk of having their hearts damaged with chemotherapy, and give them a treatment that works to avoid this damage in the first place. How amazing is that?!
Besides reducing heart damage, what are the other benefits of exercising DURING chemo?
1- It helps to maintain those extra kilograms away.
Due to drugs to control nausea and also medically- or surgically-induced menopause, a lot of cancer patients put on weight during chemo. Exercise during chemo will help you to keep those extra kilograms away.
2- Exercise reduces stress and anxiety in cancer patients.
3- Exercise increases energy levels.
It might seem counteractive, but A/Prof La Gerche’s patients said exercise gave his breast cancer patients more energy. You might need to slow down some days after chemo when your blood counts are low, but then increase the amount of exercise in the week before the next cycle of chemo. The most important thing is to learn to respect and listed to your body.
4- Exercise will help you sleep better.
5- Exercise may help with neuropathy caused by chemo.
6-It may help improve chemo brain.
7-Exercise will help you feel on control again.
During a cancer diagnosis, you lose control over your body, your treatment and your overall health. While you can’t control the side effects, A/Prof La Gerche says you can control how much you exercise during your treatment.
Overall, it is quite clear that exercising during treatment will improve your quality of life. I hope that by now I have convinced you to exercise during (and after) chemo. :-)
So let’s get into the practicalities:
Can I exercise during chemo?
Most likely yes, but remember to check with your medical team if it is okay for you to exercise, and what type of activities you are allowed to take. Depending on your surgery type, it might be okay for you to exercise after a short recovery. For example, A/Prof La Gerche said that breast cancer patients might be able to perform exercises that use their legs only, such as riding a stationary bike. During chemo, your medical team might not recommend swimming due to increased risk of infection, or any others sports with risk of falling, because during chemo you may bleed more and are more prone to infections. Also if you have a port-a-cath or a PICC line you may need to avoid doing resistance training (i.e., weights) using that arm as it may dislodge the catheter.
What type and how much exercise should I do?
Although his study involved 2 session with an exercise physiologist and one unsupervised session every week, A/Prof La Gerche says that staying active is the key! I have good news for you: every little bit helps. Try to sit around for less time and exercise for about 30 minutes a day. It doesn’t matter what activity it is as long as you are out of breath, it is difficult to have a standard conversation or you start to get a little bit of a sweat. A 30 minute walk most days is all you need – this can be a walk to work, to the shops or with the dog around the block. Other types of exercise include going up the stairs, the use of resistance bands or light weights, or riding a stationary bike. You can also look for places that provide free exercise support to cancer patients – if you are in Melbourne, the Peter Mac is one of them.
Are there any side effects?
A/Prof La Gerche says that exercise probably doesn’t have any side effects if done sensibly. Again, remember to discuss it with your medical team and listen to your body – don’t push yourself too much and if you feel unwell look for medical advice.
How about life after cancer?
A/Prof La Gerche says that “thinking about exercise during (cancer) treatment is to think about your future, because it is all about preserving your heart function for when you are cured”. So set yourself up well now and start moving!
Importantly, exercise may reduce your risk of recurrence. Several studies support that exercising at moderate pace might be able to reduce risk of recurrence of breast, colorectal and, potentially, prostate cancer (reviewed here).
During my chemo I walked to and from work every day. Each way would take me 15-25 minutes, depending on how much energy I had that day. I would also take the stairs instead of the lift between floors. In the end of most days, I would have done at least 5,000 steps. When I had appointments with doctors or had to collect blood, I would take public transport, which would force me to walk a bit more than if I was driving. Did this work for me? I like to think it contributed to my recover and remission from a stage 3 ovarian cancer and 5 months of chemo. I'm now trying to go back to my old fitness routine to keep cancer (and heart disease) away. As I start a new fitness journey, I am sure it will help me to be one step closer to having a ‘normal’ life again (or as normal as it gets post-cancer).
The bottom line is: even those days you are not feeling great, try to get out of bed and exercise. Go for a walk, breath some fresh air and enjoy the endorphins. Believe me, you will feel better!
Wishing you all much health and love
Fran xo
