Chemotherapy is prescribed to do a great number of things: to cure, aid other treatments, control the cancer, and help with symptom relief. It is a powerful tool, but as everyone knows, it brings with it a vast array of challenges, both during your cycles and after. But where does tailored exercise fit into this? Is it possible to stay active whilst undergoing chemo, and why on earth would you want to?

The plain and simple fact is that there is a growing body of evidence that shows tailored exercise during chemotherapy can reduce unwanted side effects, limit de-conditioning, AND now it is also being found to aid treatment. So, why are we not prescribing exercise like a drug? Why are we still not using it to its potential? Well, let’s talk about the benefits first…

1. Exercise creates a reduction in chemotherapy related neuropathy symptoms

Neuropathy is a relatively common side effect of chemotherapy. Essentially, it effects the hands and feet, creating symptoms like numbness, tingling and pain, cramping, difficulty handling small objects, and issues with gait and balance. Unpleasant! Multi-modal exercise, such as resistance exercises coupled with low to moderate intensity aerobic exercise like walking, creates significant reductions in both the severity and prevalence of neuropathic symptoms. Now that sounds to me like a pretty useful treatment!

2. Exercise reduces cancer related fatigue

Chemotherapy is associated with a crippling fatigue, known as cancer related fatigue. This can have a sudden onset and can impose a significant physical burden. It is also psychologically draining as it often means you are unable to do the things you love, and can impose a financial burden due to missed days as work. There are now hundreds of studies that show that exercise reduced fatigue levels. If you would like to know more, read my previous blog “Cancer related fatigue: Does exercise help or hinder?

3. Exercise reduces de-conditioning

Research has shown that the loss of rapid muscle mass is accelerated 24-fold during chemotherapy in comparison to healthy people. It is no wonder people undergoing chemo feel fatigued when they lose so much muscle, so quickly. Luckily we have a treatment for that! Specific resistance training has shown to minimise this loss of strength. Completing targeted strength training means that carrying your children, doing the shopping, getting out of the car doesn’t become so fatiguing. That has to improve your quality of life.

4. Exercise reduce risk of cardiovascular disease

Due to the direct toxic effects of anti-cancer therapies as well de-conditioning, people undergoing chemotherapy have a risk of developing cardiovascular diseases such as heart failure, stroke, and coronary heart disease. A study in 2016 found that post-diagnosis exposure to exercise was associated with substantial reductions in newly diagnosed cardiovascular diseases or cardiovascular related death. That is massive!

5. Improved completion rates of treatment

Now, oncologists provide treatment doses based on what they think will create the best chance on achieving the treatment goal. However, completion can depend on how well you can withstand the treatment and it’s side effects. So, given that exercise therapy can reduce general pain levels, cancer related fatigue, and neuropathy it makes sense that it allows more people to fully complete treatment. This can give you the best chance of survival!

6. Exercise reduces risk of death

If you exercise when diagnosed with cancer, you will reduce your chance of dying. I know that is a massive statement, but a review of 71 studies in 2015 found that exercise was linked to reduced mortality in breast, colorectal, and prostate cancers (those were the only cancers these studies focused on). In one of those studies they found mortality reduced by 24%, 32%, 39% and 40% when individuals participated in low, moderate, vigorous and very vigorous activities respectively. What they essentially found was that there was a dose response relationship with exercise and mortality. Therefore, some exercise is definitely better than none and more is better than less. It depends on personal side effects of your chemotherapy treatment.

7. There are always caveats to exercising whilst undergoing chemotherapy

It is important to be aware of the caveats to exercising while undergoing chemotherapy. Exercise must be tailored to the current functional status and capacity of each individual patient and then must be progressed and regressed based treatment cycles. Overstretching areas around catheters should be avoided. Stoma’s should be cleaned before and after sessions and if you are feeling feverish. It is also important to monitor acute changes in your pain levels, gastrointestinal disorders (nausea, vomiting diarrhoea etc), changes in heart rate, and blood pressure and breathing rates.

As we mentioned, exercise prescription must tailored to the current functional status and capacity of each individual patient. Typically you can exercise directly after each chemotherapy dose but usually once side effects really hit, intensities will need to be modified. For the same reported feelings of exertion, your exercise may change from being able to jog around the block, to being able to walk to the mailbox. Then, as you progress through your cycle, your intensity can increase. Just remember, exercise may sometimes feel like the last thing you want to do, but just like any good medicine, it will help when prescribed appropriately!

If you have any questions regarding how and when you can use exercise, please feel free to contact Holly on 8431 2111.

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