Why I've been running during chemo.
- Sophia Rossi
- Apr 30, 2019
- 8 min read
Exercise. My cancer aid, it's benefits and the research behind it.
Before you read on, I must say that although this is backed up with research, I am no doctor and therefore you must consult with your doctor if you are interested in starting exercise.
Introduction
"If we could turn the benefits of exercise into a pill it would be demanded by patients, prescribed by every cancer specialist and subsidised by the government. It would be seen as a major breakthrough in cancer treatment"
- Dr Prue Cormie, Clinical Researcher and Exercise Physiologist. (Exercise as a part of cancer treatment. Harvard Medical School. June 2018.)
Over the past few weeks my mental health has been a damn right rollercoaster. BC (Before Cancer), during stressful periods in my life I leaned on running and going to the gym to gain a form of mindfulness and relaxation. Yet when I started my treatment I took a pause on exercise after being told to rest. It seemed crazy that during my most stressful time in life I wasn't doing the one thing that made me feel better. So, I got permission from my doctor and I have once again taken up running and the benefits have been plentiful alongside my treatment.
Upon starting almost everyone has been weary of my new venture and my doctor had little to say on the subject apart from not to push myself. Granted there is a lot to read about the benefits of exercise but we don't have a exercise regime in place and exercise hasn't been encouraged at all during my consultations. Yet when I started experiencing the benefits and read the the attitudes and actions of specialists in other countries I wanted to know why there isn't more importance placed on exercise in the UK. It seems we are stuck in the old opinion that the sick need to rest when evidence proves that it is probably more harmful to not be physically active.
The facts
Exercise has proven to prevent some forms of cancer, aid alongside treatment and prevent recurrence and here is the evidence:
In an analysis (Archives of Physical Medicine and Rehabilitation, May 2018.) of 28 trials involving over 1,000 participants with advanced cancers (including leukemia, lymphoma, multiple myeloma, lung, breast, GI, and prostate), an exercise program during treatment was associated with significantly improved physical function, energy levels, weight/BMI, psychosocial function, sleep quality, and overall quality of life. Furthermore, and more importantly they found that exercise is deemed safe for cancer patients.
Cancer Research has looked into exercise and specific cancers and explains how exercise can prevent breast and bowel cancer. As many of you may know, cancer starts when cells divide too much and multiply out of control. Oestrogen could encourage cells in the breast to divide more often. If you’re doing a lot of activity it can reduce the levels of oestrogen, helping to prevent breast cancer. Insulin could also affect how cells multiply. Being very active can reduce levels of insulin and help prevent cancer.
In addition, exercise reduces the risk of bowel cancer as being active helps move food through our bodies. This reduces the amount of time any harmful chemicals in food waste are in contact with our bowel, helping to prevent cancer. It also helps control levels of inflammation in the bowel. Inflammation is a normal way our bodies responds to damage. But if there is too much, it can cause our cells to multiply more often increasing the risk of cancer. So being active can help prevent bowel cancer by reducing the levels of inflammation
Macmillan carried out research that found that exercise reduced the risk of previously treated cancers returning. They found that people exercising had:
40% lower risk of breast cancer returning
50% lower risk of colon cancer returning or dying from colorectal cancer
30% lower risk of men dying from prostate cancer
These findings are huge and should be shouted from the rooftops.
Benefits that I have really noticed
For those undergoing cancer treatment, such as chemotherapy exercise has proven to combat many of the side effects, I know because I have witnessed it first hand.
Beginning with the big one: fatigue. I can imagine that to many the idea that exercise-working out, makes you less tired is absolute madness. However, when I started doing the NHS Couch to 5k I really noticed a massive change in my overall tiredness by week 3. Of course, I still have some days where I binge watch Game of Thrones in bed smelling of the bacon I cooked when I got out of bed at 1pm. BUT, overall I have noticed that keeping up a little bit of exercise throughout the week, even a walk, often leaves me feeling spritely and energised for the rest of the day. It has proven to improve your sleep quality helping you get the rest that your body needs to recover and fight off those pesky cells. Also when your muscles get stronger over time it takes less effort for you to do things that cancer has made a bit more difficult like walking up the stairs or carrying the shopping.
Secondly, it has proven to reduce stress and anxiety, decreasing feelings of depression. I'm going to admit that in my chemo cycle I still have days where I struggle with my mental health. Whilst exercising hasn’t completely eradicated these feelings it definitely helps it. Just getting outside and breathing fresh air has proven to positively impact our mental health and combining that with exercise by going on a run left me feeling much more positive. When I have been on a run I have a large sense of achievement, boosting my self esteem and restoring a purpose into my life that cancer once took away. Like many young women I struggle with my body image and whilst I have been careful not to lose any weight (as it will compromise my treatment) I have noticed that my muscles have toned and I feel more confident in myself. In addition, doing yoga helps to balance the mind and joining group exercises like Zumba, tennis or walking groups gets you out there meeting people which will please psycho-social needs. Finally, let's not forget the science. Within the first 20 minutes of exercising dopamines, endorphins and serotonins are released giving you a natural high - what more could you ask for?
Other benefits of exercise include:
Improving bone health and prevents osteoporosis
Builds muscle strength
Helps with constipation
Helps maintain a healthy weight
Lowering your chances of developing other health problems such as diabetes or heart disease or even a new cancer
Improve your quality of life and increase your life expectancy
Reduce your risk of infections
Reduce your risk of developing thrombosis
The lack of awareness in the health system
The benefits of exercise are so immense that the Clinical Oncology Society of Australia says that exercise regimes should be embedded as part of standard practise alongside treatment, it should be promoted by healthcare teams and for the best results each patient should be referred to an accredited exercise physiologist. They promote it so much that they suggest a rather intense regime of 150 minutes of moderate intensity exercise (walking, jogging etc.) as well as 2-3 sessions of resistance exercises a week!! I don’t know about you but I would have found that tiring BC (before cancer).
Nevertheless, at least they are acting on the topic unlike the UK. Here, Macmillan and YouGov carried out a survey of 1,098 people aged 18-88 living with cancer and found that 2/5 were not physically active AT ALL. Furthermore, 77% of patients in remission hadn’t spoken to their oncologists about the importance of being physically active during or after treatment and 89% said the same about their GPs. I know that with budget cuts and restricted time GPs and Specialists have to get to the important stuff but with benefits so large it seems rather too important to overlook. Although the treatment in the UK is amazing, I do feel that exercise alongside treatment should be looked into more as the benefits are there.
How can you get started?
Firstly, I think it is important to say that before you start anything you should talk to your specialist and your GP about whether it is right for you and your treatment plan. You MUST put your health first by having the correct medical advice.
The NHS suggests that a cancer patient should do the same amount of exercise as everyone else (150 minutes of moderate-intensity a week).
My main advice for those looking to start exercise would be to do what you enjoy and take baby steps. Don't forget that exercise doesn’t have to mean going for a run or going to the gym if that's too much for you. Instead try going for a walk, climbing the stairs, or doing the gardening.
Here are some small ways to get into exercise:
Join a walking group
Join a yoga class (great alongside running as improves your balance and prevents falls)
Do a bit of cheeky salsa
Walk or cycle to the shops (I like to cycle to the pub, eat chips and cycle back)
Ask your GP to refer you to a physiotherapist
Couch to 5K! I'm currently on week 5 and it's brilliant if you can get over the cheesy music
Sticking to exercise is also a challenge so here are a few ideas for you to stay motivated:
Get an exercise buddy to encourage you on your bad days
Give yourself achievable small goals
Gradually build up how much you do
Keep track of what you've done and how far you’ve come
When you don't feel like it do something that requires least effort and reward yourself e.g. walking around garden
Macmillan has even more suggestions too for starting and sticking to exercise:
When should you avoid exercise?
Favour low-to-moderate-intensity exercise such as swimming or brisk walking over sprinting or high-volume exercise
If exercise worsens side effects e.g. feeling sick or shortness of breath after exercise then contact your doctor before continuing
Modifying exercise type based on site of treatment e.g. avoiding cycling after prostate or rectal surgery
Incorporating balance and co-ordination exercises such as tai-chi and yoga if at risk at falling instead of running on a treadmill
Avoiding high contact activities if you have cancer in bones or you're at risk of osteoporosis
Take small and gradual steps when it comes to resistance exercises
Try to stay away from public gyms and pools if your treatment has left you with low immunity
If you have a PICC line in your arm don’t do repetitive arm exercises above the head
If you have low platelets (thrombocytopenia) it increases your risk of bleeding and bruising so avoid high impact sports like running and favour swimming
If your treatment has damaged the nerves of your peripheral system (peripheral neuropathy) it will affect your grip and balance which makes some activity unsafe such as running on a treadmill or cycling.
My closing word
The evidence is out there that the benefits are huge and the best way to get into it is to find what is right for you. It doesn’t matter what you do just get out there and do it! (providing you stay safe and discuss your activities with your doctor). However, don't forget that cancer and it's treatment puts a strain on your body so you will need more time to recover after exercise than before so make sure you counter in rest and plenty of stretching.
I'd like to thank Basil Lockwood for being an ever brilliant grammar checker.
Here is a brilliant podcast on the benefits of exercise generally by the Food Medic
Thank you for wading through my thoughts, I would love to hear yours too.
Sophia x
Sources
A systematic review and meta-analysis of the safety, feasibility and effect of exercise in women with stage II+ breast cancer. Archives of Physical Medicine and Rehabilitation, May 2018.
Efficacy of exercise interventions in patients with advanced cancer: A systematic review. Archives of Physical Medicine and Rehabilitation, May 2018.
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