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Exercise: A Cancer Survivor's Tool For Wellness
Jane Clark

Benefits of Exercise
How Should I Start Exercising?

What Should I Be Aware Of Regarding Treatment Side Effects?
New Programs Make Exercising FUN!

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Have you ever wondered if there is ANYTHING you can do to reduce stress levels, enhance abilities to perform activities of daily living (ADLs), and potentially boost your immune system? Well, there is something, it is called exercise. When engaged in safely, exercise can increase quality of life; enhance feelings of independence and self-confidence. There is no magic to it. You just need to do it!

Many medical professionals, fitness professionals and physically active cancer survivors confirm that exercise (engaged in moderate levels) allows the organ systems to positively adapt and improve metabolic efficiency, thereby allowing for more intensive cancer treatments, fewer side effects and better rest/sleep patterns.

Exercise need not be intense to promote these benefits. As a matter of fact, a significant number of all cancer patients exhibit muscular weakness, decreased functional capacity and fatigue prohibiting them from previous intensive exercise activities. Survivors often feel more lethargic during certain points of their chemotherapy and/or radiation cycles. This is very normal and indicates that the body and the cancer are being affected by treatment. Allowing the body time to heal or to rest is as important, at times, as building muscle or enhancing cardiovascular strength and endurance. Listen carefully to your body when engaging in any physical activity and act accordingly. It is best to error on the conservative side when determining the time, type and intensity of any exercise activity, particularly during any treatment you may be involved in.

Benefits of Exercise
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Exercise will affect individuals in very different ways. Although exercise may be uncomfortable at times, the long-term benefits generally outweigh the immediate discomforts when done properly. Some of the benefits are listed below.

  • Physiological - The physiological effects of cancer treatment can be extremely damaging to normal tissue and normal body functions. This damage may alter different individuals in very different ways. For these reasons it is important to not only listen to your body carefully, but also communicate anything unusual you experience to an instructor or trainer. These changes may be slight or severe and may affect an individual for a day, or long term. Adjustments are easy to make in a program and will ensure your safety. Some of the physiological benefits of exercise may include, but are not limited to:
    • Enhanced restfulness and better sleep patterns
    • Maintenance or strengthening of cardiovascular system
    • Enhanced flexibility and range of motion
    • Addressing muscular imbalances resulting from cancer treatment
    • Detoxification through sweat and better circulation
    • Maintenance or regaining muscle tone and strength
    • Better oxygen to brain and tissues
    • Reduced fatigue
  • Psychological - The psychological effects of cancer treatment can sometimes prove to be as damaging as the physiological ones. These benefits may be more difficult to quantify but should not be overlooked. In fact, they may be more important at times, as far as enhancing quality of life issues. You may notice positive changes in:
    • Stress reduction
    • Relaxation
    • Improved sleep
    • Enhanced feelings of independence and self confidence
    • Refocusing energies from illness to wellness
    • Mood elevation

How Should I Start Exercising?
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It is advisable to check with your doctor/s before initially beginning a program. Ask them if there are any special considerations you should be aware of. If you are going to join a program or work with a trainer, it is standard procedure for the program director or trainer to ask for a letter signed by your doctor giving you permission to start a program.

The key to most successful exercise programs is to start slowly and to develop and maintain a routine, particularly if you do not have an extensive exercise history. During any activity you begin, make sure to stop immediately if you experience anything unusual. This may include, but is not limited to, shortness of breath, chest pains, dizziness, muscle pain, clamminess, headaches, irregular heartbeat, excessive sweating or any joint or limb pain.

When beginning activities, keep in mind the type of exercise and surroundings that will be most interesting to you. Some people love the solitude of exercising alone, while others need a group to maintain motivation and prevent boredom. Exercising with others is a good opportunity to spend time with friends, family or other survivors and to share the road promoting better health and wellness.

Walking is a great activity to begin with. You can walk just about anywhere! Before beginning, it is important to make sure to wear shoes that give your feet good support. Just lace them up and off you go! If you are just starting, even 2-5 minutes can be a good goal. As you become more comfortable, and your strength increases add a little more time. A long-term goal may be to work up to 20 minutes a day twice a week, THEN 30 minutes a day 3-4 times a week! Some things to think about when walking is to keep the head held high, the shoulders back and abdominal muscles held in. Enjoy the scenery, and stop and smell the roses, that's part of the pleasure.

Make sure to drink a lot of water during any activity you engage in. It is important to overall health to stay hydrated, and even more important during treatment. During even the most casual of activities, water is continually lost from the body. It can be very beneficial to get in the habit of carrying a water bottle at all times to keep a constant reminder to drink.

If you are fortunate to live in an area with exercise facilities nearby utilize the programs and equipment they have. If you aren't familiar with facilities near you, look in the phone book. It is a good idea to use a facility close to your home or work. The additional time it may take to travel to a facility may be enough to discourage you from going. Make an effort to tour any facility you may be considering, to check if you are comfortable, the facility is clean, and the staff is friendly. There may be community-based programs designed specifically for cancer survivors that are available at little or no cost. Take advantage of these programs. Staff is generally more knowledgeable and compassionate regarding symptoms of fatigue, nausea, lethargy and weakness, and cosmetic concerns. They can better formulate an appropriate regimen, help alleviate apprehension and introduce you to people experiencing similar effects.

If you have the financial means to hire a personal trainer, investigate the opportunities they may provide. A qualified personal trainer can design a program to specifically compliment your needs. When choosing a trainer, consider the education and level of experience the individual holds. It is advantageous if they have an undergraduate degree in an exercise related field, special hands-on training in an area related to your needs (cancer and exercise, pilates, yoga, massage, older populations, etc.) and a nationally accredited fitness certification. The American College of Sports Medicine (ACSM) certification is considered the gold standard in the fitness industry. Other recognized certifications include the American Council on Exercise (ACE), and the National Academy of Sports Medicine (NASM).

What Should I Be Aware Of Regarding Treatment Side Effects?
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It has been shown that most individuals can tolerate well-prescribed exercise programs both during and following treatment. However, individuals can vary greatly in experiences with treatment-related symptoms. Symptoms may vary with time and range from mild to severe, hindering exercise regimens to different degrees. These may include, but are not limited to:

  • Nausea/vomiting - For individuals going through treatment, nausea and vomiting were at one time the most troubling symptoms. These symptoms can now be more successfully managed with drugs, acupressure, acupuncture and proper nutrition. Please consult with your doctor if you are experiencing these symptoms.
  • Fatigue - Both physiological and psychological factors may contribute to fatigue, which is now considered one of the foremost cancer treatment related challenges. Because so many factors may contribute to feelings of fatigue it is more difficult to manage. However, fatigue may be positively impacted by exercise due to the mood elevating quality (and many other physiological changes) it often produces. If you find yourself experiencing fatigue, make yourself an internal bargain: set a realistic time goal (5 minutes?) and promise yourself if after that time you want to quit and rest you can. Most often once an individual gets going they are happy they did. Again walking is a good activity to engage in when faced with this situation.

New Programs Make Exercising FUN!
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Now that you've learned some of the basics, there are new and emerging activities that can be fun, interesting and worth trying. Whether you are a seasoned exercise veteran or new to the fitness arena, it is always advantageous to try new things to keep your exercise activities fresh. The following practices require some instruction, which may be found in books, videos, one-on-one or in group classes. Do give these activities a try, you may find you enjoy them so much it doesn't even seem like exercise!

  • Pilates Joseph Pilates began developing his increasingly popular exercise method in the late 1890s in an effort to overcome ailments suffered from asthma, rickets and rheumatic fever. He studied Eastern and Western medicine, yoga, Zen meditation and exercise regimens of the ancient Greeks and Romans. The method proved so successful for him that at the age of 14 he was able to pose for anatomical charts and had become a diver, skier and gymnast.
  • Pilates is a practice that focuses on strengthening abdominal, back and other postural muscles (those supporting the spine), which are referred to as the core. The dance and rehabilitation communities have embraced this method for many years, and recently the mainstream fitness arena has exploded with enthusiasm for Pilate's exercises.

    Pilates exercises can be practiced on the floor or with pieces of equipment. The main piece of equipment is called a reformer. This is an excellent practice for postural enhancement and can prove to be as challenging and physically rewarding as any traditional resistance program.

  • Water Exercise Although water exercising is not new, classes and activities have gained continued popularity over the last several years. Exercising in the water is extremely beneficial for those experiencing orthopedic issues. There are a lot of individuals who are inhibited from exercising on land due to these issues who have a lot of success in the water.
  • If you are currently in radiation treatment your medical professional will probably restrict ANY water activity until your skin is clear of any burns or other open areas.

    Check with local facilities that have pools about the programs they offer. It is a good idea to go several minutes early the first time you plan to attend a class and make sure to let the instructor know you are new, and share any information about your current health status.

    A good instructor will keep an eye out for you and suggest any modifications, or provide any one-on-one instruction needed to maintain your safety and ensure your success.

  • Physioballs Physioballs are another fun way to incorporate exercise into your lifestyle and feel like a kid again! These large inflated rubber balls were previously used for back rehabilitation exercises, but have evolved into the mainstream fitness arena with great success. Working with physioballs not only enhances core strength but also are also great for stretching, developing and maintaining balance.
  • Rollers Rollers are Styrofoam cylinders that are helpful in developing core stability, breathing, flexibility and postural enhancement. They are wonderful tools and are easy to use in your own home or a fitness facility. Rollers were also previously used for rehabilitation purposes, but have experienced a rebirth into the traditional fitness arena as well. Before starting with rollers it is a good idea to get basic instruction from a trainer or other fitness professional. Once you feel comfortable with the exercises, this is an ideal tool to use at home.

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Making efforts to engage in any type of fitness activity is a great investment in your health, state of mind and quality of life. As mentioned above, there are countless benefits and reasons why EVERY individual should incorporate some type of activity into their lives if they haven't already. Hopefully this article has instructed beginners on the basics, and inspired both beginners and experienced exercisers to GET MOVING!

Jane Clark has been in the fitness industry for over nine years. She has served as the Fitness Director for Chevron Corporation, UCSF Medical Center and is currently working in the same capacity for Western Athletic Clubs in San Francisco. Jane earned her undergraduate degree from the University of Wisconsin, Madison. She is certified by The American College of Sports Medicine as a Health Fitness Instructor, The American Council on Exercise as a Personal Trainer, and the Physicalmind Institute as a Pilates Mat Instructor. She continued her Pilates training at the Ellie Herman Studio in San Francisco.

Over the last few years Jane has continued her educational pursuits in the field of Cancer and Exercise. She has studied with the Cancer Wellfit Program, developed at the Santa Barbara Athletic Club. While at UCSF she produced a Personal Trainers' Conference on the topic of Exercise and Breast Cancer Care. This summer Jane received certification as a Cancer Exercise Specialist at the University of Northern Colorado's Rocky Mountain Cancer Rehabilitation Institute. Jane will be launching a program for cancer survivors at Western Athletic Clubs in San Francisco soon!

Jane Clark
Director of Fitness Operations
Bay Club/Bank of America Center & Golden Gateway Tennis & Swim Club
415-362-7207 Fax

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First appeared December 14, 2002; updated March 4, 2007