Easing back into exercise after cancer

There’s no right or wrong way to exercise during cancer treatment or recovery, but there are a few things to keep in mind, advises Dr Adrian Rotunno, Sports and Exercise Medicine (SEM) physician and a Virgin Active South Africa expert.

A cancer diagnosis changes your approach to life. It requires a mental mind shift, change in lifestyle and several coping mechanisms. The benefits of exercise in a healthy individual can be applied to a patient who has had been diagnosed with, is being treated for, or recovering from cancer. Exercise oncology shows that an intra- and post-cancer exercise intervention programme can have immensely positive effects and reduce some of the side effects of cancer and its various treatments.

In a study by Spei et al (2019), breast cancer survivors who were most physically active had a 42% lower risk of all-cause mortality and a 40% lower risk of death from breast cancer than those who were the least physically active. Exercise, whether before, during or after treatment, improves the quality of life, while reducing the future risk of cancer or cancer recurrence. Data shows that exercise in breast cancer survivors has a positive impact on overall mental and physical wellbeing. It improves the body’s lean muscle mass and muscle strength, cardiovascular fitness and aerobic capacity.

Physical activity also triggers cellular apoptosis (cancer cell death) by inhibiting the mutation of unwanted cells, which reduces the growth and proliferation of cancer cells and rids the body of damaged cells that are beyond repair. It also helps to alleviate the symptoms of fluid build-up caused by lymphedema (as a result of the cancer or treatment thereof).

There's no one way: There’s no right or wrong way to exercise during cancer treatment or recovery – unless it's done too soon or is too heavy. Personal preferences and tolerances should reflect the patient’s best interests while reinforcing their natural inclination, so the process doesn’t become counterproductive.

While The American Cancer Society advises that patients should do roughly 150 minutes of moderate intensity exercise or 75 minutes of high-intensity exercise weekly, this should be done on a case-by-case basis. Exercise programmes need to be individualised. Seek appropriate help from a health or fitness professional on the reintegration of exercise. This takes away the responsibility of success from the patient. It’s easier for them to follow an exercise regimen like a menu and have it adjusted as necessary, rather than thinking about it themselves. And gives them an accessible support structure.

Start low and go slow: It is a journey. For every month of treatment, it will generally take two months to recover. Starting low, going slow, and building up progress is vital to exercising at your own pace. In the early stages of treatment or recovery, respect the ordeal your body has gone through. Don’t feel pressured to do more than you should.

Exercise doesn’t have to be formalised to show results. Focus on light exercises that do not require too much exertion. Small and simple movements also count, such as getting up off the couch, climbing stairs, doing light household chores, gardening or walking around the block.

Try meditation, deep breathing exercises, Yoga, Pilates, Tai Chi and dancing. These get the heart going and the body moving but not too vigorously, and are good for the mind and soul.

If you plateau, take your time before progressing to the next level of your exercise routine. Listen to your body as you know it better than anybody else. As you become stronger your body will become more resilient and your fitness level and strength will increase. With time, this will allow you to get back into the types of exercise you did before diagnosis.

Set achievable goals: Avoid a zero-to-hero approach. Set achievable goals from the start and grade these slowly to keep yourself motivated. Being too ambitious may lead to disappointment.

Consult with your doctor and work with a professional trainer to start incorporating light movement into your daily routine around the home. When you feel physically stronger move outdoors or to the gym in a safe manner that prioritises your best interests. Going out in public may be difficult but try not to worry about what others think. Do what you need to do and people will respect your needs.

Find your motivation or muse, whether it's music, life anthems, podcasts, or blissful silence. Setting yourself rewards – a long bath, reading a book or watching a movie, a weekend away with loved ones, and doing something that makes you happy. It’s a way of acknowledging your reached goals. As you progress and increase your fitness goals, so the rewards can change too.

Published on October 31, 2021