Overcoming Barriers to Exercise During Cancer Treatment:
Strategies and Solutions
Cancer treatment is a physically and emotionally challenging journey, often accompanied by various side effects that can hinder a person’s ability to engage in regular exercise. However, research has shown that exercise during cancer treatment can have numerous benefits, such as reducing treatment-related side effects, improving quality of life, and potentially enhancing treatment outcomes. Despite these advantages, individuals undergoing cancer treatment may face several barriers when it comes to exercise. Let’s explore the common barriers cancer patients can encounter, along with strategies and solutions to overcome these obstacles and incorporate exercise into their treatment plan.Physical Barriers
One of the most significant obstacles to getting exercise is the physical effects of the disease and the side effects of treatment.
- Fatigue: Cancer and its treatment often cause extreme fatigue, making it challenging to engage in physical activities. To overcome this barrier, patients can consider incorporating short bouts of low-intensity exercises, such as gentle walks or stretching, and gradually increase their activity level based on their energy levels.
- Pain and discomfort: Cancer treatments can cause pain, muscle weakness, and joint stiffness, which can deter individuals from exercising. Consulting with healthcare professionals, such as physical therapists, can help develop tailored exercise programs that address pain management and improve mobility.
- Neuropathy: Peripheral neuropathy, a common side effect of certain cancer treatments, can lead to numbness, tingling, and balance issues. Engaging in balance exercises under the guidance of a physical therapist can help improve coordination and reduce the risk of falls.
Emotional and Mental Barriers
A less-spoken-about but nonetheless prevalent concern about exercise and cancer treatment is the emotional and mental health aspect. For many patients, cancer takes a toll on their self-esteem and motivation.
- Anxiety and depression: Cancer treatment often triggers anxiety and depression, making it difficult to find motivation and engage in physical activity. Incorporating exercise as part of a support network, such as group classes or therapy sessions, can provide a sense of community and emotional support, boosting mental well-being and encouraging regular exercise.
- Body image concerns: Changes in physical appearance, such as hair loss or weight gain, can negatively impact body image and self-esteem, leading to reluctance to participate in exercise. Encouraging patients to focus on the functional benefits of exercise, such as increased strength and stamina, rather than solely on appearance can help overcome this barrier.
- Fear of injury or recurrence: The fear of injury or cancer recurrence can create anxiety around physical activity. It is essential to work closely with healthcare professionals who can provide guidance on exercise modifications and help address concerns to build confidence in engaging in safe and effective workouts.
Practical Barriers
Practical barriers to getting enough exercise while undergoing cancer treatment aren’t often discussed but should get more attention.
- Time constraints: Cancer treatment often involves a demanding schedule of appointments and procedures, leaving little time for exercise. Breaking exercise into shorter, more frequent sessions throughout the day can be a practical solution to overcome this barrier. Patients can also explore incorporating physical activity into their daily routines, such as taking the stairs instead of the elevator or performing exercises while watching TV.
- Financial limitations: The cost of gym memberships or specialized exercise programs may pose financial barriers for cancer patients. Exploring free or low-cost options like community fitness classes or online exercise videos can provide accessible alternatives to traditional fitness facilities.
- Lack of social support: Limited social support can make it challenging to maintain a regular exercise routine. Engaging family members, friends, or support groups in exercise activities can create a supportive environment and increase motivation. Additionally, connecting with cancer-specific exercise programs or organizations can provide access to a community of individuals facing similar challenges.
Finding Professionals That Can Help
Finding Gyms that Specialize in Cancer Care: When searching for gyms specializing in cancer care, it is important to look for facilities that understand the unique needs and challenges faced by individuals undergoing cancer treatment. One approach is to contact local cancer support organizations or cancer treatment centers and inquire about recommendations for fitness facilities that cater to cancer patients. These organizations often maintain networks or partnerships with gyms that have experience working with individuals in various stages of cancer treatment.
Another valuable resource is online directories and databases that list fitness centers or trainers specializing in cancer care. Websites such as the Cancer Exercise Training Institute (CETI) or the American College of Sports Medicine (ACSM) can provide directories of certified exercise professionals who have received specialized training in working with cancer patients. These professionals are knowledgeable about the specific exercise considerations and modifications needed during cancer treatment.
Finding Physical Therapists that Specialize in Cancer Care: Physical therapists specializing in cancer care can provide personalized exercise programs and rehabilitation services tailored to the unique needs of cancer patients. A good starting point is to ask the oncology care team for recommendations or referrals to physical therapists who have experience working with cancer patients.
Additionally, professional organizations such as the American Physical Therapy Association (APTA) may have directories or resources to help locate physical therapists specializing in oncology. The APTA’s Oncology Section is dedicated to advancing the physical therapy care of individuals affected by cancer and can provide information on certified oncology specialists in various regions.
When selecting a physical therapist, it is essential to consider their experience, credentials, and communication style. A physical therapist specializing in cancer care should have knowledge of cancer-related complications, such as lymphedema or neuropathy, and be skilled in designing exercise programs that address these specific issues while promoting functional recovery and overall well-being.
By seeking out gyms and physical therapists specializing in cancer care, individuals undergoing cancer treatment can benefit from tailored exercise programs, professional guidance, and a supportive environment that understands their unique needs. These specialized resources can play a vital role in helping cancer patients overcome barriers and safely integrate exercise into their treatment journey.
Final Thoughts on Exercise During Treatment
Overcoming barriers to exercise during cancer treatment is crucial to harness the physical, emotional, and practical benefits of regular physical activity. By addressing physical limitations, managing emotional and mental hurdles, and finding practical solutions, cancer patients can integrate exercise into their daily routines, and experience improved quality of life.
Source: Michelle Strickland
Community Coordinator
Aging.com | Best Resources for Seniors
CETI offers free or low-cost customized exercise regimens catered to the individual needs of the cancer survivor. The certified fitness instructors are trained in cancer survivorship, post-rehabilitation exercise, and supportive cancer care.
Cancer patients, survivors, and those with chronic health risks are less active than the general population. They all want and need help when it comes to exercise but there is a severe lack of health and fitness professionals who have the expertise required to support cancer patients and older adults with chronic conditions. Working with chronic conditions, cancer patients and survivors require a much more knowledgeable and customized approach.
A safe, customized and effective exercise program helps clients experience affords the survivor less depression, anxiety, pain, injury, fatigue, and disease recurrence.
Goals: Better coping, strength, energy, endurance, mobility, sleep quality, ease in activities of daily living, functional moment, range of motion, posture, balance.
Source: CETI Cancer Exercise Training Institute
https://www.thecancerspecialist.com
Fitness programs treat …
- Strength and range of motion
- Balance and gait training
- Scar and tissue tightness and restriction
- Pain, endurance, balance issues and fatigue
- Axillary web syndrome (cording)
- Pre-operative mobility assessment
- Individualized post-operative exercise programs
Source: Breast Cancer Resource Center Austin
72% Reduction in Metastatic Cancer Seen with Intense Cardio
Exercise has always been a core pillar of my proactive lifestyle regimen for living with (aka hosting) cancer.
My daily movement routine includes some form or combination of cardio, weights, and Pilates. My well-known love of moving my body — and deep interest in exercise science and its effect on cancer is captured here.
When I was diagnosed with ‘incurable’ leukemia over 30 years ago, there was no literature that supported exercise as an evidence-based approach to incorporate into managing and treating a diagnosis.
For me, fortunately, I intuitively knew not to wait for the science to catch up before leveling up my exercise routine.
Then, in 2003, despite my best efforts, when leukemia was raging in my body, producing a chronic low-grade fever and auto-immune hemolytic anemia, I was told not to exercise. My oncologist feared that my heart would be at risk with undue physical activity. “Stay indoors and take it easy”, he said. So, I did that for about a week, until I became quite depressed.
When I pushed myself out the door and into a verdant park, to walk — and eventually into a pool to swim a few laps — the depression melted away, even if the nagging low-grade fever remained.
The point is, I needed to continue to move my body — and move it often — during that period of acute illness during the summer of 2003. (It is so hard to believe that was 20 years ago.)
Coming of Age for Cancer and Exercise Science
It took decades for the American Cancer Society, American Institute for Cancer Research, and National Cancer Institute to include guidance on incorporating exercise (and a healthy diet).
It wasn’t until several years ago during a Society for Integrative Oncology conference in New York that I heard my first presentation on exercise science. Lee Jones, an exercise scientist at Sloan-Kettering Cancer Center, was sharing recent results from a study his lab did with mice injected with human breast cancer.
The resulting data showed that aerobic exercise reduced tumor growth by conditioning the animal’s cancer to become more sensitive to chemotherapy — raising the possibility that exercise may change underlying tumor biology, making cancer easier to treat.
New Israeli Cancer and Exercise Study
Recently, researchers at Tel Aviv University have reported the results of a new study showing the risk of metastatic cancer can be reduced within a particular segment of the study group by 72% through aerobic exercise. They specifically looked at high intensity interval training (HIIT) and its impact on the incidence of metastatic disease.
So far the general message to the public
has been ‘be active, be healthy’.
Now we can explain
how aerobic activity can maximize the prevention
of the most aggressive and metastatic types of cancer.
~Professor Carmit Levy,
Department of Human Genetics and Biochemistry,
and
Yftach Gepner, PhD,
School of Public Health
and the Sylvan Adams Sports Institute
The study, found here, and published as the cover story in a recent edition of the prestigious journal, Cancer Research, included a mouse model and data from healthy human subjects before and after running.
The human epidemiological data, collected on approximately 3,000 individuals for about 20 years (all healthy at time of recruitment), had a modest impact on those who developed low metastatic stages, and showed a whopping 72% reduction of metastatic disease for those with more intense metastatic diagnoses, who participated in high intensity aerobic activity, versus those who did not engage in physical exercise.
Results from the animal model showed similar outcomes. These findings were valuable in that they allowed investigators to identify the underlying mechanisms of action — in essence, the scientists could ‘show their work’, therefore explain their ‘why’.
Samples of organs were collected from the healthy, fit mice, before and after being injected with malignant disease, and before and after high intensity aerobic exercise. From this, researchers discovered that aerobic exercise greatly reduced metastatic disease in the lymph nodes, liver, and lungs.
Studies have demonstrated
that physical exercise reduces the risk
for some types of cancer by up to 35%.
This positive effect is similar
to the impact of exercise on other conditions,
such as heart disease and diabetes.
In this study, we added new insight,
showing that high-intensity aerobic exercise,
which derives its energy from sugar,
can reduce the risk of metastatic cancer
by as much as 72%.
~Prof. Carmit Levy and Yftach Gepner, PhD
The research team hypothesized that a significant increase in glucose consumption, induced by intense aerobic activity, was the driving factor in the remarkable decrease in metastatic disease.
Metastatic cancer is the leading cause of death in Israel, where this study population resides. This remarkable discovery may lead to viable, actionable guidelines to help prevent metastatic disease.
Our results suggest
that healthy individuals
should also include high-intensity components
in their fitness programs…
It must be emphasized that physical exercise,
with its unique metabolic and physiological effects,
exhibits a higher level of cancer prevention
than any medication
or medical intervention to date.
~Yftach Gepner, PhD
You can access the full published paper here.
It’s Time: Move. Your. Body.
Now, we are starting to see growing evidence that goes beyond exercise as just a sensible lifestyle factor to help prevent malignant disease.
We all know that sports and physical exercise
are good for our health.
Our study, examining the internal organs,
discovered that exercise changes the whole body,
so that the cancer cannot spread,
and the primary tumor also shrinks in size.
~Prof. Carmit Levy
Additionally, we are investigating exercise as a way to improve efficacy of cancer treatment itself — and to reduce the often-deleterious side effects of toxic anticancer agents, and radiation therapy.
Exercise is free … and freeing. Every day, we receive more information to support physical activity as lifesaving.
Its positive affect on physical and emotional health is irrefutable. If it could be bottled, it would be the most efficacious and commercially viable ‘drug’ of all time.
And though the impact of exercise for cancer prevention, during active treatment and cancer survivorship, is profound — the positive emotional impact of exercise for those of us hosting a malignancy is equally potent and must be leveraged at every opportunity. Again, if exercise could be bottled as an antidepressant and antianxiety ‘drug’ for those living with cancer, it would be a blockbuster brand.
I think
other than all the physiology and biology
that we talk about,
the sense of control is massive,
and exercise is something you can do
that is one-hundred percent
under your control
to influence your own trajectory of recovery.
~ Lee Jones, PhD,
The Lee Jones Lab,
Memorial Sloan Kettering Cancer Center
A recent and well-illustrated study, such as this one, with a population group of over 70,000 people, demonstrates how important it is to move, and explains the role of oxygen in the body. More importantly, it reports the amount of vigorous exercise required to achieve certain results.
And there is more evidence to shout the ‘exercise message’ from the rooftops. This has to do with the benefits of an oxygen-rich blood flow to a tumor and its environment as being helpful, even though it seems counterintuitive and that starving a tumor of oxygen would make more sense. (When there is not enough oxygen in blood or tissue to maintain a balanced state (homeostasis), the condition created is called hypoxia. If a tumor becomes hypoxic, it can become isolated and impervious to treatment.)
References to studies by the Massachusetts General Hospital in Boston and Memorial Sloan Kettering Cancer Center in New York with respect to oxygen, exercise, and tumors, found that the oxygen-rich blood flow allowed a more efficient delivery of cancer treatment to the target area, thus keeping the lines of communication open.
Picture exercise as an efficient postal worker who gets important documents to the correct address through rain, hail, sleet, and snow.
Imagine a gym or track as part of standard clinical cancer care. Just like a teaching kitchen should be part of every clinic, medical center, and hospital. Meanwhile, back in the ‘real’ world, make strength-training and HIIT, and your kitchen, be an integral part of your own personal anticancer regimen.
To those individuals
that are not doing anything right now,
even just going out a few days a week
— for even ten to fifteen minutes of light walking —
that’s how you get going.
~Lee Jones, PhD
If your feet and joints are in good shape — back, knees, hips, ankles — the park is calling and, if you are medically cleared for vigorous exercise, there is never been a better time (or researched reason) to stream that HIIT video, head to the pool, participate in a sport, or join up with some active folks at the gym. Just be proactively active … aka move!
Source: Glenn Sabin
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