Depending upon the type and stage of cancer, as well as the treatment protocol, an appropriate exercise prescription should be seen as an important part of the treatment strategy.* This article will address several of the physical and psychological benefits of exercise and will assist cancer patients resume their daily living activities and a sense of normalcy. In addition, an increased level of fitness will allow those going through the cancer experience to tolerate treatments more effectively with a greater adherence to the treatment schedule and possibly better results.

Physical Benefits

Aerobic Capacity

Aerobic activities utilize major muscle groups, are rhythmic in nature and are slow enough to allow the heart and lungs to supply oxygen to the exercising muscles. They may be done as part of a warmup or lead in to other activities or more as a "stand alone" activity. As part of a warm-up, some form of aerobic activity should be done prior to flexibility and resistance exercises. Examples include walking, cycling and swimming. The use of aerobic exercises approximately 20-30 minutes a day, several times a week have been shown to minimize the effects of fatigue, nausea and depression for many cancer patients. The increased circulation will also assist in the removal of waste products due to the effects of chemotherapy or radiation.

Balance

Balance exercises may improve balance that may be due to a loss of muscle mass or neurological damage such as neuropathy.

Bone Density

Moderate weight bearing exercise such as walking or lifting weights will minimize the loss of bone density that may result from metastasis to the bones or from the use of hormone therapy such as estrogen therapy for prostate cancer or tamoxifen for breast cancer.

Fatigue

Fatigue or what is known as cancer related fatigue (CRF) is very common occurence during the treatment and post treatment phase. A spiralling effect often occurs whereby an individual becomes less physically active and deconditioned. The individual therefore loses strength and does less. Aerobic and resistance exercises have been shown to intervene in this cycle with less fatigue on the part of the patient.

Flexibility

Flexibility is often lost as a result of scarring of the connective tissue or skin related to surgery or radiation, as well as the shortening of muscles due to inactivity. Stretching prior to exercise such as after a warm shower or a daily walk is suggested. Stretching at the end of an exercise session is also an ideal time as muscles have been warmed up and are more pliable. Stretch slowly not using too much momentum or bouncing types of movement when stretching. Lifting weights slowly through a complete range of motion will often increase flexibility.

Strength

Many cancer patients lose strength simply due to a lack of use. This is common in breast cancer where patients are afraid to lift objects with an affected arm. Moderate strength or resistance training will assist in maintaining strength which is essential in performing daily activities such as carrying groceries or raking the leaves.

Weight Management

Some cancer patients gain weight due to inactivity and hormone treatment. Those with advanced cancer often experience severe weight loss or cachexia due to the loss of fat and muscle. Aerobic activities will assist in the management of weight gain while light resistance exercise will maintain some degree of muscle mass for those experiencing cachexia. Exercise may also stimulate one's appetite which is often lost during chemotherapy.

Increased Tolerance of Treatment

While exercise will, unfortunately, not cure cancer its therapeutic effects will often allow for a greater tolerance of treatment. Greater adherence to one's treatment regimen may, in turn, increase the likelihood of recovery. A common mistake for those undergoing treatment is waiting to feel better before beginning to exercise or stated differently, "waiting to get better, to get better ? thereby delaying the recovery process and a return to their former self

Psychological Benefits

Anxiety

Whether due to a "time-out ? effect, biochemical changes or the increased body temperature of exercise exerting a calming effect, many symptoms of anxiety such as muscle tension or sleeplessness can be reduced or managed by moderate aerobic activity or by the slow meditative movements of the Eastern traditions such as Tai Chi.

Control

Loss of control and identity is commonly associated with cancer diagnosis. Many of the physical benefits of exercise enable one to perform activities of daily living (ADL) and gain a greater sense of control and identity.

Depression

Whether biochemical in nature or by gaining a measure of control, exercise has been shown to reduce depression that is commonly associated with cancer.

Support

For many, exercise classes may become an informal support group. Indeed, it may be said that exercise classes are often support groups for those who dislike traditional support groups. They may also provide needed structure and interaction for those who are not working and feel a sense of isolation.

Appropriate exercise should not be seen as something that is done only when you feel better or "waiting to get better to get better." Rather, you will feel better once you become active once more.

* Please contact your physician before any beginning an exercise program.