What is exercise's role during a cancer journey?

More exercise means more energy, which is extremely beneficial to patients during a cancer journey.

While this seems straightforward, this isn’t a quantity vs. quality scenario. It’s a mix of both, personalized to everyone in different ways.

A late-phase trial published in the New England Journal of Medicine finds people who follow an exercise program after undergoing surgery and chemotherapy can reduce the risk of cancer recurrence, a new cancer diagnosis or death by 28%. The findings were presented on June 1 at the annual meeting of the American Society of Clinical Oncology (ASCO), focusing on those who had Stage 3 or high-risk Stage 2 colon cancer.

Nathaniel Leman is an exercise physiologist with OSF HealthCare. He works alongside patients with cancer, mapping out plans to keep them exercising, despite a cancer diagnosis.

Exercise is helpful to patients with cancer

During a cancer journey, exercise helps deliver medication through the body as it's intended, because a person's blood vessels are opening, allowing the drugs to get to the areas impacted by cancer better. 

"We know exercise is so beneficial for our bodies. Specifically for patients with cancer who deal with a lot of fatigue, tiredness and low energy," Leman says. "They also deal with a lot of joint and muscle pain, maybe even bone pain. Most of the time they have weakened immune systems as well. There's a lot of things through their treatment journey they'll deal with; weight loss is another one."

How exercise is beneficial for patients with cancer

"Exercising with cardio and strength training is really good for our hearts, lungs, muscles and joints. The benefits also include our mental health, and it helps keep our weight consistent," Leman adds. "It also helps to boost our immune system and keep us healthy for a long time."

Leman and his colleagues rely on recommendations from the American College of Sports Medicine (ACSM) to put together plans for patients with cancer. That includes 150 minutes of moderate, cardiovascular or aerobic (using body’s main muscle groups in repeated motions) exercise per week. This can break down into 30 minutes of exercise, five days a week.

If 30 minutes at one time is too much for a person, feel free to break it down into two 15-minute exercise periods, sprinkled throughout your day. Even three 10-minute periods are beneficial.

The main goal is to just get people to start moving. 

How to start moving

"That includes anything from walking to an aerobic bike on a moderate setting," Leman says. "Walking in a pool and doing light jogs inside the pool is something where we can take that pressure of gravity off."

If people want to achieve vigorous exercise, Lehman recommends 75 minutes a week because of the added pressure that's put on muscles and bones. 

If strength training is more your speed, Lehman recommends two to three days a week. This can include light squats, shoulder press, bicep curls, triceps extensions and rows as a few examples. Make sure to have a day of rest in between. 

Avoid powerlifting during cancer

Power lifting (power clean, heavy squats, deadlift) or exerting too much energy during a cancer journey is something to avoid, Lehman recommends. 

"We don't want to do that type of workout where we're over stressing our body to a point we can't move the next day," Lehman says. "Those athletes train for years and years and years, and they put a lot of fatigue on their body that our patients with cancer just can't handle." 

Marathons, triathlons, Iron Mans and Spartan races should be avoided as well. These extremely tough exercise events would cause too much stress on the bodies of patients with cancer. 

Lehman says exercise is good at lowering the risk of cancer, but it doesn't outright prevent cancer. 

Lehman says there is a difference between an active lifestyle and exercising. A basic active lifestyle can include things like daily chores around the house, but he wants patients to take things a step further and add committed time to exercise specifically. However, if a person is working outside in the yard all day, that can be a great amount of physical activity which could supplement exercise on that specific day.

The European Society of Cardiology reports a sedentary lifestyle for two decades is linked to being two times at risk of premature death, compared to being physically active. The American College of Sports Medicine recommends 8,000 steps a day and says that for every 1,000 added steps per day in people with a sedentary lifestyle, reduces the risk of heart disease and death by 15 percent.

OSF HealthCare exercise physiologists offer a free exercise consultation to get started. Contact your oncology care team here to learn more about exercise plans during cancer.

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