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  • Carol Michaels

The Role of Exercise in a Survivorship Plan


There are numerous issues that need to be covered in a survivorship plan. I will focus on physical activity. Exercise is an important component of a cancer survivor’s recovery process. Emerging research suggests a decrease in cancer recurrence for those who exercise. A well-designed program can also decrease side effects and improve quality of life. Moreover, acceptance of exercise as part of a good recuperation and standard of care has been gaining momentum in the medical community.

After surgery, cancer survivors should begin an exercise program designed to ameliorate the adverse effects of surgery and help them regain their pre-cancer fitness level. Exercise that focuses on functional fitness will help them be able to perform the activities of daily living and return to the activities that they enjoy.

Try to start moving as soon as possible after surgery, even if it is only walking indoors. This will help you to regain strength. Although only one limb may be affected by your surgery, try to move both limbs equally. If you had been inactive prior to surgery, start with short walks and increase the distance walked each time. You can also increase the frequency of the walks as you slowly increase the distance. Try to find a walking buddy and walk often. Build up strength slowly and make sure never to over do it. Just 15 minutes a day can improve your energy level and mood.

Cancer survivors need to be patient; returning to your pre-cancer fitness level takes time and cannot be rushed. Learn the implications of your particular surgery and the corrective stretching and strength training exercises needed to improve recovery. Patients who participate in exercise programs say that it is empowering and gives them a sense of control and accomplishment.

Exercise and fitness training have special benefits for patients during and after treatment for cancer. During chemotherapy, studies have indicated that exercise may increase fitness and energy levels, improve mood, and help patients better tolerate cancer treatments. After treatment is concluded, exercise can increase strength and aerobic capacity, improve joint flexibility, elevate mood, and assist with resumption of regular activities and work demands. In addition, exercise has been shown to decrease the risk of onset or recurrence of many types of cancer.

Fortunately, studies over the last few years have shown have suggested that regular exercise, even strength training, may decrease the risk of lymphedema or diminish symptoms of lymphedema already present. Slow progression of exercise is stressed while monitoring for fullness or aching that can indicate possible problems with lymphedema. Strength training should be performed 2 to 3 times per week. This should be done safely- without incurring pain or injury that could trigger or exacerbate lymphedema.

Your particular surgery, treatments, fitness level and healing speed will guide the progression of the exercises. Your health and recovery process is always changing and it will be important to regularly monitor your blood count, muscle and joint pain, nausea, and fatigue. You may also have lingering impairments or health concerns that need to be evaluated by a physical therapist or lymphedema therapist.

You should meet with your oncologist to review the exact nature of your treatments so that you will understand the potential side effects of your treatments. This way you will be able to understand your exercise plan in relation to your unique situation. For example, Arimedex may make your joints or muscles sore. Some medications affect balance, and cardiac function, or increase the risk of dehydration. It is crucial that you understand the health issues you may encounter as a consequence of your surgery or treatment. This will include learning which muscles are affected, which lymph nodes are removed, and the cardiac and pulmonary effects of radiation and chemotherapy.

Goals should be specific and realistic. You may want to lose weight and increase your muscle mass. If flexibility is an issue, your goal may be to improve your range of motion. Other goals might be to become stronger, have a good quality of life, better mood, or to decrease the chance of recurrence.

It is helpful to have both short term and long term exercise goals. Goals should be able to be adapted to changes in work, health, and family situations. If you are new to exercise, select an activity and set an achievable goal. Slowly add exercise to your daily activities and find something that works with your lifestyle.

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