by Leslie J. Waltke, PT, DPT
In a recent report, The World Health Organization describes a growing human “pandemic of inactivity.” Here in the United States and across the planet, this lack of physical activity and exercise is increasing the risk of many diseases like diabetes, dementia, and some types of cancer. Additionally, for cancer survivors, research has also shown that inactivity after cancer can shorten survivors’ length of life, as well as increase the risk of cancer recurrence and dying from cancer. Still, the large majority of cancer survivors either don’t exercise enough or don’t exercise at all.
So, if exercise is a proven, powerful medicine, why are so few people taking advantage of it? One answer is barriers. People report obstacles to exercise that include time constraints, low energy, and prohibitive cost. Combine that with a cancer diagnosis and living with the side effects of treatment, and you can add additional barriers like pain, fatigue, not knowing what is safe, and lack of post-cancer exercise instruction.
To be most effective, your 150 minutes of weekly exercise should include both aerobic activities, for your heart and lungs, and strength activities, to improve your muscles and bones.
If you are having trouble starting and continuing an exercise routine due to barriers in your life, you are not alone. A great place to start is by having a plan. A prescribed medicine comes as a specific drug, a specific dose, and specific directions on frequency and duration. For people with cancer or a history of cancer, exercise too should come with a prescription. Talk with your cancer doctor or nurse about any exercise restrictions you may have and ask them to refer you to a physical therapist who can develop an exercise prescription tailored specifically for you and your needs.
Let’s Lay Out an Exercise Prescription
An exercise prescription should include the type of exercise, the intensity, the duration, and the frequency.
• How much exercise: Experts agree that a great target to hit is doing 150 minutes (or 2.5 hours) of exercise a week. Ideally, these 150 minutes should be split over three to five days. If you are still in cancer treatment, just recovering, or haven’t exercised in many months or years, you may need to gradually build up to this 150-minute target over several weeks. However, no matter your age, health, or current fitness level, 150 minutes of exercise per week should be your target goal. It is OK to start with exercise sessions lasting only five to seven minutes, done several times a day. Once you are able to keep moving for 20 consecutive minutes, you can cut back your exercise sessions to once a day.
• What kind of exercise: To be most effective, your 150 minutes of weekly exercise should include both aerobic activities, for your heart and lungs, and strength activities, to improve your muscles and bones. Depending on your starting health and fitness, you can begin with aerobic activities as simple as marching in place or slow dancing in your living room to your favorite music. As you gain endurance, you can progress to walking outside, running, skating, dancing, bicycling, or swimming.
Exercise is proven to be the best way to decrease weakness and fatigue from cancer.
Early-level strength exercises can include doing simple pushups against a wall or repeatedly getting up and down from a chair several times. As you get stronger, you can begin lifting hand weights, doing yoga, or using resistance machines.
• Intensity of the exercise: Research says the intensity of your exercise should be moderate. A key point to remember is that your moderate may be quite different from someone else’s moderate, and likely even different from your younger or pre-cancer moderate. Moderate is best described as moving at a level that makes you need to breathe a bit more often. For example, you should still be able to talk and hold a conversation while occasionally needing to take an extra breath.
Breaking Down the Barriers to Exercise
Working around barriers to exercise is a big part of achieving success in starting and continuing an exercise plan. If you find yourself too tired or weak to exercise, this is a dire warning sign that you need to be exercising more. Sitting on the couch does not make you stronger. Exercise is proven to be the best way to decrease weakness and fatigue from cancer. The weaker and more fatigued you are when you begin, the more you have to gain.
Time too can be an exercise barrier for many. As it was important to your life, you found a way to fit cancer surgery, chemotherapy, or radiation into your schedule. Exercise deserves that much priority as well. There are 10,080 minutes in a week. Your exercise prescription deserves 150 of them.
Studies show positive feedback and accountability with others helps overcome sedentary behavior. Join a group, exercise with someone, or share your plan with a friend, family member, or fellow cancer survivor. Again, if you need help knowing what and how much exercise to do and what is safe for you, talk with your cancer doctor or nurse about getting you in to see a physical therapist.
Even beginning level exercise will lead to symptom reduction and a happier, healthier life in just a matter of weeks. So, get your exercise prescription filled and get started today. Exercise like your life depends on it, because it does.
Dr. Leslie Waltke is a physical therapist who has dedicated her practice to cancer care. She is an international speaker and educator, as well as the founder of the Waltke Cancer Rehabilitation Academy.
To learn more about exercise after cancer, visit The Recovery Room, a free video library specifically for people with cancer and cancer survivors. The videos are short, positive, easy to understand, and address topics such as exercise during and after cancer, lymphedema, cancer-related pain, and physical recovery. Check out The Recovery Room on YouTube (bit.ly/TRRplaylists) and Facebook (bit.ly/TheRecoveryRoom).
This article was published in Coping® with Cancer magazine, March/April 2019.