The Center for Surveillance and Applied Research and Public Health Agency of Canada shows a current trend of an increase in cancer survivorship, which means that more and more people are winning the battle against cancer. This also means that more and more people are living with the side effects and disabilities of cancer and their treatments. The fact of the matter is that chemotherapy and radiation is extremely hard on the body, but a necessary form of treatment for many. Unable to single out cancer cells alone, chemotherapy is damaging to several cells and systems in the body including the heart and the lungs (American Cancer Society, 2020). On the other hand, surgery is a traumatic experience within itself for the body and can be difficult to recover from depending on the circumstances. All in all, cancer is a debilitating disease on the body and the mind, but the question lies on how to deal with these disabilities post survival.
Can exercise combat some of the side effects of cancer treatment?
To begin answering that question, we must revert to the diagnosis stage and the action taken before treatments begin. What is becoming more prevalent over the years is research in the grouping of exercise and cancer together and using physical activity to combat some of the side effects of cancer. This research is not only limited to the aftermath of treatments but has taken a prehabilitation approach to prepare patients from the time of their diagnosis to when treatments begin. Dr. Daniel Santa Mina and his colleagues of the University of Toronto have done extensive research in this field of topic. What has been highlighted in his research is the evidence of benefits coming from incorporating a prehabilitation exercise program during the pre-operative or pre-treatment time span for cancer patients.
When should I be doing my Prehab and Rehab?
As mentioned, the time span for prehabilitation begins the moment of diagnosis and ends with onset of treatment. The idea behind this motion is that a healthier, more physically fit individual is better able to combat the side effects of surgery or chemotherapy and come out the other end with better physiological reserve. The prehab program sets a baseline of functional ability going into treatment as well as highlights and addresses any pre-existing disabilities or dysfunctions. Researchers have seen a significant decrease in post-surgical complications and effects with a minimum of a three-to-four-week prehabilitation period.
What would my program look like based on the type of cancer I have?
During these three to four weeks patients should be working alongside healthcare professionals and exercise trained individuals, such as a personal trainer, physical therapist or kinesiologist, to create a program specifically suited towards their specific disease and treatment plan. For example, someone who may have bone cancer of the femur and will be undergoing surgery to remove a portion of this bone will train differently than someone who is having abdominal surgery or chemotherapy. The patient with bone cancer is going to follow a program that targets the tissues and muscles surrounding their specific treatment plan. This could result in resistance training as an attempt to build and reserve bone density to the best possible degree, as well as training geared towards any tissues that will be vulnerable to the surgical procedure. Their program may also include lower body strengthening and cardiovascular training to reduce the amount of any deconditioning, loss of strength, loss of range of motion and fatigue. On the other hand, someone who is foreseeing a treatment plan consisting of chemotherapy might have an exercise program based more on retaining cardiovascular function to reduce the risk of cardiovascular toxicity, while also implementing full body resistance and strength training to combat the attack on other collateral body cells and tissues.
Train your body like you are training for a difficult but victorious game day!
Dr. Santa Mina has compared this stage to an athlete training for competition. An athlete will train specifically to their sport leading up to competition, focusing on every potential outcome to ensure they are prepared when game day arrives. This is a similar situation in which patients train the specific tissues and systems to handle the treatments they are about to begin in order to be victorious on game day. What is important to remember during this time is to consult with a doctor before beginning an exercise program. Based on the type of cancer and how far the disease has progressed there may be certain limitations to what some individuals may be able to participate in. These restrictions are important in forming a safe and effective program individualised for each patient. An athlete must consult a doctor and follow an injury specific return to play protocol, so patients must follow their contraindication protocol.
What do I do post cancer treatment?
Following treatment there is a long list of potential adverse effects resulting from cancer survivorship, such as decreased cardiovascular capacity, mood disorders, bone loss, and risk of developing heart disease to name a few. Even with the precaution of prehabilitation and the reduction of postoperative or post treatment complications, there are still negative effects that linger, especially for those who did not take a prehabilitative approach. This is where the rehabilitation portion comes in, which takes place after treatment to help combat the side effects from treatments that may still arise. Every patient responds differently to certain treatments and not every patient receives the same treatment, so patients need to seek clinician approval at this step as well, to be cleared for a cancer-based rehabilitation exercise program. Clinicians will also gage any assumed or potential risk and evaluate frailty to once again give the practitioner, may it be a physical therapist, occupational therapist, kinesiologist, etc., the ability to construct a safe program specific to that patient. There are also specific national guidelines practitioners can refer to, including an exercise specific guideline created by Dr. Santa Mina and his colleagues based on disease, symptom or condition management, age group and nutrition in order to create the safest and most beneficial program possible.
What are the three types of exercise programs for post cancer treatment?
Based on the 2019 exercise guidelines for cancer survivors there are three types of program approaches; resistance exercise, aerobic exercise, and both combined; each of which provide their own list of benefits. Examples of benefits that overlap in all programs are a decrease in depression, anxiety, and fatigue as well as an increase in perceived physical function and overall quality of life. The guidelines for aerobic exercise include three thirty minute sessions a week of exercise at a moderate intensity which may include activities like a brisk walk, biking, or water aerobics. For resistance training, two sessions a week for thirty minutes is the minimum, doing two to three sets of each exercise that includes a large muscle group. These sessions may include the use of resistance bands, free weights or just body weight.
Heal your mind, and body post Cancer treatment.
It is inevitable that cancer does not only attack the body, but the mind as well. By getting the body moving and being active, patients are able to contest and decrease the negative side effects of their survivorship physically and mentally. It is important to note that these prehabilitation and rehabilitation periods should be handled by a team of experts together. This team should be constructed of a clinician, nutritionist, psychologist and fitness professional that work together in several areas to improve overall health and wellness. By seeking the help of these health professionals, the results are astounding in suppressing the depression, anxiety and countless other mental and physical aftereffects. Exercise is an endorphin releasing activity which has already been proven to enhance mental health, so why not transfer this knowledge to help recovering survivors. The results are in and it has shown that a healthier body and mindset going into trauma creates a stronger competitor who comes out the victorious side standing taller!