A Step-by-Step Approach to Physical Fitness
for Cancer Survivors
As a medical doctor specializing in cancer rehabilitation, I often find myself echoing a common refrain to those around me: just move. Inactivity has both a direct and an indirect effect on our health and function. Historically, we, as a society and as medical professionals, have often underestimated the effects of inactivity. Over the past several years, a shift in thinking has begun.
You’ve undoubtedly heard about the many studies that have reported on the health risks of inactivity and the health benefits of standing or moving. Although you can argue about the details of these studies, the premise of inactivity as a bad thing for our bodies is no longer debatable.
However, the advice concerning the approach that individuals, particularly cancer survivors, should take to prevent or reverse the effects of inactivity is quite confusing. We’re bombarded daily with “quick fixes”: standing desks as a new form of exercise machine (not to mention the next-step-up version, treadmill desks), as well as new exercise products and programs that tout their effectiveness but may not have research to back them up.
What are we to make of this product and information overload?
My initial, honest response to that question is often a disappointing “I don’t know.” I actually don’t like to think about trying to find an answer to that question. I prefer to reframe our perspective and ask a different question.
We know that increased physical activity is associated with improved survival in several types of cancers, including breast cancer, lung cancer, and brain tumors.
What can we control to put our bodies and our health in the best position to thrive?
Well, thankfully, we know a few things that can help answer that question.
♦ We know that even without the effects of our bodies fighting cancer, short periods of inactivity can lead to a significant decline in our bodies’ organ systems.
♦ We know that due to cancer and the various treatments used to control or cure the disease, survivors often face physical, mental, and emotional barriers to becoming active.
♦ We know that exercise and increased physical activity improve our bodies’ internal mechanisms to heal and fight the development of cancerous cells.
♦ We know that increased physical activity is associated with decreased risk of at least 13 different types of cancers.
♦ We know that increased physical activity is associated with improved survival in several types of cancers, including breast cancer, lung cancer, and brain tumors. Given this knowledge, we can take a step-by-step approach to physical fitness.
STEP 1: Assess current activity level.
This is usually a little harder than it sounds. We tend to do a poor job of assessing our activity without using some kind of measurement. This measurement can be a step counter (whether on a pedometer or activity tracker, like Fitbit) or just measuring time and distance walked. By assessing our baseline activity levels, we can help set realistic goals to increase our activity.
STEP 2: Determine if barriers or obstacles are preventing activity.
This may include physical impairments, such as fatigue, pain, range of motion limitations, lymphedema, and weakness, or cognitive ones, like difficulty thinking clearly. We should also evaluate job and family responsibilities, social stressors, transportation, and environmental limitations.
STEP 3: Address the barriers and obstacles to activity.
Although there may be some simple solutions, this is the time to tap into your support system, including family, friends, and your cancer treatment team. In regard to functional barriers, you may benefit from seeing a physiatrist who specializes in the rehabilitation of cancer survivors. As a cancer rehabilitation physician, I perform a thorough evaluation of each survivor’s life, including prior to their cancer diagnosis, and help create a plan to work through these barriers in order to help them reach their potential.
STEP 4: Just move.
No one exercise or activity is universally recommended over another. The best exercises or activities are the ones that are safe and that you enjoy (or dislike the least). Using your baseline activity measurements as a starting point, you should slowly increase your activity in a stepwise pattern, while continuing to measure and monitor your progress. It’s also a good idea to talk to your healthcare provider before starting any new physical activity.
As your ability increases, you should begin to expand your activities, looking to improve your aerobic fitness, strength, and flexibility. As you move through the journey of life, you’ll likely run into further barriers, but a cancer rehabilitation specialist can help you maneuver these barriers.
Whether you’ve never exercised in your life or you’re a lifelong athlete, all survivors can just move – and reap the benefits of physical fitness.
Dr. Samman (Sam) Shahpar is an attending physician in the Cancer Rehabilitation Program at the Shirley Ryan AbilityLab (formerly, the Rehabilitation Institute of Chicago) and a full member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, IL.
This article was published in Coping® with Cancer magazine, July/August 2017.