The Long Road Back: Physical Fitness After Cancer

One of the aspects of cancer that surprised me the most is the physical toll that it took on my body. From my muscle strength to my ability to endure exercise, I noticed a significant decline in what my body could accomplish immediately after treatment. It didn’t help that near the end of my treatment in 2012 I was hospitalized for seven weeks while my doctors tended to a dangerous and extremely painful bowel obstruction. Nothing had prepared me for the length of my hospitalized, and I seriously don’t think my medical team planned for me to have such an extended stay in an acute care bed on the cancer unit. I will always remember the relief and unrestrained joy that I felt when I was finally discharged from the hospital. However, it wasn’t long before I realized that my ordeal had taken a tremendous toll on my body.

For the first time in my life I learned what it’s like not to be able to walk medium or long distances. It took nearly all the strength I could muster just to stand or walk very short distances, and climbing stairs was out of the question for me. I quickly discovered that the muscles in my legs had atrophied during the endless weeks that I was confined to a hospital bed. On the day I went home I had an absolutely helpless feeling as I was transported from my hospital unit to my mother’s waiting car in a wheelchair. As we drove I knew my recovery would be arduous and probably take months.

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Like many cancer patients, I began slowly and took my recovery one day at a time.  As your ability increases, you should begin to expand your activities, looking to improve your aerobic fit­ness, strength, and flexibility. 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). The central pillar of my exercise routine involves taking a 20-minute walk every day. Study after study has extolled walking as a simple, inexpensive exercise with incredible health benefits. From a cancer patient’s perspective, walking regularly has been proven to strengthen the body and ease the mind. Several recent studies suggest that higher levels of physical activity are associated with a reduced risk of the cancer coming back, and longer survival after a cancer diagnosis.

The amount of exercise you require or that is medically advisable differs among individuals and you should always consult your doctor before establishing a fitness routine. The American Cancer Society recommends that cancer survivors get 30 to 60 minutes of moderate to vigorous exercise at least five days each week. They also give some suggestions for fitting exercise into your day:

  • Start a daily walking routine.
  • Wear a fitness tracker, and try to go a bit farther each day.
  • Walk or bike to your destination, when you can.
  • Exercise with family, friends, or co-workers.
  • Use a stationary bicycle or treadmill.

The evidence linking physical activity with improved quality of life in those undergoing active cancer treatment and those who have completed it is incredibly strong. There are proven emotional and psychological benefits in addition to the physical ones. The most robust evidence is for people who have completed active cancer treatment, notes Dr. Kerry Courneya from the University of Alberta, who has led a number of clinical trials of physical activity in cancer patients. What experts have long suspected has now been proven. As a cancer survivor, exercising could help you live a longer life—free from recurrence.

Essentially there are three main types of exercises that can help cancer patients get back in shape.

  1. Flexibility exercises (stretching). Virtually everyone can do flexibility exercises. Stretching is important to keep moving, to maintain mobility. If you’re not yet ready for more vigorous exercise, you should at least stay flexible.
  2. Aerobic exercise, such as brisk walking, jogging, and swimming. This kind of exercise burns calories and helps you lose weight. Aerobic exercise also builds cardiovascular fitness, which lowers the risk of heart attackstroke, and diabetes.
  3. Resistance training (lifting weights or isometric exercise), which builds muscle. Many people lose muscle, but gain fat, through cancer treatment. For those with a high fat-to-lean mass ratio, resistance training can be especially helpful.

It’s recommend that you consult with your physician or a fitness expert to learn more about which exercises are the best for you. Personally, I know that the road to fitness after cancer can be long and difficult, but it can also be extremely rewarding. Within a year after finishing my treatment, I had progressed from pushing an IV pole down a hospital corridor to completing five kilometres in the Ovarian Cancer Canada Walk of Hope!

Walking Away From Cancer

And after all the violence and double talk
There’s just a song in the trouble and the strife
You do the walk, you do the walk of life

Lyrics to a popular song

Having cancer can feel like being in prison, especially when you’re undergoing surgery, chemotherapy, or any other number of aggressive treatments. You watch your family, close friends, and everyone around you continue to live normal lives, as your own existence becomes increasingly constrained. This was my personal experience when my ovarian cancer caused me to spend seven weeks in the hospital and when I underwent five rounds of chemotherapy. I was left exhausted, miserable and temporarily unable to engage in an active or fulfilling life.

Now that I’ve achieved remission I’ve gratefully resumed doing many of the things that I took for granted before my diagnosis, most of all I appreciate the freedom of being outside and going for long walks. It’s been a relatively mild winter in southern Alberta and this weather has been perfect for maintaining my daily walking routine. I usually prefer to walk alone and in the morning, this practice seems to help me achieve the maximum emotional and psychological benefits. Of course there are particular occasions when walking with others is the best choice, I’ve proudly marched with close to 400 people in the 5 kilometre Ovarian Cancer Canada Walk of Hope. Each year this Canada-wide event raises about 2 million dollars for research, awareness and support.

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Study after study has extolled walking as a simple, inexpensive exercise with incredible health benefits. From a cancer patient’s perspective, walking regularly has been proven to strengthen the body and ease the mind. Several recent studies suggest that higher levels of physical activity are associated with a reduced risk of the cancer coming back, and longer survival after a cancer diagnosis. Here are some other recent findings regarding the advantages of exercise, specifically walking:

  • A daily one hour walk can cut your risk of obesity in half.
  • Thirty to 60 minutes of exercise most days of the week drastically lowers your risk of heart disease.
  • Logging 3500 steps a day lowers your risk of developing type 2 diabetes by 29 per cent.
  • Walking for just two hours a week can lower your risk of having a stroke by 30 per cent.
  • Walking for 30 minutes a day can reduce symptoms of depression by
    36 per cent.
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A number of experts advocate walking as a form of meditation to help relieve stress or anxiety. For instance, Jon Kabat-Zinn’s classic Full Catastrophe Living includes an entire chapter on walking meditation. Many people with chronic illnesses, including cancer, find that they enjoy walking more when they intentionally practice being aware of their breathing and of their feet and legs with every step. There are numerous ways in which walking can help you gain greater self-awareness, as I stride down a sidewalk or path I will often utilize my senses to make me more conscious of the moment. One day I might concentrate on my sense of touch and notice the wind in my hair or the warmth of the sun on my face. The next time I’m out for a walk I’ll focus on my sense of smell and how the delicious aroma of our neighbourhood bakery is apparent when you come within about half a block of the bread and pastries.

Finally, there is growing evidence that walking stimulates our creativity and though processes. We can thank Steve Jobs for the business community’s blossoming love affair with the mobile meeting. “Taking a long walk was his preferred way to have a serious conversation,” observed Walter Isaacson in his bestselling biography of Apple’s co-founder. Some studies have actually indicated a link between walking and memory. One study found that walking 40 minutes three times a week might protect the brain region associated with planning and memory. This is significant for cancer patients, since a fair number of us report issues with recall and comprehension that are related to chemotherapy or other treatments.