Today, Australia’s peak body representing health professionals who treat people with cancer, has joined 25 other cancer organisations to call for exercise to be prescribed to all cancer patients as part of routine cancer care.
"Published today in the Medical Journal of Australia, our plan is to incorporate exercise alongside surgery, chemotherapy and radiotherapy to help counteract the negative effects of cancer and its treatment."
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"Historically the advice to cancer patients was to rest and avoid activity. We now know this advice may be harmful to patients, and every person with cancer would benefit from exercise medicine.
Why prescribe exercise?
Cancer patients who exercise regularly experience fewer and less severe side effects from treatments. They also have a lower relative risk of cancer recurrence and a lower relative risk of dying from their cancer.
If the effects of exercise could be encapsulated in a pill, it would be prescribed to every cancer patient worldwide and viewed as a major breakthrough in cancer treatment. If we had a pill called exercise it would be demanded by cancer patients, prescribed by every cancer specialist, and subsidised by government." (My emphasis)
Prue Cormie is the Chair of the Exercise and Cancer Group within the Clinical Oncology Society of Australia and leads the Exercise and Sports Science Australia Cancer Special Interest Group. Full article: theconversation.com/every-c...
There is even a specific mechanism per this paper about how exercise in untreated CLL patients can reduce inflammation: healthunlocked.com/cllsuppo....
Impact of exercise on the immune system and outcomes in hematologic malignancies (from an April 2020 'Blood' publication of a literature search review, which identified 7 studies examining exercise and the immune environment in hematologic malignancies)
As HowardR article mentioned in July 2021: healthunlocked.com/cllsuppo... , with respect to research published "...in a research journal called "Cells." Duke University researchers found that regular aerobic exercise appears to make the blood plasma of CLL patients (at the watch & wait stage) less supportive of CLL cancer cells.
The researchers didn't determine why the exercise helped but they hypothesized that exercise reduces the amount of lipids (fats and oils) in the blood stream. Earlier research had found that CLL cancer cells scarf up lipids from the blood stream for use when they multiply:
"The basic premise of the study is that exercise and diet can have a positive effect on the immune systems of those who are compromised (so focused on CLL patients)."
Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how
Physical exercise is now recognised as a medicine. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where cancer is less likely to flourish. It does this in a number of ways.
Why exercise has a crucial role in cancer prevention, risk reduction and improved outcomes
I really feel that if I am not doing that much activity and not getting my adrenaline pumping, that I feel more fatigued than if I was doing something action-oriented. In other words, at least on certain occasions, I’d rather be jumping out of helicopters into jungles than sitting on my sofa watching TV!
I do totally agree with you though, I would way rather be jumping out of an airplane, SCUBA diving or flying an airplane upside down. Since my whole CLL adventure started I have experience such fatigue, someone else said it correctly in another post...like my life energy is gone I find it hard most days simply to walk a mile with my wife. I feel like I went from being an active 50 to 150 almost over night.
I'm not sure the walking helps with the fatigue...but I figure it has to be helping something. My wife and I always say to each other "we walk every day, no matter what" and mostly we do.
For those of us with crippling fatigue, "gym" and "exercise" seem like distant memories. For nearly the entire first year on my BGB-3111 clinical trial I could not walk as far as the letter box or even sweep the floor. Fifteen months later I can walk a kilometre a day (maximum). Not being able to exercise much is a real trial for anyone like me who had always walked and biked and hiked.
Ha!!! Wouldn't that be something - an exercise pill! Then everybody could just sit on the couch and let the pill do all the work. LOL Exercise is very good for you whether you have cancer or not, but especially if you have health problems of any kind. I admit I don't do all I should every day, but I try to do as much as I can and push it when I'm feeling especially good.
Thx for spreading the message! EVERY. SINGLE. CANCER. SURVIVOR. MUST. EXERCISE!! Exercise fights cancer & improves fatigue...doesn’t get clearer than that!
So true....my husband feels so much better when he is up and about.....even when he is really tired, he forces himself up.....having dogs to walk is a bonus for both of us. We walk them twice a day!
While researching why my neutrophils spiked, I came across many references to extreme exercise boosting neutrophil counts - and it was a bad thing even for athletes. But the phenomenon is more nuanced than that.
So when does exercise cross over from helping boost immune function slightly to boosting what is essentially a stress response? It varies with each person. Surely, if you are breathing hard and the muscles involved ache the next day, that was too much. Most of us are not athletes, and the ones that are surely have noticed some changes in their response.
Before diagnosis, I used to walk several miles a day. The increasing fatigue and decreasing distance was one of the symptoms I mentioned to my doctors over and over for several years. The CLL diagnosis brought anxiety and depression - and a sense of fragility. I now had a reasonable explanation for the fatigue. But maybe I reduced my exercise too much in general. There's also the question about how we should change behavior with an acute (sudden) infection vs. with chronic infection. In any case, I noticed myself becoming frail - I'm only 63.
So "easy does it" is my motto. I tend to do too much exercise when I'm feeling good - setting myself up for a valley in the following days. I try to establish some minimum exercises. I've mentioned elsewhere that sit-to-stand (repeated rising from chair) is the single best exercise I've found for making myself feel less frail. Who likes to totter? If you seldom do it, try doing it only twice on one day, and meditate upon its effects. Gradually increase the number of times a day that you do it, more than how many repetitions at one session.
Sure, if rising from a chair makes the blood rush from your brain, don't do it too quickly, and do it slowly while holding onto something, and with some there to assist you. If you've just had an infusion, a bout with diarrhea, or a high fever, don't do anything too aggressively. Just getting up at all may be an accomplishment - but do try.
I had gotten up to doing 30 sit-to-stands within several minutes last winter. But then I had laparoscopic gall bladder surgery in January, I took a week off. It took almost 2 days for the anesthetic effects to completely leave. Getting out of bed was an olympic event. I had to transition from being mostly horizontal all the time to sitting most of the time. It's harder than some people might think!
I could do one or two sit-to-stands a week later, but I wobbled a lot. I'm only up to about 10 now - 4 months later - though a chronic upper respiratory infection reduces it to 5 some days when I have a fever. What's stressful one day, may not be stressful the next.
Above all, discuss your exercise plan with your doctors. Most of them will be glad you're even trying. The the medical community has not really caught up with the science and practice of exercise for chronic illness, much less CLL. But some exercise is almost always a good thing.
Not CLL related, but of interest with regard to "age" fitness for FCR and a better life expectancy measure -
Exercise performance, not your age, is the best guide to how long you’re going to live
"Performance on a treadmill stress test, used to calculate your “physiological” age, is a better predictor of longevity than your actual chronological age."
I would agree 100% with the thoughts behind this video..
In Sweden and the Japan the doctors already will prescribe a ‘ Dose of nature ‘…
In Japan this is a day or two in the forest.
The Americans have woken up to this prescription and America is also one place where prescription drugs are advertised on the television. Thus a group made this advert for television which has won numerous awards.
Copied below from various news releases..
This Is the Best Drug Commercial You'll Ever See
Nature RX is a grassroots movement dedicated to entertaining and informing people about the humorous and healing aspects of getting outdoors. Nature RX, Part 1 is the first video in a three-part series that aims to bring awareness to research showing that spending more time in nature improves your health, wellbeing and leads to making better environmental descisions.
Set in the world of a spoofed prescription drug commercial, Nature Rx offers a hearty dose of laughs and the outdoors - two timeless prescriptions for whatever ails you.
Side effects may include confidence, authenticity, remembering you have a body, and being in a good mood for no apparent reason.
We loved Nature RX, Part 1, a spoof drug commercial that touted the legitimate health benefits of getting outside, when it came out earlier this year. And we're just as excited about the second installment in the series, Nature RX Part 2: Discover Your Dose of Nature. Nature RX is a grassroots movement dedicated to entertaining and informing people about the humorous and healing aspects of nature.
Neil. I couldn’t agree more. One of my favorite sayings is “motion is lotion”. That more applies to maintaining healthy bones, joints, muscles and tendons; however it is also true for overall well being. Exercise helps to rid our bodies of toxins and increases the performance of all our bodily functions and organs. In addition and perhaps the most significant is how it helps our mental attitude. I am sure you know this even better than me. For anyone reading this post please heed this advice.
This article by Dr Joshua Chu-Tan explains more of how exercise affects the body beyond the exercised muscles, in this case our brain and eye health, through chemical messages that get delivered to the rest of the body.
Does exercise hold the key to a therapy for the ageing brain?
One vital piece of cancer survivorship care is keeping active
"Cancer and its various treatments can strain the body to the point that participation in fitness activities and exercise is often drastically decreased, reducing the survivor’s level of physical fitness and adding to their medical problems.
Because of this decline in fitness levels, also known as deconditioning, remaining physically active is a key component of all phases of cancer survivorship."
While the article is more specific to solid and acute cancers, the following snips relate to us:-
Evidence from the literature has shown numerous benefits that cancer survivors can accrue from participation in even a light- to moderate-intensity exercise program.
A meta-analysis conducted by Khosravi and colleagues showed that exercise training reduces pro-inflammatory markers — which are thought to support a pro-cancer environment — in cancer survivors, especially among prostate and breast cancer survivors.
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Another study from McCrary and colleagues showed evidence of rehabilitation potential from participation in multimodal exercise among patients with persistent chemotherapy-induced peripheral neuropathy.
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Engaging in physical activity is important in the aftermath of receiving a cancer diagnosis, while receiving treatment and throughout survivorship, but there is also an opportunity to mitigate any deconditioning or intervention-related physical decline.
“One of the most underappreciated opportunities to improve fitness is prior to surgery,” Silver said. “Many cancer survivors are getting second opinions and there are built-in delays such as getting biopsies and staging, in which someone has the time to improve their fitness prior to surgery, and that is called prehabilitation.”
This is one of several areas where holistic/integrated care would benefit us.
Thank you for pushing this back to the top, I looked at healthunlocked.com/cllsuppo... and found this article was interesting and gets rid of the excuse my mind was creating that perhaps since stress is bad for us then adding more stress from exercise wouldn't be good...wrong. elifesciences.org/articles/...
Again with my emphasis:- “Most of us find healthy eating and exercise advice more difficult to stick to, but the evidence shows these kinds of changes can be beneficial. Trials with supplements just haven’t shown the same benefits,” Rana E. Conway, BSc (Hons), PhD, RNutr, research fellow in the obesity group at the research department of behavioral science and health at University College London, told Healio. “There is no evidence that self-prescribed supplements reduce the risks of cancer coming back, and they could interfere with treatment.”
Also from Healio News:- "Muscle mass appeared significantly associated with survival outcomes among patients with advanced cancer undergoing an unscheduled hospitalization, according to a study published in Journal of the National Comprehensive Cancer Network.
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The researchers reported a significant correlation of higher muscle mass with improved survival (HR = 0.97; P < .001). In addition, higher muscle radiodensity appeared significantly associated with lower symptom burden as measured by the Edmonton Symptom Assessment System (ESAS) for physical symptoms (B, 0.17; P = .016) and total symptoms (B, 0.29; P = .002) and PHQ-4 for depression (B, 0.03; P = .006) and anxiety (B, 0.03; P = .008). Higher muscle radiodensity also appeared associated with shorter hospital length of stay (B, 0.07; P =.005) reduced risk for readmission or death in 90 days (OR = 0.97. P < .001) and improved survival (HR = 0.97; P = .001)."
The reality is that walking 10,000 steps a day is a laudable goal and is almost certainly beneficial. But even lower levels of physical activity have benefits. The trick is not so much to aim for some theoretical ideal but to improve upon your current baseline. Encouraging patients to get into the habit of taking a daily walk (be it in the morning, during lunchtime, or in the evening) is going to pay dividends regardless of their daily step count. The point is that when it comes to physical activity, the greatest benefit seems to be when we go from doing nothing to doing something.
I like the summary of the article that says "when it comes to physical activity, the greatest benefit seems to be when we go from doing nothing to doing something."
Many people with CLL are older folk with other health problems, so walking 10,000 steps a day is an impossible goal.
However, it's great to know that even low levels of physical activity can make a big difference to our overall health and well-being.
More on the subject of exercise, here's a short video from Prof Janet Lord, Birmingham University, UK. I posted it on the forum two years ago, but was reminded of it today.
I like this woman. I like her down-to-earth way of talking. She gives some very simple, practical suggestions for improving our immune systems. No fancy equipment, no drugs, just simple exercises/activities that we can do in our own homes.
Paula
P.S. Janet Lord does still recommend aiming for 10,000 steps a day, but I'm totally in agreement with everything else she says!
Another reason to regularly take your 'exercise pill'. From a University of Sydney, New South Wales study, Any activity is better for your heart than sitting - even sleeping
Cardiovascular disease, which refers to all diseases of the heart and circulation, is the number one cause of mortality globally.
Replacing sitting with as little as a few minutes of moderate exercise a day tangibly improves heart health, according to new research from the University of Sydney and UCL.
Professor Emmanuel Stamatakis, ProPASS consortium founder and joint senior author of the study from University of Sydney’s Charles Perkins Centre, added: “What is important to highlight about these findings is that replacing static or sedentary postures with movement is likely to improve heart health only if it becomes a long-term habit.”
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“Getting active isn’t always easy, and it’s important to make changes that you can stick to in the long-term and that you enjoy – anything that gets your heart rate up can help. Incorporating ‘activity snacks’ such as walking while taking phone calls, or setting an alarm to get up and do some star jumps every hour is a great way to start building activity into your day, to get you in the habit of living a healthy, active lifestyle.”
CLLerinOz brought this research study report to my attention.
Regular moderate to vigorous physical activity predicts larger brain size in key regions, including gray and white matter and the hippocampus, new data suggest
Of note, this research is consistent with research highlighted in this post of mine back in 2016; Brains of elderly people who exercise look 10 years younger
Exercise is my medicine and lifestyle elixir of life. I also use it to manage CLL fatigue. I feel more shit if I rest and don’t do anything than if I push myself out the door anyway even if I feel shit. 100% true fact proven over time - it’s better for me.
When I was diagnosed with breast cancer late this year I absorbed enough info as I could about what to expect with treatment and devised an exercise plan that would be sensible around that, but sensibly less than normal for me.
The day I came home from surgery I headed out for a walk and continued this until I felt well enough to go into the gym (I was off the bike for 6 weeks) and gradually increased activity tolerance. By the time I started radiation treatment I was feeling quite good.
I had to travel to receive the treatment but exercised nearly every day throughout and after completion. Then I dipped at several points with debilitating fatigue (forewarned) but did ‘something’ rather than nothing during those times.
I’m now 6 weeks post radiation treatment and getting my stamina back, finally. I was out riding for 3 hours today.
People would see me out in the forest and say it was good to see me out riding. I would reply. “ I feel shit. If I don’t do something though, I feel more shit. So I’d rather be doing something I really enjoy even if it’s tough going. I feel better for it.”
I’ve been healthy and active with a good diet for most my life.
Still got 2 cancers 😎
Exercise helps me manage life and is a big priority for me. ❤️
Thanks for compiling this information, I'm so grateful for all the work that you do for us.
With fatigue I find that Qi Gong is excellent, whilst very gentle, the movements especially of the arms seem to help the lymph node swelling in my neck, and it lifts my energy and spirits
I walk between 6 and 10 miles every day (I'm retired).....Apart from the physical exercise, it's really relaxing, and good for my mind.
This may sound a bit crazy, but I saw a bottle of cider vinegar......I noticed the sediment at the bottom of the bottle, and it made me think that, like the bottle, I need a good shake (exercise) to get my chemicals back in order......
I told you it sounds a bit crazy......but it works for me.
Although I’m dealing with this uncomfortable pressure and bloating in the stomach with the spleen enlarged, I feel best in the morning. It is the brisk 2 1/2 miles morning walks that keep me feeling mentally strong and somewhat physically strong. I’d be a hot mess otherwise!
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Leukaemia Care Updated Patient Information - Richter's Syndrome in Chronic Lymphocytic Leukaemia 
