Why physical activity should be added to cancer treatment plans

Why physical activity should be added to cancer treatment plans

While specifically about localised cancers, the article below discusses current research examining whether being physically active reduces the chance of cancer coming back and says that early results suggest the benefits of exercise for those with localised cancer may be similar to the benefits from chemotherapy:

theconversation.com/why-exe...

Note the final sentence:

"While research is ongoing, there is enough evidence to show that physical activity is an important part of maintaining good health whether it’s to reduce the risk of cancer, help prevent it returning, or to help people feel better and happier during their remaining lifetime."

I reckon regular exercise slowed my CLL progression (which resulted in a shocked stage IV diagnosis) and I note Chris (CLLCanada) credits exercise with delaying his need for chemotherapy.

Neil

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  • Exercise.. I have proved to my satisfaction that this has huge benefits combating my CLL.

    What I first noticed with my oncologist in Switzerland was that the white blood cell counts would rise in winter and then lower in the summer. We both agreed this could be due to my extensive hiking in the mountains during summer, and so I started a winter exercise regime.

    Since then I have been regularly exercising with both hiking and cycling year round, and my lymphocyte counts are almost stable with only modest increases.

    Of course this is not true science with a double blind testing schedule, but if you look at the MD Anderson and Mayo Clinic websites there are research papers which strongly support the benefits of exercise. Also the ACOR pages have many reports from others with CLL who have benefited from exercise.

    Even my kind of simple thinking says that the human Homo sapiens body did not evolve, nor was it designed, for sitting in front of a television eating copious amounts of fat and carbohydrates.!

    So I STRONGLY advise anyone with CLL to get out and do some exercise, even small amounts help, and over time the exercise does get easier and easier.

    Dick

  • I came across some references regarding the benefits of exercise for those with cancer.

    These are not links, but you can copy and paste into Google to obtain them.

    REFERENCES

    1.Lemanne D, Cassileth B, Gubili J. The role of physical activity in cancer prevention, treatment, recovery, and survivorship. Oncology (Williston Park) 2013; 27(6):580-5.

    2.Schmitz KH, Troxel AB, Cheville A, et al. Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials 2009; 30(3):233-45.

    3.Schmitz KH, Ahmed RL, Troxel AB, et al. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA 2010; 304(24):2699-705.

    4.Chang CJ, Cormier JN. Lymphedema interventions: exercise, surgery, and compression devices. Semin Oncol Nurs 2013; 29(1):28-40.

    5.Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012; 11:CD006145.

    6.Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010; 42(7):1409-26.

    SEE also botf.ca/

  • I am glad to hear this, I was Diagnosed 9 months ago but blood tests showed signs as far back as 2009. I was sceptical at first about exercise but have felt much better and alert since starting a daily simple walking regime, only to the local shops so far but its a start, I have also just signed up s a candidate for UKIP so I will be door knocking in a few weeks time so that should help my regime improve and I will meet a lot of new people instead of hibernating.

  • I have been physically active all my life and since diagnosis have completed 2 more Great South Runs (10 mile road run around historic Portsmouth, for Leukaemia and Lymphoma Research). The sense of well being and the effect of de-stressing that exercise brings is, for me, unrivaled.

  • Exercise is good for lots of reasons: I was active both before and after diagnosis

    However, I do find that cardio exercise is now very difficult - even after a short run I am out of breath and wheezing....I have to disguise this when playing footie with the kids. So I have had to ditch cardio-based forms.

    I still swim, play golf (but puff and need rest after climbing a hill to the green) and cycle (steadily).

    But gym-based running / cross trainer has had to go and even rowing is much harder.

    Anyone else with this experience and (even better) overcoming it?!

  • I very much agree with Aussie Neil. Like Mikey I have been active for most of my life and still run 20 to 25 miles a week. Shortly after being diagnosed in 2006 I ran the London marathon for Leukaemia Care and to celebrate being 70 have entered the Birmingham half marathon in October running for Cure Leukaemia. I am sure my physical exercise has had a huge effect on the progress of my condition although my consultant keeps saying 'dont over do it!'

    I have to say I feel I am very blessed being able to run as much as I do and sometimes feel guilty about mentioning it when I know there are so many others not so fortunate.

  • Regular walking twice a day (8kms total) and a low glycemic index diet, reversed my absolute lymphocyte count (ALC) from a high of 136k to 42k. It stayed at that for 3 years... a regression of CLL.

    I also lost 54kgs in weight...

    My improved health made my subsequent 12 rounds of chemo immunotherapy in a year, very easy to handle...

  • Good to know, thanks for posting.

  • Thanks for bring this is issue up. I have been active most of my life and spent about 10 years competing at the level of an Olympic caliber athlete. In 2006 I began to notice a drop in my level of energy. This decline continued for several years and 2009 after three years of feeling very tired and having increasingly less energy I saw a doctor at age 50 and the only problem that was discovered was CLL stage 0.

    I have always enjoyed exercise and mostly still do, but over the past two years I have been finding that I am taking increasingly longer to recover from bouts of moderate to intense exercise. So while I still enjoy being active, mostly playing ball hockey and cycling, I dread the after effects that can often involve increased lethargy and tiredness that can often lasts at least 36 hours and sometimes longer. One of the friends I go cycling with is 15 years older than I am and he has no complaints about tiredness or length of recovery after a ride. He only complains about how much slower he rides these days compared with ten years ago. He doesn’t have CLL.

    I have looked for links between my level of exercise and my white counts. As far as I can tell there is no relationship. I think the effect of exercise on health like many other aspects of health is not as well understood as many people like to believe. We CLL patients are frequently being told by CLL experts that the course of CLL is very individual that we must be careful not to use research based on populations to make predictions or other statements about individual cases. If this is true of CLL research, I think it is reasonable to conclude that this is also true of research about exercise. There is variability in the ways people respond to exercise. Exercise will be very beneficial (mentally and/or physically) for some and perhaps have little or even no benefit for others and it seems to me there is no way to accurately predict exactly who these individuals are. As write this I am reminded of one fellow CLLer who gave up exercise to improve his overall level of energy.

    I would like to see this gap in knowledge closed in a way that would make it possible to accurately weight the cost/benefit ratio of exercise for individual cases especially for CLL patients. I often feel so lousy several hours after exercising that I can’t imagine how it is possible that exercise is a net gain for me. I wonder if my current experience with exercise is similar to that of someone who enjoys the feelings of relaxation and euphoria that comes with drinking alcohol but dreads the hangover they will face the following morning.

    Finally, while I am nota physiologist I do know that exercise impacts the compositions of our blood and the production of cytokines. CLL also impacts cytokine levels in our blood and Dr. Hamblin has speculated cytokine secretion of CLL cells may explain the fatigue reported by many CLL patients. Could exercise compound this effect? This is something researchers should investigate sooner rather later. It could provide better insight into a quality of life issue many CLL patients confront day-to-day. Could I be better off reducing my exercise habit? How much is enough? How much is too much?

  • You've raised some interesting points placebo_09.

    I would certainly welcome any warning signs of when I'm about to set myself up for a day or more of lethargy from overdoing exercise. Having been very fit prior to CLL dramatically impacting my health and fitness, it took me far longer to recover my fitness after a CMV infection because exercise became a 'one step forward, two steps back' process. I'd feel good while walking or cycling and thus found it very easy to overdo it, then lose any fitness gains I'd made because I was too fatigued to do much of anything for the next few days. I had to slowly learn to pace myself. I also found that after any moderate to intense exercise, I'd get really bad nausea spells that would last half an hour or more - again with no warning.

    I doubt there is an easy way to know what your exercise tolerance is and suspect that Dr Hamblin could be right about the cytokine involvement, perhaps with fatigue also influenced by our changed ability to fight off infections - i.e. our bodies have to work harder to prevent infections from taking hold and also to get on top of them once they have. We also know that neutrophils are released into the blood stream by vigorous exercise - presumably the body's defence mechanism to assist with repairing muscle tissue along with any wounds or bruising that is at a higher risk of occurring.

    Chris mentioned his personal experience of how improved fitness helped him get through chemotherapy easily and there is good evidence that improved fitness certainly helps us cope better with chemotherapy and subsequent recovery. This makes sense to me; if your cardiovascular system is fitter, then your body can better neutralise and eliminate the chemo cocktail from your body, lessening the opportunity for additional damage to healthy cells.

    But yes, there is so much we still don't know,

    Neil

  • I think I should clarify...I see exercise in my case as a engine for weight loss. I lost a large amount of weight and over a number of years improved my overall health through exercise and diet. My doctors speculate that weight loss perhaps reduced an inflammatory situation or over active immune responses, which in turn reduced my absolute lymphocyte count (ALC). Nobody knows for certain.

    After a number of months of an inability to walk, due to some nasty treatment side effects, and/or DLBC lymphoma in my spine, I now force myself everyday to shuffle down the block with a cane for support. Each day I'm able to go a bit further... small victories.

    Getting out again and getting moving, has had a very positive effect on my appetite, sleep and general senses of well being.

    I'm one case and we are all different...but when I wasn't able to walk, it was the one thing I missed the most...

    ~chris

  • Just received a newsletter from the CLL Global Research Foundation which opens with an article on the treatment options for older patients. They state in this article "By definition, most studies consider 65 and older as elderly. We do not believe this definition to be true for most patients, and other elements such as fitness status and presence of other serious medical conditions need to be considered."

    Note the specific mention of "fitness status".

    The newsletter then goes on to state regarding the German CLL8 study that "Their group and others have shown that older patients who are in excellent condition with limited other medical conditions can be treated with fludarabine based regimens, such as fludarabine, cyclophosphamide and rituximab which is the standard of care regimen for younger patients."

    "Use it or lose it."

    Neil

  • Just done a walk on Derbyshire -not exactly flat! Was struggling to get to the top of a big hill and pushed myself to my limit. The group I was with thought I couldn't do hills! But the view from the top was worth it mind over matter is an essential with cll

  • In an attempt not to spook CLL'ers who have pre-existing physical limitations and co-morbidities that prevent them from formal exercise, I'm always more comfortable hearing this termed as 'physical activity'. I noticed that the research moves between these two expressions when in fact they possibly mean different things to people.

    Whenever exercise is mentioned, I hear about fellow members cycling, hiking, skiing, running marathons and extensive gym work-outs and it makes me worried that my physical inability to engage in these kind of formal exercises might reduce my chances!

    And that's a bit scary!

    I had hoped to take up the non weight bearing activity of swimming but read on here recently of the dangers of contaminated water and dodgy changing rooms for the immuno-compromised! Nevertheless I think I'm going to have to risk that in the warmer weather.

    So to me the importance is 'keeping active' and if that means something like retail therapy which forces me to walk longer distances round the shops then so be it! :-)

    It's simply about moving as much as is physically possible within our limitations and I think walking is excellent for those who can manage it. If not, chair exercises or simply keeping the limbs moving.

    One of the questions I have concerns using vibrating exercise plates. I use one for circulation but have had to curtail it for a while with a spinal problem but I wondered if anyone had heard of benefits for our condition of using these plates?

    Newdawn x

  • Can't help you with the physical activity plates Newdawn, [ :) ] but I fully agree with you about the negative perception associated with the no pain, no gain philosophy and/or the supposed need for structured exercise to gain any benefit. It is encouraging to see more and more papers coming out lately, reporting that any additional physical activity provides benefits. Even the supposedly greater benefits from more strenuous activity are now being questioned, I just read recently about a study that showed that the same benefits could be gained by gentle activity - it just took longer to achieve those benefits. So if you are no longer able to sprint, there's no need to despair. Just go for a longer walk.

    I think a lot of this (historical) thinking comes about because much of the research into the benefits of physical activity has been aimed at finding ways to maximise the performance improvement for professional athlete training. Also quantifying additional effort is easier and more accurately assessed by measuring elevated respiration/heart rate over the short period of time when the athletes are being monitored during training compared to the more intrusive, less accurate alternative of trying to measure changes in overall physical activity throughout the day over a few months.

    What do those papers you cited say about this Dick?

    Neil

    PS Newdawn, you've convinced me to change the title of my post.

  • I completely agree with New Dawn re talking about "physical activity" rather than exercise. Glad you changed the title, Neil.

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