Physical Activity and Cancer: Why You Should Move More
The many health benefits of exercise are well noted. Physical activity helps you maintain a healthy weight, lowers the risk of chronic disease, and boosts mood. But should exercise be a priority when you’re getting cancer treatments? Especially if side effects wipe you out?
“Yes. It might seem like exercise is just one more thing that will drain your energy,” says Lynn Gray-Meltzer, PT, DPT. “But research and clinical experience show that starting or maintaining an exercise program while getting cancer treatments can ease side effects and improve stamina, as long as your approach is gradual and progressive.”
Dr. Gray-Meltzer has worked closely with the Lifestyle Medicine Program at Mass General Cancer Center, where she served as site principal investigator for the group exercise study for breast cancer survivors.
In this article, Dr. Gray-Meltzer and Steve Wechsler, PT, DPT, PhD, who conducts breast cancer research at Massachusetts General Hospital, share their insights on the benefits of exercise during cancer treatment.
The benefits of exercise when you have cancer
Numerous studies indicate that being physically active during and after cancer treatment can:
- Give you more energy and lessen feelings of fatigue
- Improve survival rates from certain types of cancer
- Lower the risk of certain cancers coming back (cancer recurrence)
- Make it easier to complete daily activities and enjoy life more
- Help you feel less anxious, depressed, and stressed
- Reduce symptoms of lymphedema (swelling)
Plus, being sedentary may make it harder to bounce back when cancer treatments end.
“If you have lost significant strength and flexibility, then suddenly resume strenuous activities, you may overdo it and end up with shoulder pain, back pain, shin splints, and other injuries that make you sedentary again,” Dr. Gray-Meltzer explains. “Exercising throughout treatments helps prevent a steep decline in physical health.”
What counts as exercise?
The Centers for Disease Control and Prevention (CDC) recommends adults get at least 150 minutes of moderate-intensity physical activity and two sessions of strength training for all the major muscle groups every week. Those recommendations don’t change even when you have a chronic illness like cancer. In fact, guidelines from the American Cancer Society advise aiming for up to 300 minutes of moderate physical activity each week.
That number might sound overwhelming, especially if you were inactive before a cancer diagnosis, or you’re struggling with treatment side effects. The good news is that you can gradually build toward your exercise goal.
“Some movement is better than no movement,” says Dr. Wechsler. When you’re managing cancer, the consensus is to “start low and go slow.”
“Focus on doing something active each day and build on that progress,” says Dr. Wechsler. “It’s okay to do light stretches on the days that you’re struggling. This activity counts toward your exercise goals.”
Exercising when you have cancer
Dr. Gray-Meltzer and Dr. Wechsler collaborated with other experts, including Amy Comander, MD, a Mass General Cancer Center oncologist and director of the Lifestyle Medicine Program, on a study investigating barriers to group exercise programs for breast cancer survivors.
A few things everyone agrees on: Some movement is better than no movement, and it’s best to “start low and go slow.” This means starting with low-intensity activity, doing something active each day, and gradually building on that progress with strength training.
Activity pacing is a strategy for managing activity level and fatigue. On a day where you don’t feel well, you can do light stretching or walk around the block once in the morning and again in the afternoon. When you feel better, you can do the laundry and part of your strength training program. “It all counts towards your exercise goals,” says Dr. Gray-Meltzer.
You don’t need a gym membership to be physically active. Drs. Gray-Meltzer and Wechsler offer these tips for improving physical activity, strength, and balance from the comfort of home.
Physical activity
When you’re in the throes of cancer treatments, exercise can look a little different. “Your focus should be on building the stamina to do daily functional activities like going upstairs to your bedroom or grocery shopping,” says Dr. Gray-Meltzer.
Instead of doing 30 minutes of activity in one setting, Dr. Wechsler recommends ‘snacktivities’ or activity snacks. “You do a few minutes of small, but frequent physical activity throughout the day,” he says.
Walking and climbing stairs are two good exercises to start with. Here again, the advice to “go low and slow” applies. For instance, you might set a goal to walk to your mailbox every day for a week. The next week, try to make it down the block, and so on. You can gradually increase how far, fast, or long you walk. Don’t forget to count activities like gardening, house cleaning, and shopping.
Strength training
Strength training helps combat the loss of muscle that naturally occurs as you age. Strong muscles protect joints and bones, lower your risk of falls, and give you more stamina to do daily activities. Muscle also burns more calories than fat, which can help you achieve and maintain a healthy weight.
If you’re getting started, begin with a lower weight and fewer repetitions (the number of times you perform an exercise) and sets (how many times you perform the exercise with a short break in between). Then slowly increase the weight, reps, or sets as you feel stronger. The goal is to work every major muscle group at least twice a week.
If you don’t own dumbbells, you can use:
- Your body weight to do standing toe raises, squats, push-ups, chair stands (standing from a seated position)
- Household items like a can of soup or filled water bottle (each weighs about 1 pound) to do bicep curls, triceps kickbacks, overhead lifts, and other arm-strengthening exercises
- Resistance bands to perform upper and lower body exercises
Balance exercises
The CDC also recommends weekly balance activities for adults 65 and older who are more at risk for falls and fractures. But cancer and cancer treatments can cause you to feel dizzy and off-balance, increasing fall risk. Some people develop numbness, tingling, and pain (neuropathy) in their feet and legs. Plus, certain cancer treatments can cause bone loss (osteoporosis), increasing your risk of fractures if you fall.
Strengthening the muscles in your back and stomach (core muscles), legs, and arms improves balance. But you should also include balance-specific activities, such as:
- Balancing on one foot with your back close to a counter in case you lose your balance
- Walking heel-to-toe or walking backwards near a sturdy surface at first in case you need support
- Yoga or tai chi
Exercise as lifestyle medicine
Exercise is one part of lifestyle medicine in cancer care, which also includes nutrition, sleep, stress management, and mental health. “The parts interconnect,” says Dr. Wechsler. “Exercise helps you sleep better, so you feel rested and have more energy to be active. A healthy diet gives you energy to exercise. And exercise reduces stress levels, as well as depression and anxiety.”
If you’re not sure how to get started, talk to your primary care provider or oncologist. A physical therapist or exercise physiologist with experience helping people with cancer can help create a safe, effective exercise program.
You can also check out these Mass General Cancer Center YouTube videos: