Be Fit or Be Fatigued!Exercise to boost cancer survival

Written by Dr. Keith I. Block, MD

If you have or have had cancer, you’re likely aware that doctors generally advise patients to rest and cut down, or even cut out, any physical activity.  This is a bad idea.  In fact, a very bad idea!  If you do have cancer, and particularly if you are in treatment, you may in fact be fatigued and tired and hearing advice to rest and forget fitness may sound great.  But beware!  This is definitely not the time to become a couch-tomato!  Ok, ok, couch-potato.  Because increasing your activity and committing to a fitness routine can actually counter fatigue.  And the fact is, you are better off with more, rather than less, activity!

Over the past decade, evidence has been mounting that exercise can reap major therapeutic dividends for people with cancer.  Rather than depleting your body, an individualized, carefully monitored aerobic exercise and muscle workout regimen can result in better energy levels and improved treatment tolerance, as well as a better overall quality of life.  And the best news of all is that exercise may actually improve your chances of surviving cancer!

In the 2011 issue of Recent Results in Cancer Research, epidemiology professor Kathryn Schmitz of the University of Pennsylvania School of Medicine reviewed the evidence to date and concluded that exercise does confer a significant benefit in terms of overall survival.  In one study of female colon cancer patients – reported in the August 2006 issue of the Journal of Clinical Oncology – increasing physical activity by 6 hrs/week cut mortality by 61%!  In addition, 6-9 hours of walking cut recurrence by more than 50%!  A study of breast cancer patients, reported in the same issue of the Journal of Clinical Oncology, showed that walking 3 to 5 hrs/week cut breast cancer mortality in half!  The link between exercise and improved survival of breast cancer patients could well be related to favorable changes in estrogen and insulin levels, as well as better weight control (which in turn lowers the risk of breast tumor recurrence and disease progression).  Moreover, several studies have shown that both diet and exercise may help curb insulin levels, oxidative DNA damage, and the rates of tumor proliferation – all factors linked with cancer progression and reduced survival, as reported in the 24 November 2010 issue of Acta Oncologica.

As most of you likely know, muscle atrophy and blood circulation worsens with lack of movement.  The longer such limitation persists, the greater the decline in muscle.  This is true for all of us.  But for cancer patients, the disease itself can have a detrimental impact on muscle; in some cases an advanced cancer can waste muscle by over 80% of the body’s previously existing muscle mass!  By shifting the body’s metabolism in the catabolic or “breakdown” direction, cancer actually amplifies the muscle-degrading effects of inactivity.  This in turn can lead to immune dysfunction, as the muscles are a major reservoir for the amino acid glutamine, which serves as a key fuel for the immune system.

Finally, a vital balance exists between rest and activity.  Drs. Marie-Christine Mormont and Francois Levi of Paris University in Villejuif, France, have carefully monitored the sleep-activity rhythms of people with cancer.  They observed that patients with the most abnormal sleep-activity rhythms were five times more likely to die within two years of their diagnosis of metastatic colorectal cancer.  A second study showed that, among metastatic colorectal cancer patients with more normal sleep-activity rhythms, treatment responses improved and the five-year survival rates were up to 50% higher than those of patients with abnormal rhythms!

Attending to this concern, at the Block Center we first evaluate each patient's sleep and activity cycles.  Not simply the time and quality of sleep, but the impact on activity cycles as well.  Once assessed, we train and condition each of our patients in order to re-establish healthy rhythms and optimize their biological clock.  In addition, we perform a detailed fitness assessment on all of our patients - even those that are bed-ridden!  Each receives a fitness regimen that has been tailored to their individual needs.  For building and maintaining muscle, I recommend resistance training through gentle workouts with low weights, stretch bands, pilates or slow weight-bearing exercise, all intended to help build and maintain muscle tone, strength and breath.  Balancing this resistance training with aerobic workouts is essential, but, once again, tailored to each patient's personal needs and condition.  Qigong and Tai Chi are slow, graceful, mindful exercises that nicely fill the need for flexibility while providing a centering and internal balance.  Just as important, though, are nutritional-pharmacologic strategies to control cachexia, the chronic low-grade inflammatory process that tends to keep your muscles in breakdown mode (see the blog posted on 12/16/10, “Overcoming cancer cachexia”).  In short, think fit!  Whether food, sleep, or exercise, a body in balance with adequate rest and focused fitness is a body best equipped to heal!

For more information on The Block Center for Integrative Cancer Treatment, visit BlockMD.com.

Comments

[Nancy Opgaard]

I think it's fantastic that this kind of information is finally more available to more people. Understanding why something works is so important in helping people incorporate things into their lives, making it part of their lifestyle. Thank you for all the good work you are doing!

[deb]

Could you explain or elaborate a little on what ''sleep-activity rhythms'' means, and what's normal vs. abnormal?

Thanks... I'm kind of confused about it and don't want to just make assumptions!

[Air Jordan 13]

There are 4 steps to happiness: 1 you 2 me 3 our hearts 4 together

[Carol]

Wonderful post! I think that exercise will not only boost cancer survival but itself will keep cancer patients from being depressed and in totality will keep not only keep them fit physically but mentally as well.

[Wayne]

I've long believed that a strong body and mind are essential to improve the bodies resistance to, and recovery from, diseases such a cancer. And that regular exercise is a great way to achieve this. You don't have to be a fanatic - 30 minutes, 3 - 4 times a day can be enough.
If you have already established a habit of regular exercise, then getting back into that habit as soon as possible during recovery can only be good, both mentally and physically.