If you follow my FB page (Yoga with Leona), you saw that I recently posted an awesome interview that Dr Leslie Waltke (of The Recovery Room) did with Dr Kathryn Schmitz on the importance of exercise in cancer survivorship. If you haven’t had a chance to watch it, please do (https://www.facebook.com/lesliewaltkept/videos/386294369484336). They are both brilliant and dynamic leaders in their fields, each working for many years in different aspects of exercise in cancer. Dr Waltke is a physical therapist with many years specializing in cancer rehabilitation, and creator of the best practices in cancer physical therapy, and teaches physical therapists and other medical specialists from around the world how to best work with cancer survivors. Dr Schmitz is an exercise physiologist, a leading researcher in exercise oncology, has directed many of the important scientific studies looking at the benefits of exercise in cancer prevention and cancer survivorship, and co-developed the guidelines that we now use to recommend exercise in cancer. So these 2 are powerhouses! And their experience and work are so beautifully complementary to one another.
Exercise seems so simple that it is hard to believe that it is as powerful as it is. The benefits of exercise in cancer survivors are truly staggering. Not only does exercise help us feel better (improving fatigue, overall quality of life, sleep, lymphedema, physical function, depression and anxiety), but it also has been proven to reduce the chance of our breast cancer coming back AND to reduce the chance of us dying from breast cancer (for those who meet the recommended 150 minutes per week of moderate intensity exercise vs those who do not exercise)! Read that again. And those reductions in risk of recurrence and death are not small. Different studies report slightly different numbers, but the reductions are generally in the range of 40-60%! That is a huge difference, and is as much or even more than the benefit associated with some of our traditional treatments. I’ll write another blog about the proposed mechanisms by which exercise has these amazing benefits (otherwise you’d be here all day reading just this one!).
As I always say, we can’t control everything that happens in our cancer journey. And it is really important to learn to let go of our need for control so that we can establish some peace. However, there are some things that we can control. And how we move our bodies is one of them. No matter where we are in our cancer journey, we can work on moving our bodies, and try to strive for that goal of 150-300 minutes of moderate intensity exercise per week. If you do more vigorous forms of exercise as well, the minutes required are lower. How do you define “moderate intensity”? They give a perfect and simple guide in the video, which is that moderate intensity is any exercise that gets you working hard enough that you can still talk, but you couldn’t sing or speak in long, complicated sentences. In other words, your body should be taxed enough that it affects your breath, but not so much that you can’t really talk at all (that would be moving into the “vigorous” realm). So whether that means brisk walking, dancing, tennis, or vigorous yoga, get those minutes in!
Importantly, Dr Waltke and Dr Schmitz talk about the fact that what is moderate intensity for one person might not be moderate intensity for another, so we all need to evaluate the level of our exercise for our specific situation. AND, moderate intensity may look very different even for the same individual, at different times through their treatment. For example, the week of your chemotherapy, just getting up and walking to the mailbox or doing a load of laundry may constitute moderate intensity, while 2 weeks later when you have recovered a bit, you might need to walk all the way around the block one or a few times to get into that moderate range. So it is important to know that this will be a moving target, and that is ok. Also know that sometimes you may need to exercise in shorter periods, for example just 5-10 minutes several times per day, rather than 30-60 minutes all at once. This is a place where yoga philosophy and training ourselves to really tune in to our bodies, to study ourselves, to be flexible and compassionate with ourselves, and to use our energy rightly is so important. We can’t be so attached to some specific exercise goal (ie I must walk 2 miles 3 times a week or whatever) that we wind up hurting ourselves, and taking steps backward. So really listen to your body, adjust as needed, and just do your best. Learn to push on days when you feel up to it, and to back off on days when you need to. Eventually you will build strength and the exercise will get easier and easier for you. You will feel empowered, and you will also be much more in tune with yourself and your health.
Another very interesting challenge that they discuss is what to do for the person who really doesn’t like to exercise. First, they encourage us to explore lots of different types of exercise. There really are so many things we can do. From walking, to dancing, to swimming, weight lifting, yoga, aerobics, zumba, hiking, rowing, and walking your dog. Most people can find something they like. But if you truly can’t, then just buckle down and do it anyway! We all have to do some things we don’t like, right? But we do them anyway because we know they are important or good for us. I mean, do you really like brushing or flossing your teeth? But you do it anyway, right? Getting our exercise in truly is important, in so many ways. Aside from all of the benefits discussed above specific to cancer survivors, there is also extensive literature in the general population for the role of exercise in prevention and treatment of everything from heart health to blood sugar/diabetes, arthritis, and dementia. There are just so many reasons to get our bodies moving!
Please check out the website for the Exercise is Medicine/Moving through Cancer program for more information, great graphics, links, and references (https://www.exerciseismedicine.org/support_page.php/moving-through-cancer/).