exercise and cancer: how staying active can positively impact your health and well being

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Exercise and cancer: How staying active can improve your health and well-being Bladder Cancer Advocacy Network, Us TOO International, ThyCa: Thyroid Survivors’ Association, Inc., and Inspire have partnered to bring patients and their caregivers this free educational webinar

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Carol Michaels MBA, ACE, ACSM

Carol is the founder of the Recovery Fitness® an exercise program developed to improve the recovery from cancer surgery and treatments. She is a nationally recognized Exercise Specialist, consultant, author, and is the 2016 IDEA Fitness Personal Trainer of the Year. Carol is a speaker for corporate wellness programs, fitness organizations, and cancer related organizations, and created the Cancer Specialist Recovery course in partnership with the National Federation of Professional Trainers.

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Benefits of exercising during and after treatment

Today We Will Discuss

The Potential Side Effects of Surgery and Treatment ü  Surgery can create adhesions

ü  Chemotherapy may affect balance, immune system, cardiac function, as well as cause nausea, fatigue, sarcopenia, anemia, and neuropathy

ü  Radiation can cause fatigue, tightness, and increase the risk of lymphedema

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Exercise-related precautions 2

Exercise components, including specific exercise examples 3

Tips for getting started 4

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Benefits of Exercising During Treatment

•  Increase energy and reduce fatigue •  Evidence supports this benefit for many cancers,

including bladder cancer •  Improve ability to tolerate cancer treatments

•  Improve mood and well-being •  Evidence suggests exercise can reduce anxiety/

depression and improve well-being for many forms of cancer

•  Improve outcomes for certain cancers •  Prostate cancer and bladder cancer studies suggest a correlation between exercise and

survivorship •  Light exercise may improve prognosis by maintaining or improving lung capacity and

oxygen flow

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Benefits of Exercising After Treatment

•  Increase strength and muscle mass

•  Improve aerobic capacity

•  Improve flexibility

•  Prevent bone loss

•  Improve mood and quality of life

•  Improve survivorship for certain cancers

•  Maintain a healthy weight and improve blood sugar control •  important for cancers of the

thyroid, prostate, and breast

•  Decrease pain

•  Decrease stress, anxiety and depression

Research also suggests that exercise may decrease the risk

of recurrence for certain cancers (e.g., breast cancer and lung cancer)

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Exercise-Related Precautions

•  Fatigue

•  Neuropathy

•  Myelosuppresion

•  Neutropenia and anemia •  Avoid infections, wash hands often

•  Osteoporosis •  Thyroid cancer, prostate cancer,

and breast cancer can increase risk of bone loss

•  Cardiopulmonary issues

•  Lymphedema •  A lymphedema specialist, physical

therapist or cancer exercise specialist can help you learn exercises (also visit Lymphnet.org)

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Exercises

•  Pain and fatigue levels change

•  Common sense–routine should be customized according to physical and emotional side effects

•  Healing times and pain tolerance differ greatly

•  Listen to your body

Exercise Progression

•  Relaxation breathing

•  Aerobic exercise--cardiovascular exercise improves circulation which improves oxygen levels and can help to decrease symptoms of fatigue

•  Stretching

•  Strength training

•  Balance training

Exercise Components

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Exercises

•  American Cancer Society recommends 150 minutes of moderate intensity or 75 minutes vigorous intensity each week

•  Helps with weight management

•  Helps prevent cardiac issues

•  Start with a few minutes of walking, bring a buddy, and gradually build up (modify to fatigue level)

Aerobic Exercise •  Improves circulation

•  Increases elasticity of the muscle and brings oxygen to the muscle

•  Active stretching: hold for 1-2 seconds and repeat 10 times

•  Static stretching: hold for 10-30 seconds

Stretching

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Shoulder Stretch

Exercises

Shoulder Flexion

Source: Exercises for Cancer Survivors by Carol Michaels

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Pectoral and Shoulder Stretch

Exercises

Side Bend


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Exercises

Corner Stretch

Shoulder Opener


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Exercises

Knee Drops Shoulder Flexion with Cane


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Exercises

Shoulder Extension and Back Scratch Flexion and Butterfly Stretch


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Exercises

Shoulder and Pectoral Stretch Hamstring Stretch


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Exercises

Seated Stretching

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Benefits of Strength Training

•  Increases muscle mass which decreases as we age and is compounded by treatments

•  Decreases risk of injury--start after having 80% ROM

•  Use free weights - can improve by small increments-machines work the large muscles

•  Start with one set of 5-10 reps, rotate muscle groups

•  If taking time off, start with lighter weight

•  Pelvic floor exercises are especially important for people with bladder and prostate cancer

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Exercises

Shoulder and Back Strengthening Group Strength Training


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Balance

Balance and Strength

•  Balance training can counter muscle imbalances

•  Neuropathy--can not feel feet (be safe)

Start the balance training with the following exercises:

•  Standing on one foot for 10 seconds

•  Tightrope: put the heel in front of the toe of the other foot

•  Calf raise: raise each heel up and down

•  Leg lifts: front, back, and side Source: Exercises for Cancer Survivors by Carol Michaels

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Exercises for Osteoporosis

•  Include weight bearing, strength training, posture , and balance exercises

•  Avoid forward bending from the waist and rotation

•  Strengthen core with exercises that do not involve forward flexion--no crunches

•  Some yoga and Pilates exercises have to be modified •  Single leg circle and the corkscrew are safe •  Spinal extension exercise such as Pilates

swimming and back extension may be performed

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Lymphedema

•  Lymphedema is swelling produced by an accumulation of lymph fluid in tissue

•  Symptoms include a feeling of tightness and heaviness

Safe Exercises for Lymphedema

•  ROM exercises, elevate the area above the heart, stretch the neck and shoulders •  e.g., pendulum arm swings ,stretches that

move the arm in flexion, extension and abduction

•  Walking, biking, swimming - water creates compression but vary strokes

•  Think of the lymphatic system as a road system

•  Can occur right after surgery or years later

•  Strength Training - muscle can pump the lymph fluid away from the affected area. •  Start with light weight

•  Pilates - using deep breathing

•  Some yoga poses can cause flare ups

•  Monitor for fullness

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Exercises

Pendulum Exercise


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Getting Started

•  Contact your local hospital to see if they offer exercise programs geared towards cancer patients and survivors

•  Call National Federation of Professional Trainers at (800) 729-6378 •  They are currently working to get more personal trainers

trained as cancer recovery specialists

•  Contact the American College of Sports Medicine •  https://certification.acsm.org and click on “Find a Pro”

at the top of the page:

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Summary of Key References

1.  Steven Moore et al. Association of Leisure - Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016.

2.  Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012.

3.  Rock, CL et al. Nutrition and physical activity guidelines for cancer survivors. A Cancer Journal for Clinicians. 2012.

4.  Kristina H Karvinen et al. Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study. Cancer Epidemiology and Biomarkers. 2007.

5.  Gopalakrishna et al. Lifestyle Factors and Health-Related Quality of Life in Bladder Cancer Survivors: a systematic review. Journal of Cancer Survivorship. 2016.

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Summary of Key References

6.  Stephanie Cash et al. Recreational physical activity and risk of papillary thyroid cancer among women in the California Teachers Study. Cancer Epidemiology. 2013.

7.  Hwang, Yunji MS et al. Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study. Medicine. 2016.

8.  Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res. 2011.

9.  Winters-Stone KM, et al. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Arch Phys Med Rehab. 2015.

10.  Focht, Brian C et al. Medicine & Science in Sports & Exercise. Effects of a Combined Exercise and Dietary Intervention on Mobility Performance in Prostate Cancer. 2016.

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If our speaker is not able to answer your questions today, we encourage you to post them on Inspire.

Questions & Answers

ThyCa.inspire.com UsTOO.inspire.com BCAN.inspire.com

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Thank you for attention! Carol Michaels 973-379-4779

[email protected] www.CarolMichaelsFitness.com

exercise and cancer: how staying active can positively impact your health and well being

Health & Medicine