Fatigue affects up to 70% of cancer patients and can be a result of both the disease and the treatments (surgery, chemotherapy, radiotherapy and all the dynamics that surround them and affect people’s routine). Because of this, for a long time it was believed that the best thing to do was to remain at rest as much as possible and reduce the practice of physical exercises during the treatment against the disease.
After studies and research that systematically proved the opposite, today the recommendation is that patients, in their vast majority, keep their bodies moving while fighting cancer – some exceptions will be noted below. It is also worth noting that excessive rest can lead to loss of bodily functions, muscle weakness and reduced mobility.
The practice of physical activities is not only safe, but can improve the quality of life of the person undergoing treatment, bringing physical benefits:
• Relief from adverse effects of chemotherapy (such as nausea)
• Increase in disposition;
• Reduction of tiredness (the one that affects up to 70% of patients);
• Improvement of the vital functions of the organism;
• Strengthening immunity;
• Improved balance (decreasing the risk of falls and bone fractures);
• Decreased risk of osteoporosis; and
• Improved blood circulation.
The effects of physical exercise are also reflected in maintaining an adequate body weight, one of the main ways to prevent and fight cancer. Excess body fat causes an inflammatory process and increases the production of hormones, which can damage cells, causing or accelerating the onset of the disease.
Overweight, obesity and adult weight gain are associated with cancers of the esophagus, stomach, pancreas, gallbladder, liver, intestine (colon and rectum), kidneys, breast, ovary, endometrium (body of the uterus), meningioma, thyroid, multiple myeloma and possibly prostate (advanced), breast (in men), and diffuse large B-cell lymphoma.
Psychologically, physical exercise during cancer treatment helps to:
• Control anxiety, normal in cancer patients;
• Alleviate depressive symptoms that arise with the diagnosis of the disease;
• Increase patient autonomy in their daily activities;
• Improve self-esteem; and
• Improve mood and social relationships.
Recommended physical exercises during cancer treatment
There are many benefits of physical exercise during cancer treatment, but it is important to carry out a program based on what is safe, effective and comfortable for the patient.
The past of physical activities and the new limits of the individual’s body must be taken into account – they may have changed due to the type of cancer, its staging and the treatment defined to combat the disease.
This is not the time to exercise to lose weight or gain muscle mass; the objective is to maintain physical capacity and alleviate adverse effects of treatment. The most recommended physical exercises for the fit cancer patient are:
• Light aerobic activities (walking and light cycling);
• Light Pilates; and
In general, at least 30 minutes of physical activity per day is recommended, but there is evidence that benefits occur even when time availability is less. Daily duration is one element, but not the main one.
Precautions to practice during cancer treatment
Exams requested by the doctors responsible for cancer treatment (and their due analyses) and some precautions are part of the precautions for the practice of physical exercises during cancer treatment. The main ones are:
• Carry out blood tests and verify that all the results are as expected so that physical exercises do not harm the general health condition;
• Not doing physical activities on days when you feel pain, discomfort or other disabling symptoms;
• Reduce the duration of physical exercise if you get tired during its performance;
• Avoid uneven surfaces that can impair balance and facilitate falls;
• Swap the treadmill for the exercise bike if you feel numbness in your feet;
• See your doctor immediately if you notice bleeding, swelling, pain, dizziness or blurred vision during or after exercise;
• Avoid chlorinated pools after radiotherapy sessions; and
• Avoid water sports and other sports with risk of infection if you are using a catheter.
Conditions that contraindicate the practice during cancer treatment
Despite the benefits already presented, not all cancer patients can perform physical exercises. Some conditions that contraindicate the activities are:
• Severe anemia (decreases resistance, as the hemoglobin that is lacking in the blood is responsible for bringing oxygen to the lungs);
• Low platelet level (they are responsible for clotting and healing); and
• Bone pain caused by tumors and their metastases.
In some cases, the treating physician may assess the benefits generated by low-load activities, such as hydrotherapy, and indicate some movement for the body. Remember: in order not to cause damage to health and treatment, any and all modality adopted must have been approved by the specialist doctor.
7 practical tips for exercising on a daily basis during cancer treatment
Tiredness and adverse effects of cancer treatment can make it difficult to create a daily exercise routine. To assist in this process until the habit is created, here are some practical tips:
1) Choose physical activities that bring pleasure to everyday life – exercise should never be synonymous with suffering;
2) Swap the car for walking on short paths;
3) Go up stairs – respecting your pace – instead of using the elevator;
4) Take friends to exercise with you;
5) Go for walks and cycling outdoors (in squares and parks or common areas of condominiums, for example);
6) Depend as little as possible on gyms (reserve the use of facilities for rainy days or intense cold);
7) Limit screen time (TV, cell phone, tablet, computer, video game) in your days – they are addictive and can discourage you from kicking off the day’s exercise.
Which doctors should advise on the practice of physical exercises during cancer treatment
In the multidisciplinary team that monitors cancer treatment, the specialists who can advise on the practice of physical exercises are the oncologist, the physical therapist and the physical educator.
Myths and truths about physical exercise during cancer treatment
All physical exercises are good for the health of cancer patients
MYTH. High-impact, high-performance exercises, such as competitive running and heavy-duty weight machines, are harmful to health and are prohibited for cancer patients.
It is good for cancer patients to exercise when they have nausea, to relieve it
MYTH. Physical exercise can relieve common post-chemotherapy nausea, but as a continuous, not immediate, effect. During a bout of nausea, it is best to temporarily dispense with the activity.
Even those who have never done physical exercises can adhere to them during cancer treatment
TRUTH. Any and every patient who is able to move and who is guided by specialized doctors can and should perform physical exercises during cancer treatment, and thus improve health and quality of life.
Those who already exercised before the diagnosis of cancer can keep their physical activity routine unchanged.
MYTH. The past is important, but the body’s limits can change because of illness and treatment. Physical and clinical evaluations must be carried out by the specialist doctor, so that physical exercise does not harm the patient’s health or treatment.
Adding small physical activities to everyday life is enough to help the health of cancer patients
TRUTH. There does not need to be an athletic and systematic activity for the body to feel benefits during cancer treatment. Moving the body daily, no matter how small – small household chores or changes in locomotion, for example – already promotes an evolution in the quality of life.