Managing Side Effects with Exercise

Our bodies are made to move. Muscles attach to bones by tendons and when contracted, pull bones into different positions, creating movement. Not only do our bodies want to move, but they need to move. A sedentary lifestyle is often a precursor to chronic diseases such as cardiovascular disease, cancer and diabetes. Research shows that exercise plays a significant role in the treatment plan of a cancer diagnosis.  Exercise is proven to help manage some of the most common side effects associated with cancer treatment, such as chronic fatigue, lymphedema and joint and bone pain. Even a small amount of safe and appropriate exercise has a huge impact on alleviating these side effects and improves quality of life.

Most people with a cancer diagnosis will at some point experience a greater level of fatigue than they have before. This is referred to as Cancer Related Fatigue (CRF) and is one of the most common side effects of cancer. It differs from regular fatigue in that it is much more intense and often the level of tiredness that is felt is out of proportion to an activity that someone may have just done. For example, walking for 15 minutes, a task that normally may not tire one person out, leaves them feeling as if they have just run a marathon.  Symptoms of weariness, lack of concentration and loss of memory is also reported. The onset of CRF is often multifactorial; there is not one thing that causes this side effect. Research on this topic has highlighted increased levels of inflammation, red blood cell suppression, muscle wasting, psychological factors or even the tumour itself being the culprit behind the symptom. While it may seem counterintuitive to be exercising when feeling tired, more and more science is backing the use of moderate intensity exercise to alleviate these feelings of heightened fatigue. Research shows that moderate levels of aerobic exercise(about 65% of your maximum heart rate) reduces levels of inflammation, supports the production of red blood cells, and offsets feelings of depression and anxiety. Activated muscle is also the source for energy production, so engaging in light resistance exercise is important for alleviating fatigue. Adjusting how much and how intense you exercise is based on your level of fatigue is important. A thirty minute brisk walk may become a 10 minute stroll around the block, but research shows that some sort of movement is better than no movement at all. Modification is key, and staying active at the level which your body can tolerate will make an impact on your overall energy.

Descriptions of pain or discomfort are subjective. One person’s threshold for pain may be higher than another person’s or a similar sensation of pain may be interpreted differently from one person to the next. Regardless of how pain is perceived, it is a common side effect of cancer treatment. Treatment may cause damage to bone, soft tissue and nerves resulting in bone and joint pain and peripheral neuropathy. Bone and joint pain is often experienced as a generalized deep aching sensation that is felt with or without movement. Chemotherapy treatment is intended to target fast growing cells and often cells that are responsible for bone development fall victim to the effects of chemotherapy. Aromatase inhibitors cause a loss of bone density, which leads to higher rates of osteoporosis and bone fractures, so often bone and joint pain is felt in those prescribed this hormonal agent. To alleviate symptoms exercise is prescribed, as it has been proven to be a natural pain remedy by decreasing the sensitivity to painful stimuli. Strengthening muscle encourages support and stability of bone and joints and also allows for healthy joint range of motion. Avoiding movement will weaken muscle, creating more unstable joints and compounding joint and bone pain. Exercises targeting large muscle groups and elevating heart rate to 65% of maximum heart rate for at least 20 minutes will greatly impact and reduce feelings of pain and discomfort. Safe and appropriate exercise prescribed by a registered Kinesiologist is essential in alleviating this side effect and keeping the body moving optimally.

More and more research indicates exercise as a suitable agent for alleviating the many side effects of cancer treatment. Not only limited to cancer related fatigue and pain, the benefits of exercise span to include psychosocial factors as well as prevention of recurrence and lifelong survivorship.  Including safe and appropriate activity into your daily regime during all stages of the cancer journey is suitable. Discussing your exercise needs with a Kinesiologist will ensure safety and confidence that you are doing the best to support your body during a diagnosis.

by Kelly Wanless, BKin
Exercise Therapist
Inspirehealth, Lower Mainland Centre