Exercise counters cancer-related fatigue

An Exercise Program for You: 5 Tips for People With Cancer

Exercise counters cancer-related fatigue

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Sami Mansfield is founder of Cancer Wellness for Life, an organization that develops oncology exercise resources for individuals, hospitals, and corporations. She’s also Director of Oncology Wellness for the Sarah Cannon Cancer Institute at HCA Midwest Health and has been an oncology exercise specialist since 2003. Follow Sami on @bewellwithsami.

The role exercise plays in cancer care is becoming increasingly important. Exercise is known to be safe and helpful for cancer survivors during and after treatment, and oncologists and their teams continue to recommend it for their patients. Oncology rehabilitation programs are growing and are now considered to be part of standard cancer care.

Recent research studies point to many specific benefits of exercise.

Some show it significantly improves cancer-related fatigue compared to medications and that it can help improve survival for some advanced cancers, including metastatic colorectal cancer.

Research also shows the long-term benefits of increased exercise and a healthy lifestyle after cancer to reduce other diseases, as well as the benefits of higher intensity exercise.

These tips can help make it easier to create—and stick to—a personalized exercise routine that’s right for your life. Remember to talk to your doctor before starting an exercise routine, so you can develop a plan that works best for you.

#1. Learn about the physical activity recommendations

For adults, the U.S. Centers for Disease Control and Prevention recommends 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week. The guidelines also recommend 2 days of full-body strength training.

  • 150 minutes breaks down to 22 minutes per day, 7 days per week. Or you can do 30 minutes of exercise 5 times per week. Moderate-intensity exercise should leave you breathing heavily but able to carry on a conversation in short sentences.
  • 75 minutes breaks down to 15 minutes per day, 5 days per week. Vigorous-intensity exercise is when you can answer a question during exercise, but only in a word or two.
  • Full-body strength training, also called resistance training, is resistance-based exercise that creates muscle overload to stimulate new muscle to grow. You can do it with small weights, resistance bands, exercise machines, or the weight of your own body, such as with pushups. Other forms of resistance training, such as water exercises or certain types of yoga, can be helpful if you have joint pain.

#2. Use a variety of exercises

There are different types of exercise. An effective exercise plan will include a variety of types of exercise to have the best benefit for the whole body.  

  • Aerobic training. Activities walking and running are great aerobic exercise. But activities of daily living (ADLs), such as laundry, bathing, dressing, or cooking, may be your starting point. When you’re too tired to complete ADLs, adding extra aerobic exercise can make you more fatigued because the same muscles are being used.
  • Resistance training. Although resistance training is one of the most important types of exercises during and after cancer treatment, it’s not done enough. Movements such as standing up from a chair or toilet, climbing stairs, and carrying grocery bags all require muscle. Resistance exercise, which can help reduce fatigue and improve body function, will make these tasks easier. It’s also important to building bone density.Tip: A common start to resistance training is to complete 5to10 sit-to-stands from a chair several times per day. Another way is to grab 1-pound soup cans or hand weights and complete 10 repetitions of arm curls and shoulder presses each day.
  • Core training. Core training is the basis of movement.The muscles around the middle of your body, from just under the ribs to a few inches below where your hip bends, are your core. These muscles are used in every single movement your body makes, even rolling over in bed.Tip: To strengthen your core, sit in a hard-backed chair with your chest tall and shoulder blades pulled back. Then, try to tighten your abdominal muscles and sit in this position for as long as possible. Be careful not to hold your breath. Start with 2 to 3 minutes. Work up to maintaining this posture when you drive a car or walk across the room.

#3. Train for your life by using functional fitness

Think about the movements that you need to accomplish in your life and train for them.

For example, if you need to bring laundry from one level of your home to the next, start by moving an empty laundry basket or small pile of towels multiple times to activate the needed muscles.

If you find it difficult to carry groceries, train with a sack that has just a few small canned goods. Set the sack onto the floor, then pick it up and onto your kitchen counter. Try this type of exercise planning for any movement that makes sense for your life.

#4. Remember to refuel your tank

Hydration and food, especially protein, is key to recovery after exercise and resistance training. Exercise also has a powerful role in improving the quality of sleep, which also aids recovery. If your body cannot recover properly from new physical exertion, it can be harder to stick with your exercise program.

#5. Find an accountability partner

Another way to make your exercise program consistent is to tell someone close to you what your exercise plan is. Then, empower that person to encourage you by asking you about it regularly, or even join you. Share your goals and ask them what theirs are.

Read more exercise content on the Cancer.Net Blog.

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Source: https://www.cancer.net/blog/2018-09/exercise-program-you-5-tips-people-with-cancer

Managing Fatigue or Weakness

Exercise counters cancer-related fatigue

Feeling weakness or fatigue is common in people with cancer, but it's different for each person. Feeling weak is often one part of having fatigue. It's important to remember that fatigue might get better after treatment ends for some, but last many months to years after treatment for others.

Describing and managing weakness

Weakness is decreased strength. If this is caused by surgery in a certain part of the body or loss of a body part, the weakness might be helped by physical therapy or occupational therapy.

If weakness is caused by having an infection or having changes in blood levels, such as low blood counts, low electrolytes, or changes in hormones, treatment to help with the specific problem can help decrease weakness.

Describing fatigue

Fatigue can have many causes. People with cancer describe fatigue in many ways. They may say they feel tired, weak, exhausted, weary, worn-out, or slow. They may say they have no energy and can’t concentrate. They also talk about having heavy arms and legs, little drive to do anything, being unable to sleep or sleeping too much. They may feel moody, sad, irritable, or frustrated.

No lab tests or x-rays can diagnose or show your level of fatigue. The best measure of fatigue comes from the way you describe your fatigue level to your cancer care team.

You can describe your level of fatigue as none, mild, moderate, or severe. Or you can use a scale of 0 to 10, where 0 means no fatigue at all, and 10 means the worst fatigue you can imagine.

Ask your doctor or nurse how to describe your fatigue so they can understand how it affects your everyday life.

If you have moderate (4 to 6 on the 0 to 10 scale) to severe (7 to 10 on the 0 to 10 scale) fatigue, your doctor could ask you for more information. You might be asked questions :

  • When did the fatigue first start?
  • When did you first notice that this fatigue is different?
  • How long has it lasted?
  • Does anything make it better? Worse?
  • Are there times of day that you notice it more?
  • How has the fatigue affected the things you do every day or the activities that give meaning and enjoyment to your life?

Is it fatigue or depression? 

Some signs of fatigue or weakness often look a lot those of depression, and it’s easy to confuse the two. Depression involves an inability to feel pleasure – people who are depressed feel sad or unworthy. They may give up hope. You can have fatigue and not be depressed, although some people have both fatigue and depression.

Sometimes it may be hard to find a label for what you’re feeling. Your doctor might want you to see a mental health professional to get another opinion on whether depression is part of the problem. If it is, treatment can help.

Managing fatigue

Because the symptoms of fatigue in people with cancer are usually caused by more than one problem, doctors, nurses, social workers, physical therapists, pharmacists, dietitians and nutritionists, and a number of others might be involved in treating your fatigue or weakness. These symptoms often are caused by more than one problem.

Treating different specific cancer-related problems, anemia or pain, might make you feel better, but other things may need to be done, too. For this reason your cancer care team might have you try many different things to help manage your fatigue or work with a palliative care team to address multiple symptoms.

There’s no way to know if you'll have fatigue, how bad it will be, or how long it will last. In some cases, it can be hard for the doctor to figure out exactly what’s causing your fatigue. Still, there are things you can do to help manage it.

Different activities and therapies

Exercise, yoga, massage therapy, counseling, and dietary or nutritional counseling are all used to help treat fatigue and weakness.

If you’re having problems sleeping or sleeping too much, your doctor or nurse may suggest sleep therapy. This therapy can help you minimize sleep disturbances and learn improved sleep hygiene.

More research is needed and is being done in this area, but there are stimulant drugs your health care team may prescribe you if your fatigue doesn't improve. These stimulants are only prescribed for a short period.

It's important you talk to your doctor about the benefits of taking these drugs, as well as the different side effects that may occur such as daytime sleepiness, withdrawal symptoms, insomnia, memory problems, or allergic reactions.

Exercise and yoga

Research studies have shown that physical activity during and after cancer treatment can decrease fatigue.

Your health care team can refer you to exercise specialists (physical therapist, physical medicine, rehabilitation specialist) to help you with a safe exercise plan that can be modified to your condition.

Yoga has helped improve sleep for some people with different types of cancer who are going through treatment.

Talk to your doctor firstand always be careful about exercising if you have any of these conditions because they can lead to injury, pain, bleeding, or other problems if they aren’t taken into account before you start to exercise:

Massage therapy

Massage therapy has helped some patients during cancer treatment by possibly reducing stress levels and improving sleep. Talk to your doctor first before starting massage therapy.


Behavioral therapy or mindfulness-based stress reduction has helped cancer survivors reduce fatigue. Sharing your feelings with others can help ease the burden of fatigue. You can also learn coping hints from others by talking about your situation. Ask your health care team to put you in touch with a support group. Or contact us to find a group near you.

Mental health counseling, stress management training, and relaxation exercises are some ways you can learn to improve the feelings related to fatigue and help overcome the tiredness you feel.

Studies have shown some breast cancer survivors reported lower distress and fatigue with counseling and behavioral therapy.

Nutritional counseling

Nutritional deficits can add to the problems of fatigue and weakness. Your health care team may refer you to a dietitian to check your calorie and nutritional intake.

You may be prescribed vitamins or supplemental electrolytes (sodium, potassium, calcium, iron, or magnesium) to help reduce your symptoms.

Cancer patients, who may be managing other side effects (nausea, vomiting, bowel problems, mouth sores ) or different medical conditions that affect eating, can benefit from this counseling.

What the patient can do

  • Rest, but not too much. Plan your day so you have time to rest. Take short naps or rest breaks (30 minutes or less), rather than one long nap during the day. Too much rest can lower your energy level and make it harder to sleep at night.
  • Certain drugs used to treat pain, nausea, or depression can make a person feel tired and sleepy. Talk with your cancer care team about this. Sometimes adjusting the doses or changing to a different drug can help.
  • Talk to your health care team about any problems with your nutritional intake
  • Regular moderate exercise – especially walking – is a good way to ease fatigue. Talk to your doctor about the right exercise plan for you.
  • Ask your family or friends to help with the things you find tiring or too hard to do.
  • Try to sleep 7 to 8 hours each night. Sleep experts tell us that having regular times to go to bed and get up helps us keep a healthy sleep routine.
  • Each day, prioritize – decide which things are most important to you and focus on those tasks. Then plan ahead. Spread activities throughout the day and take breaks. Do things slowly, so that you won’t use too much energy at once
  • Avoid caffeine
  • Avoid exercising too late in the evening.

What caregivers can do

  • Help schedule friends and family members to prepare meals, clean the house, do yard work, or run errands for the patient. You can use websites that help organize these things, or ask a family member to look into this for you.
  • Try not to push the patient to do more than they are able to.
  • Help the patient set up a routine for activities during the day.

Call the cancer care team if

  • You feel too tired to get bed for a 24-hour period
  • You feel confused, dizzy, lose your balance or fall
  • You have problems waking up
  • You have problems catching your breath
  • The fatigue seems to be getting worse.

These may be signs of other problems that need to be treated.

Source: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fatigue/managing-cancer-related-fatigue.html

Exercise counters cancer-related fatigue

June is cancer survivor’s month – an opportune time to talk about new strategies to address a major side effect of many cancer therapies – fatigue. Side effects from cancer can be debilitating but there are strategies to help improve and reduce discomforts. I had the privilege of attending the 2019 AICR Research Conference in Chapel Hill, North Carolina in May.

As a certified specialist in oncology nutrition, I appreciate that this conference provides updates on the most current research on nutrition and physical activity for cancer prevention and survivorship.

Learning about new research findings allows me to take this enriched knowledge back to the people in the clinic who are seeking information to help them through cancer treatment.

Almost all of my patients struggle with cancer-related fatigue. Cancer-related fatigue is more than being tired. It is more than needing a nap. It is persistent exhaustion regardless of the amount of activity completed that day. This fatigue interferes with a person’s ability to complete even normal daily activities.

Being unable to work in your yard, play with your children or grandchildren or spend time enjoying leisurely hobbies significantly decreases quality of life. I often see this side effect lasting years past treatment. Although counter-intuitive, studies show that exercise can lessen the effect of cancer-related fatigue.

Exercise indeed can combat cancer-related fatigue better than pharmaceutical options.

A meta-analysis discussed at the AICR Research Conference concluded that exercise and psychological interventions should be the first-line treatment prescribed by clinicians for treatment to combat cancer-related fatigue.

The best improvements in cancer-related fatigue were seen in studies that used exercise as the primary treatment, rather than medications or psychological treatment.

In the 1980’s and prior, rest was considered the best care for those receiving cancer treatment. It was not until 2009 that exercise was evaluated as a therapeutic intervention for cancer survivors for the first time.

Precisely at this time, my interest as a cancer dietitian was starting to blossom at my first clinical position. We did not have concrete recommendations to share with survivors about exercise until 2012.

That year, the American College of Sports Medicine (ACSM) published a paper concluding that exercise was safe for survivors during and after cancer treatment, providing evidence to encourage survivors to engage in exercise.

The exercise regimen for those undergoing cancer treatments is obviously a well-monitored one. Whether patients are getting ready to start a treatment, are currently receiving or have completed treatment, I evaluate their physical activity and muscle mass, and continue to evaluate these parameters during every counseling session for any noticeable decline.

The discussion starts with a review of the ACSM guidelines. I encourage my patients to avoid inactivity as much as possible.

If they are going to have a surgery, I recommend returning to daily activities as soon as possible after surgery, and continuing normal activity and exercise as much as possible throughout treatment.

If they are currently exercising and it is safe for them to continue, I encourage them to do so and even do more. If they are not exercising but can safely begin, we discuss ways to get started that will work with their lifestyle.

Having the energy to engage in normal daily activities and to return to hobbies is a goal of many of my patients. When cancer-related fatigue improves, quality of life improves.

I see the improvement in mood, physical function and in their overall demeanor. Participating in an exercise program through the cancer center or in the community helps provide a structured program with trained experts.

I strongly encourage my patients to get involved in a supervised program for best results.

Look for cancer rehabilitation programs in your area. Many local hospitals offer rehabilitation programs ReVital Cancer Rehabilitation or survivorship exercise classes.

LIVESTRONG has partnered with YMCA to create a 12-week physical activity program for survivors. There are professionals who are certified cancer exercise trainers that can be found locally.

There are also home-based programs Onco Move, On Track, and Get Up, Get Moving that are available through the Oncology Nursing Society.

Thirty minutes per day seems doable for those receiving treatment studies but some people may need to work up to this level. Exercising at a moderate to vigorous intensity level as much as possible, but again build up to this as necessary. This intensity level may be harder to maintain as the duration of treatment progresses but do your best. Any and all activity will help

The American Institute for Cancer Research helps the public understand the relationship between lifestyle, nutrition and cancer risk. We work to prevent cancer through innovative research, community programs, and impactful public health initiatives.

Source: https://www.aicr.org/resources/blog/using-exercise-to-combat-cancer-related-fatigue/

Exercise counters cancer-related fatigue
Posted at 08:00h in Prevention by Samantha Skelton

Cancer-Related Fatigue: What It Is and How You Can Deal With It

While there are many different side effects of cancer, did you know the number one overlooked side effect is fatigue?

Cancer-related fatigue can take an enormous toll on an individual undergoing cancer treatment, and yet it seems to be one of the most overlooked side effects, due in part because people experience everyday fatigue as well.

But what makes cancer-related fatigue so taxing?

According to the Lymphoma Research Foundation, “There are many factors, including the disease, treatments, medications, pain, nutritional deficits, anxiety, and depression that can cause cancer-related fatigue.”

This isn’t just a sluggish afternoon that many people experience in their day-to-day lives. “People describe it as feeling weak, listless, drained, or “washed out.” Some may feel too tired to eat, walk to the bathroom, or even use the TV remote. It can be hard to think or move. Rest does not make it go away, and just a little activity can be exhausting,” the American Cancer Society reports.

How Can I Manage Cancer-Related Fatigue?

Talk to your cancer care support team. They’re there to help you! Once you describe your level of fatigue and what activity causes you to feel completely depleted of energy, they can recommend ways to lessen your fatigue.

Tips for Preventing Fatigue

The Lymphoma Research Foundation outlined a few tips to keep track of and even avoid fatigue if possible. When you’re experiencing cancer-related fatigue from treatments and your diagnosis, here are other things you can do to try to lessen fatigue:

  • Keep a diary to help identify which times of the day, during which activities, or during what times related to treatment cycles you have the most energy. Logging this information can help you prevent from engaging with certain activities that cause you the most fatigue and engage during times when you have the most energy
  • Prioritize tasks and put the ones you use the most energy first, so you can accomplish your important to-dos before fatigue sets in.
  • Organize your surroundings so that you have easy access to items you need most frequently
  • Avoid food or drinks that don’t give you sustainable energy. For example, food or drinks with high sugar levels can cause you to “crash” later and bring on high levels of fatigue

And while it might seem counter-intuitive, exercise has been shown to reduce cancer-related fatigue. We suggest watching our webinar on exercise and talk with your health care team about what types of exercise might be appropriate for you.

Interested in other resources?

Check out Triage Cancer’s Stress Management resource page for helpful information and videos on managing stress, which can also contribute to fatigue. You can also read a previous blog post on Cancer-Related Fatigue here.

Similar Posts You May To Read:

Source: https://triagecancer.org/cancer-related-fatigue

Exercise counters cancer-related fatigue

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Exercise Helps Counter Cancer-Linked Fatigue

Exercise counters cancer-related fatigue

From the WebMD Archives

By Alan Mozes

HealthDay Reporter

THURSDAY, March 2, 2017 (HealthDay News) — Whether from the disease itself or the treatment, cancer can be exhausting, but a new review says there are ways to beat back cancer-related fatigue.

The review included a look at 113 past studies that included more than 11,000 adult cancer patients. The researchers found that exercise and/or behavioral and educational therapy seemed to be more effective than prescription drugs for dealing with fatigue.

“Exercise and psychological treatment, and the combination of these two interventions, work the best for treating cancer-related fatigue — better than any pharmaceuticals we have tested,” noted study lead author Karen Mustian. She's an associate professor with the University of Rochester Medical Center's Wilmot Cancer Institute in Rochester, N.Y.

The upshot, said Mustian, is that doctors should consider exercise and psychological interventions as the “first-line therapy” instead of more medications when it comes to tackling cancer-related fatigue.

The study team noted that cancer-related fatigue is a very common problem among cancer patients, both during and following treatment.

The American Cancer Society describes the phenomenon as distinct from routine tiredness. Even if you get rest, you're still tired. Your arms and legs may feel heavy. You may feel too tired to do even the simplest tasks, such as eating a meal, according to the ACS.

Beyond affecting overall quality of life, cancer-related fatigue can also interfere with a patient's ability to continue cancer treatment itself. That may result in a poorer prognosis and, in some cases, a reduced chance for long-term survival, the study authors said.

For the study, Mustian and colleagues looked at cancer-related fatigue triggered by the onset of cancer itself, rather than as a side effect of treatment.

Almost half of the patients included in the review were women battling breast cancer. Ten studies focused solely on male patients. In all, almost 80 percent of study participants were women. Their average age was 54.

The analysis excluded studies that looked at so-called complementary therapies, with an exception made for alternative exercise treatments, such as yoga or tai chi.

In addition, the research team didn't include studies that had assessed drug treatments involving erythropoietin medications (such as epoetin alpha, brand names Procrit and Epogen).

These drugs are designed to stimulate red blood cell production, and are “used primarily for treating anemia and are not recommended as a stand-alone treatment for [cancer-related fatigue] due to adverse effects,” the study authors stated.

Studies included looked at the impact of four different treatment approaches: exercise alone (including aerobic, such as walking or swimming or anaerobic, such as weight-lifting); mental health interventions aimed at providing information and/or helping patients understand and adapt to their current situation; a combination of both exercise and psychological treatment; and prescription drugs, including stimulant medications (such as modafinil, brand name Provigil) and ADHD meds (such as methylphenidate, brand name Ritalin).

All four interventions led to improvement in fatigue. But the researchers found that exercise therapy led to the best outcomes.

But psychological therapies produced similarly positive results, as did treatments that integrated exercise with mental health efforts.

The team concluded that when it came to controlling cancer-related fatigue, the exercise and/or psychological therapy approaches appeared to outperform prescription drugs.

Colleen Doyle is managing director of nutrition and physical activity for the ACS. She said exercise has many benefits, not just helping to ease fatigue.

“But because many people undergoing treatment do experience fatigue, it's nice to know that there is something an individual can do to help reduce that fatigue and gain some of the many other benefits of exercise [both during and after treatment]: reduced stress, less anxiety, [and] benefits to physical functioning,” Doyle said.

But can the typical cancer patient actually handle an exercise regime? Mustian says yes.

“These are not your elite athletes or fitness buffs,” she said. Almost all of the studies focused on people who had been sedentary and were placed on a low-to-moderate intensity exercise regimen, involving activities such as yoga or resistance training.

“So they are normal people who were not regular exercisers, and who were able to complete these interventions and have relief from their fatigue,” Mustian said.

Doyle said that for patients who weren't previously active, it's important to start slowly.

“Our recommendation for survivors is essentially avoid inactivity as best you can. There will be days when you feel not doing much of anything, and that's okay, but strive to do something. Even if it is gentle stretching exercises, or a five-minute walk down the block,” she advised.

Mustian stressed that relatively few studies looked at combining exercise and psychological therapy.

“So it is not as clear what the best way to combine them would be,” she noted. The researchers said more studies need to be done to explore the ideal way to integrate exercise and psychological interventions.

The study was published March 2 in JAMA Oncology.

SOURCES: Karen M. Mustian, Ph.D., M.P.H., associate professor, Wilmot Cancer Institute, department of surgery, University of Rochester Medical Center, Rochester, N.Y.; Colleen Doyle, M.S., R.D., managing director, Nutrition and Physical Activity, American Cancer Society; March 2, 2017, JAMA Oncology Copyright © 2013-2017 HealthDay. All rights reserved.

Source: https://www.webmd.com/cancer/news/20170302/exercise-helps-counter-cancer-linked-fatigue

Optitrain: a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy

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