Moving your body during and after cancer treatment is important. Exercise can be a natural way to help you take some control of your physical health. It can improve your energy levels, quality of sleep, muscle strength and range of mothing, increase appetite, and even decrease the chance of some cancers reoccurring. Exercise also has many mental health benefits, including reducing anxiety, reducing symptoms of depression, improving self-esteem, improving cognitive functioning and it may increase social connections. In the past you may have been advised during an illness to rest; however, many providers may encourage movement due to its benefits. The National Health Institute (NCI) states that there is now evidence that those living with cancer will benefit from being more physically active. An exercise program consisting of a half hour of aerobic exercise three times weekly is sufficient to improve anxiety, depression, fatigue, quality of life and physical function in cancer survivors. A study on breast cancer survivors concluded that overall quality of life, including depression, emotional function and mood were significantly improved following a 7-week yoga program. It’s understandable that complications of treatment and side effects could make physical activity difficult. Not everyone who is coping with cancer can meet the suggested goal due to physical challenges, hospitalizations, or the time demands of treatment. In addition, low mood, difficulty with motivation or “all or nothing thinking” can get in your way of exercise goals. It’s important to know that any movement or physical activity is beneficial and even in increments of 10 minutes at a time can have a positive impact on your health and wellbeing.

Perception of exercise

There are endless ways to engage in physical activity. The most important aspect of physical activity is that you are moving your body in some way. You may find that your comfort and ability has changed following treatment and may continue to change. If exercise activities are new to you, movement or activity that doesn't require special equipment can be a good place to start. You can increase your strength by using light household items for weights, using a stretchy piece of clothing as a resistance band, or using your stairs to help build leg muscles and endurance. You may also consider quick options for added activity benefits such as taking the stairs at the clinic rather than an elevator or parking your car to allow for a longer walk.

If physical activity is not new to you, you may look at exercise a bit differently than before cancer, your body may feel different, and you may experience limitations you did not have before. Consider changing your regular exercise routine to meet your current energy level; decide where your energy level is for the day and adjust the physical activity to match. It may also be beneficial to try new types of exercise and activities

It may be helpful to consider your health long term goals and determine whether your current behaviors support those goals. For example, if one goal is to lose weight, or to reduce BMI to lower your risk of recurrence, consider if yourcurrent behaviors promote weight loss. If your current behaviors do not support your goals, it could be helpful to uncover the reasons why. It can be helpful to identify potential barriers or ambivalence around your goals. Once those are uncovered you may be able to find solutions to these problems. For example, if you find that you struggle with fatigue the most the day after treatment, it’s acceptable to rest that day and build your routine around the times that you have more energy. Your oncologist can make diet recommendations to help you achieve your goals

Engaging in exercise may also decrease isolation and improve social interaction. There may be traditional gyms or wellness centers in your community that offer group training classes. You may find a connection with someone that may make you feel less alone. You may also consider contacting your treatment team to determine if there are cancer specific exercise programs offered to patients and survivors; a peer program could be an additional way to gain support. You may feel more comfortable in an exercise group that is made up of others who have been in a similar situation.

Some people have immunosuppressing medications that make them anxious about exercising in a public area. You may consider avoiding peak hours when going to the gym; early mornings or late afternoons often are less crowded and may decrease potential exposure. Outdoor activities may be a way to stay active and find new and exciting options. You may also discover virtual classes or a fitness app as a safe option.

5 Suggestions for Staying Active

Start Slow- Some patients find it helpful to rethink how they approach an exercise plan following a cancer diagnosis; it may be helpful to start with low impact activities and work up to more high impact when it feels right. A brief walk at low intensity can still carry benefits including improved mood and increased energy. Make sure to listen to your body and never push yourself if you feel dizzy or unsteady

Create Manageable Goals- Some patients find it helpful to create physical activity goals that are realistic and manageable. Achieving even small goals can help you feel more empowered and in control. You may find it beneficial to give yourself credit for even the little things; be mindful of an “all or nothing” attitude. Making and achieving even small goals can be worthy of celebrating. The longer you are consistent with these goals, the easier it becomes to make sustained behavioral change.

Consider an Accountability Partner- You may consider finding a workout partner who can help keep you on track and hold you accountable for the goals you have set. Having someone on the journey with you can help with isolation and increase social stimulation.

Plan- Some patients find it helpful to plan for physical activity; you may use a physical activity chart or calendar to map out what days and times you would want to exercise. Planning may help you feel in control. Contingency plans are needed for the unexpected symptoms or barriers to exercise that are encountered during cancer treatment. Instead of the “all or nothing thinking” (either I meet my goal in my plan or don’t do anything), consider one small part of your goal you can accomplish.

Get Creative- You may at times feel as if your routine is becoming boring; it could be helpful to consider variety in the types of activities you engage in. The variety in exercise can add happiness that may improve the likelihood of consistency. Another thing to consider is using the power of temptation bundling. Temptation bundling is paring something that you genuinely enjoy with something that you may not enjoy quite as much. Things like listening to music, a pod cast, or audio book while walking or exercising, or even talking to a friend can make exercise more enjoyable.

Determine any Emotional Barriers- If you find yourself experiencing challenges in meeting exercise goals, it may help to consider uncovering the root of the issue. Are you feeling fatigued physically or could it be mentally you are feeling down and as a result you are not able to get moving, are you feeling guilty about not having exercised before treatment or do you have fears about not being successful with your exercise plan? Maybe you are unsure, if you are unsure what is standing in your way, it may help to keep a journal or thought log that will keep track of your physical activity and any emotions felt before and after doing exercise. This may help to pinpoint emotional challenges that may be standing in the way of your exercise goals.

Exercise can be a powerful tool to maintaining health both during and after cancer treatment; keep in mind that there are many options to staying active. Maintaining an exercise plan with cancer can sometimes be challenging as emotionally and physically you are going through many changes; if you would like additional support around the emotional aspect of exercise and wellness, consider scheduling an appointment with an Iris mental health professional.