Exercising with cancer

From the British Medical Journal:

‘Physical activity has well-documented health benefits. Population-level cohort studies have shown that people who exercise enjoy a higher quality of life and improved health status compared with those with sedentary behaviours.

Randomised controlled trials have shown similarly favourable findings in arthritis, cancer, diabetes, heart disease and respiratory illnesses, among other chronic conditions. Large-scale observational studies have also established a clear association between exercise and all-cause mortality. Given the overwhelming evidence in support of the health benefits of exercise, the Global Burden of Disease study has recently ranked physical inactivity as the fifth leading cause of disease burden in Western Europe, and as one of the top modifiable risk factors along with smoking.’

Exercise boosts immune function significantly, and most importantly, exercise increases the production of Natural Killer (NK) Cells – the immune cells that target and destroy cancer cells. Although it has been known for many years that exercise has a profound cancer-mitigating capacity it was only recently that the mechanism was discovered – during exercise NK Cells flood out of the spleen into the blood stream.

The spleen is part of your lymphatic system. NK Cells are white blood cells, manufactured in bone marrow, and commonly found in your lymph nodes. The lymphatic fluid is filtered through these lymph nodes and the NK Cells are there to kill any cancer cells that may turn up. However, lack of exercise means that there is, effectively, an underproduction of Natural Killer Cells. The work is left up to the NK Cells in the lymph nodes alone to do the whole job of clearing the body of cancer cells, but it just won’t be enough.

Exercise also stimulates your lymphatic system to work effectively. Although your lymphatic system is seldom discussed, it has many purposes that are vital to your wellbeing, including processing waste and toxins. When your lymph fluid becomes stagnant through inactivity, you get sick. The thing is, unlike blood circulation which has a heart for a pump, the lymphatic system relies on movement to shift the lymph fluid through a series of valves. Given that immune cells that kill cancer are carried in your lymph fluid, it becomes fairly obvious that movement is critical if you are to deliver immune cells (and anti-cancer medications) to tumour cells.

Exercise also has significant metabolic effects. Your metabolism comprises multiple biological processes that are more efficient in a person who is fit and exercising. Think of fitness as being a state of efficiency. Biochemical processes work better, and importantly they interact successfully, when you exercise. An unfit body is inefficient, prone to inflammation (the mother of all disease), prone to high blood sugar and high blood pressure, has a compromised immune system, and hormone function is diminished – along with loss of function, mobility, and the accumulation of body pains.

For a cancer patient, managing sugar levels is very important. Although many cancers make energy from fat, cholesterol or protein, glucose plays an important role in supporting the metabolic processes of all cancers to some extent. Exercise lowers blood sugar levels and helps one of best known biochemical processes – insulin function – work efficiently. It also burns fat in your blood and utilises free proteins. These factors contribute to the reduction of ‘food abundance’ that is ordinarily available to cancer cells in a person who is inactive and on a standard western diet.

Simply put, the human body was designed to move, not sit. Sitting is the nemesis of human health. It is also one of the most significant contributors to cancer. Combine inactivity with processed food and the cancer epidemic that is engulfing the Western world is easy to explain – including the dramatic rise in childhood cancers.

Exercise is gold. But which exercise should you be doing? How much? How often? And when?

The most important thing is to start from where you are. This may sound obvious but it is often ignored, and the result is injury. I start all my clients with proprioceptive exercises which stimulate the nervous system and improve control over the body. I incorporate activation and balance exercises as well, and progress these with increasing complexity and difficulty. This type of exercise ‘tunes’ the body and addresses any underlying issues, such as inactive muscles and muscle imbalances. Combine this with an appropriate stretching program and, in combination with the exercise I have described, your body will be free of tightness and imbalances, and working just how it should.

From here it is possible to improve cardiovascular fitness, endurance, strength and function – and it will happen naturally as a progression from the proprioceptive exercises. This is a very different process and outcome from simply going to the gym, getting on the treadmill or bike, and feeling like hell. With many years experience training reluctant people, I have found that how you start exercising is critical. My clients don’t break a sweat for the first five weeks – and then they are really surprised to see what they are capable of by then. That’s when they get excited and actually want more!

While it is important to make sure that you don’t trigger an injury, if there is an activity that you like to do, then go for it – maybe mountain biking, rowing, tennis, hiking. But you do need to be doing something daily, to clear the lymphatic system, get the blood pumping, get muscles working. You don’t have to smash yourself, but make it count.

And you don’t have to go to the gym every time – or at all. So long as you know what you are doing. I exercise at home – I converted the garage into an exercise space. You don’t need much equipment so you can even do it in your lounge room if you want to.

Can you do exercise while you are undergoing treatment? Will your treatment conflict with exercise? Australia has taken the step of being the first country in the world to require oncologists to prescribe exercise as ‘standard of care’. So there is no reason to fear exercise if you have cancer – exercise is medicine and, quite frankly, it is hard to imagine anyone recovering from cancer without it.

Exercise is proven to significantly increase the effectiveness of chemotherapy. Exercise also mitigates inflammation and loss of homeostasis that are the consequence of drug treatments. This means a reduction in ‘treatment fatigue’ – which may seem counter-intuitive – but the bottom line is that exercise makes standard drug treatments more effective while also mitigating the negative side-effects of those treatments. You will feel better for it – much better in fact.

So there you have it – exercise works. Notably it is effective for multiple disease risks and symptoms – cancer, inflammation, fatigue, cardiovascular health, strength, endurance, all forms of functionality, and very importantly it has a very positive effect on mental health.

I remember my specialist saying to me ‘I don’t get people like you here – this is the only thing wrong with you’. I had cancer but all my other numbers were good. I was a fully functioning, fit, healthy human being – just that I had cancer (which is another story). I am certain that my fitness has made a significant difference to my survival as a person with cancer. (I will never call myself a ‘cancer patient’ – I am not a victim.)

The point is that most people with cancer have other things going on as well. It is great to know that exercise works on all levels – it will improve all your numbers, from blood pressure to BMI, as well as help you recover from cancer.

It doesn’t matter if you haven’t done exercise for a while, or even if you are undergoing chemotherapy. It’s not about punching your heart rate to maximum or breaking into a soaking sweat. It’s about doing the most relevant exercise to where you are right now.

I can help you get into exercise. Exercise is a component of the Individual Coaching Program. In this program we talk about your exercise history, and look for an ‘opening’ – a way into exercise that is the best fit. Some people are already exercising, others haven’t done much in years. But there is always a way forward – a way to build on what you are already doing, or discovering new ideas and possibilities.

From many years of experience I would say that the number one obstacle to doing regular, ongoing exercise is simply a lack of knowledge. What is exercise? What are the possibilities? Which exercise suits which purpose? And which exercise is the most suitable for your body at this point in time? You need to be able to answer these questions.

In the Individual Coaching Program we will answer these questions, and get you started. As the old proverb says, a march of a thousand miles begins with the first step. And there is possibly no greater motivation than the will to survive cancer.

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