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Cancer and Physical Therapy

Cancer affects over 1 million people a year. In fact, 77% of all cancers are in adults 55 years old and over. We are living longer today, and thus the possibility of getting cancer as we age increases. We now know that 75% of all cancer risks are caused by environmental/behavioral factors that include tobacco, diet, chemical exposure, occupational hazards, and radiation. Three of the leading causes for cancer are within our control -- thus we can greatly affect our chances of getting cancer by the choices we make, particularly in our diet and daily activity.

Individuals who have to undergo cancer treatments can suffer from fatigue and overall physical weakness. This is often described as a sudden onset of overwhelming exhaustion and lack of energy, with no great relief or improvement from rest. Cancer treatments such as radiation, surgeries, and chemo-therapy can cause side effects that interrupt the body’s natural physiological and immune processes, creating fatigue and loss of energy. The fatigue and muscle weakness you are feeling stem from cancer treatment side effects, which include tissue dehydration, electrolyte imbalances, acid-base disturbances, hypoxia, neurologic toxicities, cardiac abnormalities, and dizziness which all contribute to complete & constant tiredness.

Exercise is a good non-pharmacologic intervention that can help minimize pre and post side effects from cancer treatments. A 2004 research study looked at exercise as an intervention for fatigue stemming from cancer treatments and found that as one increased with exercise, fatigue decreased. The study looked at a home-based aerobic and walking programs that proved effective for cancer related fatigue. The training exercise guidelines from this study included: 1) frequency of exercise – 3-5 days per week, 2) Intensity: 50-70% of maximum heart rate or 11-13 on a Borg Perceived exertional scale, and 3) Duration: Each session lasted 15-30 minutes.

It is also beneficial to begin a light resistance program two days a week. The resistance program can be as simple as a few exercises using tubing, light hand weights or light settings on weight machines (make certain someone who has expertise shows you how to properly use these tools). Other ways to stretch, strengthen and exercise include yoga, water aerobics, and Tai Chi. I know several cancer patients who have benefited greatly from gentle, restorative yoga -- both in mind and body. Make sure the instructor understands your condition and works with you gently.

Exercise and resistance programs can begin before, during and after cancer treatment(s). It’s important to note that exercise can be important to you during your cancer treatments. However, it is also important during cancer treatment that your blood levels are adequate. Talk to your oncologist to ensure blood levels are adequate to safely exercise. Remember that exercise duration, frequency and intensity can all be modified at a safe level. Resting is not always the correct solution to prolong fatigue. For example, do not exercise when your white blood count is below 3000/mm, or your Hemoglobin is less than 10g/dl or your blood Platelets are less than 25,000mm. Further, do not exercise on the day of your chemo-therapy treatment or radiation.

As a physical therapist, I encourage you to consider an exercise program developed in collaboration with your therapist, oncologist and you. Of course your care and progress has to be monitored to insure safety, and more importantly to ensure you gain the benefits of the exercise program to help combat fatigue and muscle weakness. A physical therapist has the clinical expertise to monitor blood levels and provide the correct exercise prescription in conjunction with your oncologist approval.

In addition to exercise, there are some nutritional changes or additions you might consider when undergoing cancer treatments. Again, you will want to discuss this with your physician before making any dietary changes that could affect or interact with your treatment.

  1. Chemo nausea – Ginger

  2. Radiation - Spirulina (blue green algae), Wheatgrass

  3. Breast Cancer - Lemon, Rosemary, Pomello

  4. Inhibits the growth of cancer cells/tumors – Fenugreek, Cucumber (skin – use organic), Pineapple, wheatgrass, turmeric, turnips, flaxseed, garlic

  5. Stimulates enzymes to fight cancer growth – Cloves, Garlic

I personally believe it is important to consume as much fresh, local, organic produce as possible when undergoing cancer treatments. The less food processing and the closer to its natural state, the better. So look for fresh wheatgrass, fresh ginger, fresh turmeric root, fresh herbs, and so on. Make certain all produce is thoroughly cleaned. You do not have to suffer from body fatigue and muscle weakness while under-going cancer treatments. Talk to your physical therapist or ask your physician about curbing fatigue and muscle weakness that involves prescribed activities and not rest.


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