However, many people still feel unsure how this can help especially when you are going through treatment, feeling very unwell and tired. Most importantly you need to remember everyone is different. Treatment is specifically tailored to each individual and this should be the same with exercise. Side effects, coping mechanisms and general wellbeing effects are not the same for everyone, what works for one person isn’t necessarily going to work for you.
A good exercise programme can help to ameliorate many cancer or treatment related side effects.
Exercise is medicine, wonderful for our physical and emotional health. It is one thing you can do for yourself, which is very empowering. It can be carried out before, during and after treatment but you need to be mindful of how you are feeling. It is possible that exercise lowers the risk of cancer relapse although whether it can prevent recurrence of leukaemia or any other type of blood cancer is still unknown. Keeping your fitness up after treatment can reduce longer term risks such as heart disease which may be associated with some treatments. It can also increase the likelihood that you are fit enough for optimum treatment in the future, should your cancer return.
When thinking about exercising it is always good to speak to someone from your medical team to keep them informed as they may advise you of any precautions you need to take. What you are able to do will be determined by your treatment as you may be in hospital for a few weeks due to low blood count and some treatments put you at a higher risk of infection.
Some side effects are more common than others but, in general, if you are able to exercise at an level that is tailored to your physical needs, these sides effects should not be made any worse and, in some cases, may improve.
Contrary to belief, exercise can help with tiredness and does not exacerbate the condition. An overemphasis on energy conservation can result in treatment related losses of aerobic fitness and muscle strength. Exercise can help to decrease bone pain, improve sleep and appetite. If your weight has increased, gentle exercise may not stop you putting weight on but it can help in reducing the amount gained. During treatment there can be muscle wastage which impacts on your muscle to fat ratio. As your fat increases, your muscle mass depletes. However, by exercising, you can try and reduce this wastage and start to control the weight increase. If the amount of lean muscle mass lost has been very significant, it’s best to begin with strengthening exercises first, then build up to some aerobic exercise. For more information on suitable exercises, seek advice from exercise specialist or physio.
Exercise can also have significant improvement on your wellbeing and quality of life, helping to relieve stress related to the disease and treatment.
After a blood cancer diagnosis, keeping fit and active might be the last thing on your mind, but exercise can benefit both your treatment and recovery. Here, our Nurse Advisor, Fiona Heath, explains more.
There are many benefits to being physically fit whilst undergoing cancer treatment for leukaemia, and in the recovery period too. It can reduce stress and give you more energy, and a large amount of research and information is available on these benefits.
What sort of exercise should you do?
You need to ensure you choose something you enjoy which is also appropriate for your level of fitness, diagnosis and circumstance. There is no point doing something you have no interest in as most people find it hard enough getting motivated to exercise in the first place.
When you feel able to exercise, you should increase your exercise activities gradually. At first, you may feel much more tired than usual, but over time this will improve. Regular exercise can help increase strength, maintain muscle mass and promote flexibility. It also helps to alleviate fatigue, and activities that include weight-bearing exercise can also help to improve bone density and reduce the risk of bone thinning (osteoporosis).
The key to exercising is to plan it into your schedule and find as many ways as possible to incorporate it into your everyday life. Aim to work up to doing 30 minutes of exercise four to five times a week if you can. If you find it difficult to do 30 minutes at one time, break it down into 10-minute blocks and increase it as your strength and endurance improves.
The extent and rigour of the exercise that you do will depend on your current activity levels and physical condition. Walking for 20 minutes each day is an excellent choice of exercise for almost anyone. Mild exercise like walking is very good for you and helps to alleviate fatigue. Start exercising slowly and gradually build up to a more strenuous workout. Don’t push yourself to the point where you are very tired and out of breath. Staying active during the day will also help encourage normal fatigue at night, making it easier to sleep.
Although exercise has many benefits for leukaemia patients, it is important to always check with your healthcare professional before starting any exercise program and to be aware that you may need to take some precautions.
Low red blood cells (anaemia): Red blood cells carry oxygen to your organs and tissues. When they are low, they may not be able to keep up with the increased demand put on your body during exercise. You may notice that you get tired much more easily and might have difficulty catching your breath when you exert yourself. During times when you have low red blood cell counts, you should reduce the intensity of your workouts or avoid them altogether depending on the advice of your medical team.
Low white blood cells (neutropenia): When your white blood cells counts are low, you have a decreased ability to fight off infections. At this time, you should avoid crowds and keep your exercise routine closer to home. Gyms, swimming pools and changing rooms increase your risk of being exposed to a virus or bacteria that can make you unwell. If you have a fever, don’t push yourself to exercise. Take some time off to help your body heal and recuperate.
Low platelet counts (thrombocytopenia)
Platelets are responsible for forming clots in your body. When your platelets are low, you are more at risk of bleeding and bruising. For this reason, you should avoid contact sports and activities in which you may be at high risk of falls or injury. You may choose to use resistance bands instead of heavyweights that you could drop.
Some people have a loss of sensation, or feelings of pins and needles, in their hands and feet due to cancer treatments. This is called peripheral neuropathy. If you have this, it might be better to use a stationary bike than to do other types of weight-bearing exercise.
Central Venous Catheter
If you have a central venous catheter (CVC) you will need to make sure it is well secured before exercise activities. A tunnelled CVC can be tucked into a sports bra or taped or fastened to your body. Peripheral CVC (PICC lines) should be taped or wrapped securely to prevent them from becoming dislodged.
After you have completed your treatment
The NHS currently recommends that adults aged 19 to 64 should try to be active daily and should do:
- At least 150 minutes of moderate aerobic activity such as cycling or brisk walking every week and
- Strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).
This should be viewed as a target to work towards, it is important to start at a low level of intensity and work up gradually, especially if you are recovering from treatment.
Another benefit of keeping your fitness up after treatment is that it can reduce longer-term risks such as heart disease, which may be associated with some treatments. It can also increase the likelihood that you are fit enough for optimum treatment in the future, should you need additional treatment.
Published: March 2018
Next planned review: March 2020