Mushrooms seem to be almost magical in promoting health benefits. From fighting respiratory infections to cancer, this assortment of small fungi are gigantic warriors.
There is a lot of research, clinical data and statistics related to cancer – types, causes, and treatments – available to anyone interested in looking them up. There are, of course, the usual suspects /causes of cancer (more on that later). But there could be a case made out to look beyond the obvious. Scratch deeply and look below the surface. There is another omnipresent trigger we lug around and don’t give this Machiavellian it’s due. It coexists as both cause and effect, feeds off us, is often suppressed, and is usually the last to be addressed, if at all.
‘Unaddressed and unresolved emotions’.
The source of these could be singular, or more likely, multiple. Cracking or crumbling relationships, pressures of work (often tied up with a sense of ‘worth’ & ‘success’), irritants at home (from the mundane to the serious), overwhelming sense of responsibilities as a spouse, parent, child, maintaining a lifestyle, etc. come to mind easily. This tangle slowly and silently claws away at body, mind and soul. Some may immediately label it ‘Stress’. But this emotional web can manifest in other physio-psychological avatars too. It is silent and deadly. It attacks all systems- skeletal, muscular, nervous, circulatory, etc. All organ systems on one hand, and cognitive and emotional on the other, interfering with and impairing our quality of living and coping abilities. While one needs to clearly distinguish and recognize medical reasons for what they are, the truth is, this silent trigger is omnipotent. Abstract though it may seem, emotions wield the power to mess with our tangible systems. They have the capability of producing unwanted, negative, and damaging results in the human body. Sometimes, drastically so.
SHOULD WE BE LOOKING MORE SERIOUSLY AT OUR EMOTIONAL HEALTH IN OUR BATTLE AGAINST CANCER?
A long, relaxed conversation with a cancer survivor friend brought this aspect to the fore yet again. He has overcome cancer twice and tried all treatments – mainstream and alternate, including adopting a complete lifestyle change which most of us can only aspire to. But there remains an unaddressed issue. After years spent on this journey of cancer, getting on and off track, he calmly mentioned this point in relation to his experience of it. It was interesting to hear him analyze his own life experiences. Aware of what’s impacting him (acknowledging the source of his emotional drain), he recognizes the need let it go, and admits that he hasn’t been able to yet. Driven by his emotional moorings, he hasn’t been able to sever this source of recurring negativity in his life despite nudging by family, friends, healers and a few doctors.
He further went on to calmly say that till such time as he lets go, he is not fighting the root causes of cancer completely. (I say ’causes’ so as not to make an oversimplified case of cancer triggers, especially in relation to emotional health, nor is it my intention to present this as a thought in conflict with medical advice or challenge it.) He intends to seriously weigh the worthiness of continuing with this emotional baggage and its impact on his body.
DOES THIS MATTER?
He isn’t the first person – or the last – to have mentioned this connection. There is something more than pure abstraction at play here. And it’s worth acknowledging the elephant in the room. We are, after all, feeding it and it is rolling its weight all over us. Emotions impact us and negative emotions more so. Our bodies respond in myriad ways trying to combat it. Labored breathing, racing/irregular heart beat (cardiovascular), tight muscles (muscular), tingling in fingers/toes (neural), aches and pains (skeletal and muscular), compromised digestion, high/low blood pressure (other body systems)… these are just some common perceptible symptoms and responses to our altered emotional states. We have all experienced them to varying degrees and at different points in our lives. Not to mention what happens to our (emotional) responses and thought process.
It becomes a cause of concern when this altered state continues for a longer period of time. The body appears to adapt and these symptoms become silent and internal in nature. The impact, meanwhile, continues on a wider, cellular level, and various manifestations of this silent aggressor may emerge over a period of time, including possibly, as cancer.
SHOULD WE EMPOWER OURSELVES BETTER?
Does it mean all cancers are somehow the result of negative emotions or negative emotions will always lead to cancer? There is no definite, categorical ‘Yes’ as an answer. But, it could prove helpful investigating and addressing how our underlying emotive states may be leaving us exposed to greater possibility of serious health conditions, including cancer, along with all other clinical causes. As a precautionary tool, I reckon paying attention to emotional health plays a rather important role. We know that a healthy and fit lifestyle has so many advantages in serving as prevention for many health conditions. ‘Fitness’ needs to encompass emotional and mental health (strength and fortitude) too, by constantly sieving out the negative and enhancing the positive. It requires acknowledgement and working upon, with a conscious approach. As a cancer coping mechanism, focusing on positive emotional health and reducing negative (draining/sapping/unhappy/stressful/fearful) emotions plays a powerful role.
Emotions have the power to alter the human state at the conscious and subconscious levels. They can be an ally or a foe in our battle against ill health. They have the ability to align internal systems/processes to either facilitate or hinder external efforts.
So while one may refrain from an outright ‘yes’ to the question raised above, one cannot say an outright ‘no’ either. As science discovers deeper working of the human ecosystem, it is increasingly revealing the intertwining of our emotive state with our physical one.
Humans are emotional beings.
We cannot challenge it nor ignore the fabric that differentiates us. When one goes against the basic grain it creates friction. Prioritizing striving for a residual state of positive emotional health needs a deliberate plan and push. It is not easy. But neither is cancer nor its treatment. Using different techniques to spot and train our emotions, create emotional alchemy, makes sense now more than ever before, with different types of cancers spiraling and affecting all age groups, sometimes with the known triggers missing.
“Until you make the unconscious conscious, it will direct your life and you will call it fate.” –C. G. Jung
Originally printed on bodyinmotion.in. Reprinted with permission.
Vani Pahwa is a Functional Fitness specialist with over fifteen years of experience, and cutting-edge certifications from leading internationally-accredited and globally recognized fitness institutes. She is also a Cancer Exercise Specialist (perhaps one of the first in the country). Sought after for her multi-disciplinary fitness modules and expertise, Vani has conducted fitness workshops for leading corporate houses, conditioning and training camps for various sports communities, training programs for coaches, personal training programs for CEOs of multi-nationals, athletes, junior and senior sports professionals among others. Her combination of specialties, client profile and range, and extensive work experience makes her unique in the country. She is the founder of Body in Motion.
** If interested in further research on the topic you may read up related links including:
The rising rate of prostate cancer necessitates developing better methods to prevent and treat prostate cancer. Prostate cancer is the third leading cause of cancer death among U.S. men, according to the American Cancer Society. The country’s 3.3 million prostate cancer survivors account for 21 percent of all cancer survivors.
There are many reasons why a cancer patient should stay as active as possible through cancer treatment and recovery. I will begin by pointing out a few studies that show how exercise can benefit cancer patients. These studies demonstrate how exercise can reduce certain side effects from treatment, increase energy, decrease stress, and improve quality of life. In the last article of this series, I will suggest ways to develop an exercise program that is based on an individual’s needs and is safe and effective.
There is evidence to support the use of exercise in prostate treatment. Exercise plays a role in the all-around improved physical and mental health and therefore should be considered in the treatment plan. We know that exercise can decrease recurrence for some cancers and the role it plays in weight control, which is correlated with some cancers. For prostate cancer specifically, data indicates that obesity increases the aggressiveness of prostate cancer, and thus mortality. Men receiving androgen deprivation therapy are at higher risk for depression. Exercise reduces depression.
Studies do have their limitations. Some use self-reported data about lifestyle and exercise. Moreover, there may be a low number of minority participants who may often have higher cancer rates. The following are a few of the published studies, which confirm that exercise should be included in the treatment plan for prostate cancer patients.
Studies have suggested that patients with high levels of physical activity had a lower rate of disease progression and also reduced mortality from prostate cancer. Ying Wang, PhD, a senior epidemiologist in the Epidemiology Research Program at the American Cancer Society in Atlanta, and colleagues analyzed data on 10,067 men diagnosed with non-metastatic prostate cancer between 1992 and 2011. Men with prostate cancer, which hasn’t spread may have longer survival the more they exercise. A study demonstrated that men who were the most physically active had a 34% lower risk of dying from prostate cancer when compared with men who were the least physically active. Men who either maintained or increased their exercise level also benefited. Prostate cancer patients who kept up a moderate to high level of physical activity also had better survival prognoses compared with their more sedentary counterparts. Those men who were more active before diagnosis were more likely to have lower-risk cancer tumors and a history of prostate screenings. They were also leaner, more likely to be nonsmokers and vitamin users and they ate more fish. Wang concludes, “Our results support evidence that prostate cancer survivors should adhere to physical activity guidelines, and suggest that physicians should consider promoting a physically active lifestyle to their prostate cancer patients.”
Androgen Deprivation Therapy leads to numerous side effects, which can be decreased through exercise. Side effects of ADT include loss of muscle, increase in fat mass and osteoporosis. Risk for diabetes and heart disease also increases. Brian Focht, reported at the November AICR convention, that functional ability increased dramatically as did quality of life for those that exercise, and side effects of ADT were reversed.
Exercise can decrease blood sugar levels, which lower insulin levels and also helps to lower inflammation. There does appear to be a positive association between insulin levels, inflammation and prostate cancer risk.
The evidence for physical activity in reducing anxiety and depression, while increasing general-well being is fairly substantial. Improving well-being can have a dramatic beneficial effect on sexual function. Consistent exercise will also help to lower insulin, blood sugar, and improve overall cardiovascular health, all of which have positive impact on erectile dysfunction and libido.
In 2016, Rider and Wilson studied the connection between ejaculation and prostate cancer, which was published in European Urology. Men that reported higher ejaculatory frequency were less likely to be diagnosed with prostate cancer. This study showed a beneficial role of frequent ejaculation particularly for low-risk disease.
Some doctors have traditionally told patients to rest during this time but Favil Singh’s research confirms the importance of getting fit prior to surgery. Singh’s research published in the journal Integrative Cancer Therapies has shown that a regular dose of physical activity prior to surgery helps the recovery process. This reduces time in the hospital.
Singh stated “This is the first time we’ve been able to demonstrate the benefits of ‘pre-habilitation’ for prostate cancer patients. It is safe, side effect-free and can be done while undergoing chemo or radiotherapy. Just two sessions a week of resistance and exercise training for six weeks can make a difference to recovery.”
Often, there is a waiting period in between diagnosis and surgery. If fitness level can be improved before surgery the patient, then the patient goes into the surgery stronger and may have a better recovery.
The American Cancer Society and American College of Sports Medicine recommends at least 150 minutes of moderate physical activity or 75 minutes of vigorous exercise each week. This advice is a good goal for those who have been inactive. Unfortunately, in my view this is insufficient for a significant number of cancer patients. Having worked with cancer patients for over 20 years, I believe that this recommendation needs to be changed. It is impossible to include aerobic exercise, strength training, and other exercise methods in the current recommended time frame.
Carol J. Michaels is the founder and creator of Recovery Fitness® LLC, located in Short Hills, New Jersey. Her programs are designed to help cancer survivors in recovery through exercise programs. Carol, an award winning fitness and exercise specialist, has over 17 years of experience as a fitness professional and as a cancer exercise specialist. Visit her website, carolmichaelsfitness.com
Steven C. Moore PhD, et al, Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016; 176(6): 816-825.
Lynch B.M., Dunstan D.W., Vallance J.K., Owen N. Don’t take cancer sitting down: A new survivorship research agenda. Cancer. 2013, Jun 1; 119(11): 1928-35 Medicine
Kristina H. Karvinen, Kerry S. Courneya, Scott North and Peter Venner, Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study, Cancer Epidemiology and Biomarkers Prevention May 2007, 10.1158/1055-9965
Gopalakrishna et al, Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review. Journal of Cancer Survivorship, 2016 (5): 874-82
Vallance, J., Spark, L., & Eakin, E.. Exercise behavior, motivation, and maintenance among cancer survivors. In Exercise, Energy Balance, and Cancer (2013) (pp. 215-231). Springer
Cannioto et al., The association of lifetime physical inactivity with bladder and renal cancer risk: A hospital-based case-control analysis, Cancer Epidemiology, Volume 49 August 2017
Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012; 14(11): CD006145.
Booth FW, et al., Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012 Apr; 2(2): 1143-211.
Stephanie Cash et al, Recreational physical activity and risk of papillary thyroid cancer among women in the California Teachers Study. Cancer Epidemiology, Feb 2013,37(1): 46-53
Hwang, Yunji MS; Lee, Kyu Eun MD, PhD; Park, Young Joo MD, PhD; et al, Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study, Medicine, March 2016, Mar; 95(9): e2893
Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2011; 4: 486-501.
Galvao, et al. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010 Jan 10; 28(2): 340-7.
Galvao, et al. Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis. 2007; 10(4):340-6.
Winters-Stone KM, et al. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jan; 96(1): 7-14.
Giovannucci EL, Liu Y, Leitzmann MF, Stampfer MJ, Willett WC. A prospective study of physical activity and incident and fatal prostate cancer. Arch Intern Med. 2005; 165: 1005-1010.
Storer TW, Miciek R, Travison TG. Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy. Asian J Androl. 2012, Mar; 14(2): 204-21.
Focht, Brian C.; Lucas, Alexander R.; Grainger, Elizabeth; Simpson, Christina; Fairman, Ciaran M.; Thomas-Ahner, Jennifer; Clinton, Steven K., Effects of a Combined Exercise and Dietary Intervention on Mobility Performance in Prostate Cancer, Medicine & Science in Sports & Exercise. May 2016:48(5S): 515.
Rider J, Wilson K.et al. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow up, European Urology. December 2016, volume 70, issue 6
Singh F. et al. Feasibility of Presurgical Exercise in Men With Prostate Cancer Undergoing Prostatectomy, Integrative Cancer Therapies (2016). DOI: 10.1177/1534735416666373
Wang et al, Recreational Physical Activity in Relation to Prostate Cancer–specific Mortality Among Men with Nonmetastatic Prostate Cancer. European Urology July 2017 online bit.ly/2tXMK6Y
I am a 12 year breast cancer survivor, and experienced what cancer patients go through, not just from theory, but from living it. I’m going to talk about the role that Pilates had in my rehab and why I consider essential for cancer patients and survivors.
After surgery and treatment, most cancer patients are left with lack of flexibility and range of motion, and poor posture because of the scar tissue. Most experience fatigue from chemo and radiation or just stress of the circumstances. Many go through hormonal treatment which reduces the muscle mass, increases the risk of osteoporosis and bone fracture, bone pain, fatigue, mood swings and lack of stamina and stress.
Breathing is an essential part of Pilates. It helps with stress and stamina, reduces fatigue, opens the lungs and helps with mood swings. When we are paying attention to our breathing, we clear thoughts and allow the oxygen and energy flow through our bodies.
Awareness is a principle that helps us increase the consciousness of our body and the parts that are in disharmony and need to be repaired, isolating them from other parts to progressively make them stronger and healthier. Mind –Body connection
Control is another principle helps coordinate the body parts and move them with the correct alignment, avoiding jerky movements used in general workouts (especially using the Core which we call the powerhouse) and increasing BALANCE that is so affected in cancer patients.
Flexibility and range of motion are key in the rehabilitation for mobility and functionality of the limbs or part of the body affected so we start testing the patient range of motion without any resistance at first.
Pilates machines have springs that allow switching among different resistance according to the patient’s condition avoiding injuries and pain,
Allowing the patient to get FLEXIBLE then STRONGER and then MANAGE THEIR OWN BODY improving posture, Functionality, mobility, self-image and self-confidence.
Graciela Perez is a National Academy of Sports Medicine (NASM) Personal Trainer, Aerobics and Fitness Association of America (AFAA) Aquatic Specialist, and a Cancer Exercise Training Institute Cancer Exercise Specialist. She’s been helping people reaching their health and fitness goals since 2003.
It’s been said: “If all the benefits of exercise could be placed in a single pill, it would be the most widely prescribed medication in the world.” Scientific evidence continues to mount supporting the numerous medicinal benefits of exercise. In fact, there’s hardly a disease that I can think of that exercise won’t help in one way or another, be it prevention, treatment, or even cure in some instances.
Exercise is important for everyone even individuals who have cancer. It is important to understand your body and know what you can do. An Exercise Specialist can help you to figure out an exercise plan that works for you. Everyone is unique and therefore needs an individualized exercise program.
It is important to notify your Exercise Specialist when you have treatments. The exercise program may need to be modified for a few days after treatment. Modification is important to help preserve energy and wellbeing. You may need to do two sets of an exercise instead of three for a training session or two. Exercise can help you to stay strong and relieve stress even if you are only able to do twenty minutes every other day.
There are also some precautions to take. While exercising, you may want to wear gloves. Wearing gloves helps you to keep your hands clean during workouts. This is important because the immune system is already weakened. Wiping equipment before use will also help you to be as clean as possible. It is important to wipe mats and dumbbells as well.
Start your exercise program slowly and progress when you are ready. Fitness is an individual journey and everyone starts at a different place. It is important to not compare yourself to others and keep focused on your goals. Your exercise prescription will depend on which phase of cancer you are in.
There are many ways that exercise can benefit individuals during treatment such as: maintaining your physical capabilities, lessen nausea, maintaining independence, improve quality of life, control weight, decrease anxiety and depression, and improve self-esteem.
When you are recovering from treatment you may notice that the side effects linger. Your Exercise Specialist will adjust your program according to how you feel. Eventually, you will be able to progress and feel less fatigued. It is important, however, to continue to be active after treatments have been discontinued. Research shows that there is less chance of cancer recurrence in active individuals.
Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness. Contact Robyn by email at: firstname.lastname@example.org
American Cancer Society (2014). Physical Activity and the Cancer Patient. Retrieved http://www.cancer.org/treatment/survivorshipduringandaftertreatment/stayingactive/physical-activity-and-the-cancer-patient
Web MD (2007). Exercise for Cancer Patients: Fitness After Treatment. Retrieved http://www.webmd.com/cancer/features/exercise-cancer-patients?page=3
Cancer surgery and treatment often results in survivors suffering debilitating physical impairments. These can often be ameliorated by a good exercise program that has the added benefit of helping survivors to engage in those activities in which they participated prior to their diagnosis. This article addresses some of the physical side effects cancer survivors may face, including lymphedema and a series of safe and effective techniques to restore functional fitness for those with or at risk for lymphedema.
Surgery, chemotherapy, radiation, and hormonal therapy have side effects, which exacerbate the problems faced by cancer patients. Surgery can create adhesions that can limit range of motion, and cause pain, numbness and tightness. Removal of lymph nodes creates scars and may decrease range of motion. Radiation can cause fatigue, tightness and stiffness. It also can increase the risk of developing lymphedema. Chemotherapy may affect balance, a patient’s immune system, and cause neuropathy, fatigue, sarcopenia, and anemia. Hormonal therapy can cause joint pain and early menopause and the side effects associated with menopause.
Before beginning a cancer exercise program, a patient must receive medical clearance. A medical history, base line range of motion and girth measurements, and a general fitness assessment are taken. It is important to note that many exercises and movements may be contraindicated based on a person’s fitness assessment, medical conditions, and particular surgery. There are different exercises necessary for each type of reconstruction. For those who were active prior to surgery it is imperative to slowly work back up to the previous level of activity. It is not wise to go back to a gym and immediately continue with a pre-cancer exercise routine.
Research has shown that exercise is safe for cancer survivors, even those with or who are at risk for lymphedema. Dr. Schmitz stresses the importance of starting slowly and using proper form with a well trained certified professional. Her study demonstrates the importance of exercise after cancer with slow progressive improvement in order to decrease risk of lymphedema. The research shows that breast cancer survivors no longer have to give up activities that they enjoy doing and avoid activities of daily living. Aerobic exercise is essential to good health and we advise a patient to walk as much as possible. Initially, one might start by walking around their house or up and down their block and then slowly increasing the distance walked. Many physicians recommend that their patients try to walk during chemotherapy. This may decrease fatigue. If using aerobic equipment, make sure not to grip on the railing.
Unfortunately, there is no way to know which patients with lymph node dissection will get lymphedema. This makes it imperative to follow the established guidelines and take a prudent approach to exercise. Patients who have lymphedema need to progress slowly and use a properly fitted garment. Our goal is to promote physical activity without exacerbating lymphedema. Severe range of motion issues and cording problems are referred to lymphedema specialists. Moreover, measurement of the limbs that are at risk for lymphedema are performed frequently to make sure they have not changed in size. Symptoms can be managed easier if they are addressed promptly. Progress is monitored in order to make appropriate modifications to a patient’s program. It is important to learn the right exercises for a patient’s particular situation and how to do them properly and with good form. The patient should learn which exercises to perform, the sequencing, and quantity of repetitions. Exercise smartly and under professional guidance!
Lymphedema can be debilitating and painful and can affect the emotional health of the patient. Our bodies work better if engaged in regular physical activity, but it must be done in a safe manner if lymph nodes have been removed or radiated. A cancer fitness program for someone with lymphedema should begin as an individualized program. The patient must be supervised to make sure there are no subtle volume changes to the limb. Ultimately, we want a patient to be able to exercise on his or her own.
The starting point is a low impact exercise program, performing range of motion stretches and techniques to improve venous drainage. First, we elevate the affected area above heart level. Over time, stretches are incorporated until a patient can achieve 80% of range of motion. At that point, we start adding strength training. A stretching program for those with upper body lymphedema begins with moving or stretching the neck and shoulder areas. If a patient is still healing from breast cancer surgery, begin with pendulum arm swings. The arm is then moved and stretched in all directions, going across the chest and behind the head and back. Stretches that move the arms in shoulder flexion, extension, abduction, and adduction are added. Finally internal and external rotations are addressed. Patients suffering from fatigue can perform many of the stretches while in bed. An easy-to-follow DVD is Recovery Fitness Simple Stretching, which can be found on www.recoveryfitness.net.
All of the exercises incorporate abdominal breathing, which can stimulate lymphatic drainage. This intra-abdominal pressure may help move sluggish lymph fluid, stimulate lymph flow, and act as a lymphatic system pump. This type of breathing enables oxygen to get to the tissues. Abdominal breathing and relaxation breathing, along with the proper exercises can also reduce stress, a common cancer side effect. If weak, it may be best just to stretch and breathe deeply.
Strength training may help pump the lymph fluid away from the affected limb. Exercise helps the lymphatic fluid to April / June 2013 ~ NATIONAL LYMPHEDEMA NETWORK 13 move. Muscles pump and push the lymph fluid and can help move the lymph from the affected area. Strength training may also strengthen the arm so that it can handle those activities that may have otherwise led to swelling with a greater level of ease. Always wear a sleeve and stop if there is swelling or pain. Start with light weights and slowly increase repetitions and eventually weight.
Cancer survivors should follow a systematic and progressive plan. Exercise starts with a warm-up and cool down. Begin with deep breathing. Keeping a strong core should be emphasized. It is important to remember that following treatment the body may have become weaker. Even if a patient had exercised using 10 pound weights before surgery, if one is at risk for lymphedema they must start with a light weight. We teach patients to always listen to their bodies and to stop if they feel tired or if their limb aches or feels heavy. Patients must be aware of any changes in their body.
Progression of exercise should be gradual. A deconditioned person should start without using any weight and concentrate on proper technique. If 8-10 repetitions can not be executed, repetitions should be decreased or the weight lowered or resistance band used changed to less resistance. The exercise routines have to be adapted for the day-to-day changes that that can affect the ability to work out. Our program will start using a very light weight, with few repetitions, typically 10. In subsequent sessions, patients can add repetitions. After performing 2 sets of 10 repetitions with no problem then a small amount of weight may be added in 1 pound increments. We also alternate between a strength training exercises with a stretch for each muscle group and to alternate an upper body and lower body exercises. Pilates exercises are great way to incorporate deep breathing with strengthening the core. The deep breathing helps to pump lymphatic fluid and will also help reduce stress.
Every patient is unique. Many patients have pre-existing medical issues. The exercise program should be modified to accommodate all body types and needs. Some might need pillows for comport or postural problems. Also if osteoporosis is an issue, a cancer therapist should have experience working with this population. Always monitor the affected limb. Look for feelings of fullness or aching. We do not want to overwhelm the lymphatic system. Drink plenty of water and stop immediately if any pain. Lymphedema patients should elevate their limbs after a session.
Learn which aerobic exercises are considered safe. Walking, biking, and swimming are considered very safe. Hot tubs, pools, and warm lakes may increase risk of infection. In choosing an activity, consider the risk of injury, prior medical condition, and fitness level. Injuries can create further complications for those with lymphedema. It is still unclear whether certain sports can be safe. For example, tennis can put a lot of stress or repetitive activity on one’s limbs. It is important to know if the activity was something performed prior to lymphedema. If the patient wants to resume the activity in order to exercise, have fun, and to have good quality of life, a sports fitness program can be instituted. This should be performed under medical guidance. In a sports fitness program, the muscles used in the sport are progressively strengthened so that the sport can be resumed. Patients must use caution as they return to a sport.
One of the most important things that can be done to decrease the risk of lymphedema is to keep weight at a good level. Those individuals with whom I have worked who have had lymphedema typically see a marked reduction of swelling in conjunction with weight loss. My students who are successful in losing weight have the most success in lymphedema control. Proper nutrition is important and decrease salt intake. Evidence suggests numerous benefits of exercise: improved fitness level, physical performance, quality of life, and less depression and fatigue. Exercise is part of a healthy lifestyle and will help in weight control and emotional health. There are exercise programs that are targeted at cancer survivors but not all of them will meet the needs of someone at risk for lymphedema.
My goal is for cancer survivors to participate in individually structured and group exercise programs at all cancer centers or facilities close to their homes.
Article reprinted with permission from Carole J. Michaels.
Carol J. Michaels is the founder and creator of Recovery Fitness® LLC, located in Short Hills, New Jersey. Her programs are designed to help cancer survivors in recovery through exercise programs. Carol, an award winning fitness and exercise specialist, has over 17 years of experience as a fitness professional and as a cancer exercise specialist.
Once a virtual death sentence, cancer today is a curable disease for many and a chronic illness for most. With continued advances in strategies to detect cancer early and treat it effectively along with the aging of the population, the number of individuals living years beyond a cancer diagnosis can be expected to continue to increase.
Approximately 15.5 million Americans in the United States are cancer survivors. By 2026 that number is expected to reach 20 million. Anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of his or her life is considered a cancer survivor. And while not all cancer survivors are older adults, many are simply because of the cumulative effect of years of lifestyle issues that are risk factors for their disease. Survivors less than or equal to 19 years old comprise 1% of the cancer survivor population, 6% of survivors are aged 20–39 years, 33% are aged 40–64 years and 60% (more than half) are aged greater than or equal to 65 years.
Breast cancer survivors are the largest constituent group within the overall population of cancer survivors (22%), followed by prostate cancer survivors (19%) and colorectal cancer survivors (11%) (3). Gynecological and other genitourinary cancers each account for 9% of cancer survivors, followed by hematological cancers and lymphoma (7%) and lung cancer (4%). Other cancer sites account for much smaller percentages and together are responsible for 19% of the total number of survivors. In terms of stratification by gender, more than two thirds (69%) of all female cancer survivors have a history of breast (41%), gynecological (17%) or colorectal (11%) cancer. For male survivors, two thirds (66%) have a history of prostate (39%), other genitourinary (such as testicular or renal) (14%) or colorectal (13%) cancer.
Not surprisingly, cancer survivors are often highly motivated to learn more about things like nutrition, supplements and herbal remedies, and exercise that might improve treatment outcomes and ultimately their survival and quality of life. For many of the most important nutrition and physical activity questions faced by cancer survivors, the scientific evidence comes only from observational and laboratory animal data, or unreliable reports from poorly designed clinical studies. Moreover, the findings from these studies are often contradictory. Very few controlled clinical trials have been done to test the impact of diet, nutritional supplements or nutritional complementary methods on cancer outcomes among cancer survivors.
In an effort to identify and evaluate the scientific evidence related to optimal nutrition and physical activity after the diagnosis of cancer, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity and cancer. The findings of this group guide healthcare providers, cancer survivors and their families through the mass of information and help them make informed choices related to diet and exercise. The Expert Committee reviewed all of the scientific evidence and best clinical practices for different types of cancer and “graded” both the quality and certainty of the scientific evidence for factors affecting the most common cancers. As was already mentioned, there are few clear answers to many questions, a wide range of sources and often conflicting information. But, these experts agree that even when the scientific evidence is incomplete, reasonable conclusions can be made that can help to guide choices in the areas of nutrition and physical activity.
Physical activity may help cancer patients build up their physical condition; decrease the number of comorbid conditions (like heart disease and diabetes); reduce drug interactions; help cancer patients cope with treatment; restore good health; improve quality of life during and after treatment; and help cancer patients and survivors maintain independence as long as possible
Physical rehabilitation programs similar to those for cardiac rehabilitation may be effective in managing, controlling or preventing adverse medical and psychosocial outcomes manifested during cancer survivorship. For example, exercise programs are being developed as interventions to improve the physical functioning of persons who have problems with mobility as a result of therapy and are also being shown to be efficacious for weight control after breast cancer treatment, lessen the effects of chronic fatigue, improve quality of life, prevent or control osteoporosis as a result of premature menopause and prevent or control future or concurrent comorbidities.
Diet, weight and physical activity interventions carry tremendous potential to affect length and quality of survival in a positive manner and prevent or control morbidity associated with cancer or its treatment.
General Physical Activity Guidelines for Cancer Survivors
In general, physical activity is likely to be beneficial for most cancer survivors. Recommendations on the type, frequency, duration and intensity of exercise should be individualized to the survivor’s age, previous fitness activities, type of cancer, stage of treatment, type of therapy, and comorbid conditions.
Particular issues for cancer survivors may affect or contraindicate their ability to exercise. Effects of their cancer treatment may also promote the risk for exercise-related injuries and other adverse effects.
The following specific precautions are from the American Cancer Society:
- Survivors with severe anemia should delay exercise, other than activities of daily living, until the anemia is improved.
- Survivors with compromised immune function should avoid public gyms and other public places until their white blood cell counts return to safe levels.
- Survivors who have completed a bone marrow transplant are usually advised to avoid exposure to public places with risk for microbial contamination, such as gyms, for 1 year after transplantation.
- Survivors suffering from severe fatigue from their therapy may not feel up to an exercise program, so they may be encouraged to do 10 minutes of stretching exercises daily.
- Survivors undergoing radiation should avoid chlorine exposure to irradiated skin (e.g., swimming pools and whirlpools).
- Survivors with indwelling catheters should avoid water or other microbial exposures that may result in infections, as well as resistance training of muscles in the area of the catheter to avoid dislodgment.
- Survivors with significant peripheral neuropathies may have a reduced ability to perform exercises that use the affected limbs because of weakness or loss of balance. They may do better with a stationary reclining bicycle, for example, than walking outdoors.
For the general population, the ACS and other health organizations recommend at least 30 minutes of moderate physical activity at least 5 days per week to reduce the risk for cancer, cardiovascular disease and diabetes. These levels of activity have not been studied or tested specifically in cancer survivors, however. For the general population and for cancer survivors, any movement is likely beneficial. Therefore, although daily and regular activity may be preferred and may be a goal, any steps that are taken to move from a sedentary to an active lifestyle should be encouraged. For survivors wanting maximum benefit, the message should be that the health benefits of exercise are generally linear, with benefit related to higher intensity and duration, although extremely high levels of exercise might increase the risk for infections.
Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.
With cannabis becoming increasingly mainstream in modern culture, its population is becoming aware of its use for a number of purported medical reasons ranging from skin ailments to digestive issues and pain. California has recently allowed its recreational use. Today, the industry is still nascent with a market of ill-vetted products with equally nascent scientific claims. However, cannabis may be unique in its application to holistic care as mediated by the endocannabinoid system and thus it is prudent to know what is useful and what isn’t.
The history of cannabis use is ancient and has resulted in many breeds of cannabis which differ in the phytocannabinoid content, ratio and terpene profile. Cannabinoids are molecules that act on cannabinoid receptors that comprise the endocannabinoid system. The endocannabinoid system modulates the psychological stress, emotionality and inflammation responses. CB1 and CB2 are examples of receptors within this system whose span is diverse, for example, they are found in the brain, gut and persist in osteoarthritic cartilage despite degradation grade. Interaction with these receptors can occur through phytocannabinoids; each of which has differing effects. To complicate matters, phytocannabinoids influence the effects of one another. Furthermore, the method of delivery also influences the effects; for example, ingestion allows the liver time to process phytocannabinoids into its derivatives which have their own effects.
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are two well-known examples of phytocannabinoids. THC has claims to work as an analgesic, antiemetic and antispastic; although, adverse effects include paranoia, lethargy, and tachycardia. THC can also induce euphoria which may play a role in how the analgesic properties work. CBD has claims to work as an anti-inflammatory, antiepileptic and works to block the binding of THC to CB1 and CB2 receptors. The interplay that cannabinoids have on one another has led to the notion of the “entourage effect.” (The idea that cannabis plant as a whole has curative effects.) Pharmacologically speaking, only a combination of THC and CBD, in a 1:1 formulation, manufactured by G.W. Pharmaceuticals has been vetted for its medical claims.
From oils and tinctures to hash and kush, the recreational market has driven into existence a myriad of products with a myriad of claims akin to the early days of the dietary supplement market. Assuming the source comes from one that complies with the current regulation, medical cannabis falls into three categories: plant, processed and formulations. Plant products refer to cannabis products in which the cannabinoids have not been altered and removed from the cannabis plant. These products use no heat or chemicals in their preparation and include: buds, keef, hash.
Processed products apply heat or chemicals to the cannabis plant in order to remove desired terpenes and cannabinoids. Processed products include oils, tinctures, e-juice, etc. and can be assumed to contain a higher percentage of cannabinoids in natural and unnatural ratios. Formulations are processed products whose consistency in manufacturing and medical claims have been vetted by the FDA. Formulations include products like Sativex and Epidiolex. Of course, marketing practices blurs the usage of terms; therefore, it is incumbent of the self to understand the product.
Jakub Pritz, Ph.D. has been working in the cannabis industry since 2015 as a separation operator and consultant for the production of recreational cannabis oils and other cannabis-related products. He can attest to current cannabis production methods and what the person should be aware of. His interest is to create botanical extracts of cannabis to be delivered in differing modalities depending on the effects sought and data affirmation. For example dosage control in inhalation for acute pain relief, transdermal applications for arthritic pain and oral methods for digestive symptoms. Patrons should be aware of the euphoric effects of THC and the interactions cannabinoids have with one another in varying ratios.
Prior to this, Jakub held a post-doctoral position at UCSD’s Moore’s Cancer Center where he was in charge of data management and accruing international radiation oncology centers to join the International Evaluation of Radiotherapy Technology Effectiveness in Cervical Cancer (INTERTECC). This trial required the coordination of several centers to follow strict data collection standards, quality checking of the institution capabilities and implementation of plan protocol. He received his Ph.D. in Applied Physics (concentration in Medical Physics) from the University of South Florida in 2011.
As an athlete, Jakub competed in the Patriot League as a swimmer, setting records along the way. During his graduate school years at the University of South Florida, he participated in, coached and competed with their water polo club.