I pride myself on being a science geek through and through. I understanding the scientific method, I understanding retesting getting consistent results. But I think accepting results of scientific testing comes down more to the mighty dollar and marketing than to the betterment of human lives.
A cancer diagnosis is tremendously overwhelming and often takes away the feelings of control over one’s life. After diagnosis comes the whirlwind of information and new decisions that revolve around living with cancer. Health & Wellness Coaches work with clients in a variety of ways to help them navigate through the healthcare system and develop a self-created plan for treatment and lifestyle that supports the client in managing and re-gaining control over their lives.
I have mentioned many times thus far, not just that exercise is the managing partner of integrative oncology, but I try to be really careful to say the right exercise. As much as exercise does hold the key to our magic kingdom of health within, there are contraindications, both in terms of prevention and recovery, and prevention of recurrence.
To understand this, let me give you a very brief intro to oxidative stress. We have all read about the importance of eating our fruits and vegetables to provide much needed antioxidants. This is because we live a life where oxidative stress is in abundance. As exercise is the one and only Rx with no bad side effects, the truth is, we should always say “the right exercise”.
Unfortunately in our world of extremes and quick fixes, we think of exercise as bop till you drop. Pushing hard, sweating — and as some celebrity trainers like to take pride in — push till you
throw up.
OK… I will NEVER support the latter, under any circumstance, but for some people pushing to the point of sweaty, dirty, pumped, driven, is a great thing.
I do believe the fountain of youth is our own sweat! And yes, that level of intensity to achieve that state differs greatly amongst people.
The danger exists, when people exceed their optimal levels, which we can do unknowingly. Given the chronic illnesses, the data seems to support most people are not exerting themselves in terms of exercise or physical activity anywhere near that optimal level.
However, with people recovering from cancer, it is very important to work at the right level, and know that slow and steady wins the race. And just to throw in another caveat – yes this level of intensity will vary drastically, depending on the type of cancer and treatments utilized.
Oxidative stress occurs when the production of reactive oxygen species (ROS), often referred to as “free radicals,” exceeds antioxidant defence. There are many perpetrators in our world to the production of reactive oxygen species: alcohol, sugar, toxins, certain chemicals… a very long list, and the truth is we have to add exercise to this list if we are doing it beyond the appropriate point. Or if exercise is counterproductive to…
The balance between the ROS and antioxidants is out of whack, upsetting our inner ecosystem, creating an environment for cancer to survive and thrive. As always, its all about balance.
And this is yet another reason it is critical to have a well balanced, nutrition packed diet. The expression often used is “eat a rainbow”, because eating an assortment of colors (fruits and vegetables, not candy) is a great way to ensure getting a variety of antioxidants our bodies need to combat those free radicals. And by the way, the danger of an imbalance in this equation is a factor in not just cancer but many other diseases, including heart disease, Alzheimer’s, depression, macular degeneration, autoimmune disorders. Now, let’s think about the many possible side effects of treatments (medications) for these diseases… cancer. OK, let’s eat our antioxidants! (I promise, much more about antioxidants in another article)
Or as my chick flick heart insists: Exercise & Nutrition are the greatest love affair of all times. One just cannot live without the other.
The point is NOT don’t exercise because it might be a source of oxidative stress. The point is we must expand our view of what exercise is. The point is to understand physical activity vs. exercise, dynamic vs. static exercise. Exercise is NOT about pushing in misery until you drop in a gym you don’t like! The point is there are many types of exercise that can be performed multiple times through out the day to tweak our immune & circular systems, and to accomplish that flow of Qi, that inner ecosystem.
The other point we have to remember, in all of our wonderful forms of exercise: training, cardio respiratory, strength, yoga, pilates, Qi Gong Tai chi, they all have wonderful benefits and healing powers. However, there are boundaries & contraindications for all of them. There are a number of parameters involved when deciding on an exercise program for cancer recovery & beyond. To name a very few: the type of cancer, treatment, potential for lymphedema, other pre-existing medical conditions, level of conditioning, goals of the program, fat loss suggested, preservation of muscle mass, side effects of treatment. And every one of these categories opens up many
other considerations.
But the most important factor of all is the F factor, FUN. What will we actually, enjoy, embrace, do, and want more. We learn very quickly in the fitness business, “no time” is an excuse. When we know the literally infinite possibilities for physical activity, no time is an excuse, or, a very limited knowledge of what exercise is.
But step one is MOVE. Whether we move and pump those muscles when seated or standing, get it moving and pumping. Please consult a trained professional in cancer exercise training.
Even if the professional tells you they have worked with many cancer patients, it does not mean he or she has been trained in cancer exercise, and knows the many forms of exercise available, not just their own platform, and is aware there are contraindications, and potentially could have an adverse effect on recovery.
There is no one Rx for each cancer. We cannot say, “For breast cancer do this, for prostate cancer do that.”
Cancer exercise is both art and science, supports a mind body connection and creates an environment within to optimize treatment outcomes. Yes, always get permission from the health care professionals, but don’t let them think you are considering training for Ironman, This is not what cancer exercise is all about.
In exercise, we follow the FITT formula: Frequency Intensity Type Time
For cancer exercise I have modified this formula. FFITTT: FUN Frequency Intensity Type Time Telomeres…. leaves you hanging for another blog!
For a constant supply on recent studies on cancer prevention and recovery, please join me on Facebook.
Shira Litwack is the Director of International Relations and Master Trainer at, Cancer Exercise Training Institute and creator of Best in Health Radio.
Rebounding is a complete cellular exercise, stimulating the activity of the lymphatic system (a critical part of the immune system). Rebounding 3-5 times per week at a minimum of 10-15 minutes at a time is highly beneficial.* It is effective at a minimal bounce, using acceleration and deceleration, with each bounce, to open and close the one-way valves between the lymphatic system and the cells. Lymphatic fluid surrounds all of the cells of the body. While bounding toxins, poisons, and metabolic waste are pulled out of the cells into the lymph fluid, while oxygen and nutrients (transferred previously at the capillaries, from the blood) are pulled in the cells from the lymph fluid. Within the lymph system are lymphocytes, for example- white blood cells, which consume metabolic waste, bacteria, and dead cells. Rebounding keeps the lymph system moving and unplugged, so lymphocytes have free reign to do their job. More importantly, bounding does this without stressing the hips, knees, or ankles, or creating shin-splints. It can be done on a daily basis or multiple times per day without creating overuse injury.
What is the Lymph System and how does it help me?The lymphatic system acts as a secondary circulatory system, except that it collaborates with white blood cells in lymph nodes to protect the body from being infected by cancer cells, fungi, viruses or bacteria.
The lymphatic system is a system of thin tubes that runs throughout the body. These tubes are called ‘lymph vessels’.
Unlike the circulatory system, the lymphatic system is not closed and has no central pump. It is not under pressure and only moves because of exercise or muscle contraction.
When the lymphatic system is congested, the cells become deprived of oxygen, affecting the body’s ability to rid itself of its own waste material. Over time, other body systems that rely on the lymphatic
It takes only two minutes of rebounding to flush the entire lymphatic system, while cleansing and strengthening cells and lymph nodes. A further benefit to the body is that during this brief time span the white blood cells of the immune system triple in number and remain elevated for an hour. These specialized cells play a major role in the body’s defense against illness and disease.
At this point another two-minute rebound session would increase the demand for white blood cells as the process of cleansing, strengthening, and the flushing away of spent cells and other cancerous debris is repeated.
When beginning a program of regular rebounding it’s best to gradually increase time and intensity as the body – including bones and internal organs – adjusts to the increased gravitational load and becomes stronger.
Rebounding increases capacity for respirationAmong the various functions of the lymphatic system is its ability to carry waste away from the cells and bloodstream to the body’s organs of elimination. The system consists of veins and capillaries, with one-way valves, that contain a clear fluid called lymph. This fluid also surrounds cells throughout the body and collects cellular debris before draining it into the lymphatic system. Lymph carries the waste on a one-way path toward the heart and passes through many filters (lymph nodes) where special white blood cells attack and eliminate foreign molecules.
Once the lymph fluid approaches the heart it is returned to circulation and makes its way for further cleansing of toxins by the liver and kidneys. The lymphatic vessels are not connected to the blood circulatory system, and unlike blood which is pumped by the heart, lymph fluid relies on bodily movement and exercise to drive it through the lymphatic system. Forceful flushing of the system cleanses lymph nodes, contributes to healthy, clear lymph fluid, and boosts the immune system. Stagnant, slow-moving and thick lymph fluid is due to a lethargic, toxic body and weakened immune system.
When the lymph fluid remains sluggish the lymph nodes become clogged and lose their filtering ability. Without routine flushing of the lymph, debris becomes trapped in the body, creating a toxic overload and contributing to the onset of disease.
It takes only two minutes of rebounding to flush the entire lymphatic system, while cleansing and strengthening cells and lymph nodes. A further benefit to the body is that during this brief time span the white blood cells of the immune system triple in number and remain elevated for an hour. These specialized cells play a major role in the body’s defense against illness and disease.
At this point another two-minute rebound session would increase the demand for white blood cells as the process of cleansing, strengthening, and the flushing away of spent cells and other cancerous debris is repeated.. Therapeutic rebounding has been shown to reduce cancerous tumors and improve or heal a host of other ailments (3).
When beginning a program of regular rebounding it’s best to gradually increase time and intensity as the body – including bones and internal organs – adjusts to the increased gravitational load and becomes stronger.
Doreen Puglisi, MS is the Founder and Executive Director of Pink Ribbon Program. The Pink Ribbon program works to give every woman the ability to regain a sense of well-being that had been lost from diagnosis through surgery into recovery.
References:
The event men look forward to — and women don’t — the Movember Moustache.
Rebounding is a complete cellular exercise, stimulating the activity of the lymphatic system (a critical part of the immune system). Rebounding 3-5 times per week at a minimum of 10-15 minutes at a time is highly beneficial. It is effective at a minimal bounce, using acceleration and deceleration, with each bounce, to open and close the one-way valves between the lymphatic system and the cells. Lymphatic fluid surrounds all of the cells of the body. While bounding toxins, poisons, and metabolic waste are pulled out of the cells into the lymph fluid, while oxygen and nutrients (transferred previously at the capillaries, from the blood) are pulled in the cells from the lymph fluid. Within the lymph system are lymphocytes, for example- white blood cells, which consume metabolic waste, bacteria, and dead cells. Rebounding keeps the lymph system moving and unplugged, so lymphocytes have free reign to do their job. More importantly, bounding does this without stressing the hips, knees, or ankles, or creating shin-splints. It can be done on a daily basis or multiple times per day without creating overuse injury.
The lymphatic system acts as a secondary circulatory system, except that it collaborates with white blood cells in lymph nodes to protect the body from being infected by cancer cells, fungi, viruses or bacteria.
The lymphatic system is a system of thin tubes that runs throughout the body. These tubes are called ‘lymph vessels’.
Unlike the circulatory system, the lymphatic system is not closed and has no central pump. It is not under pressure and only moves because of exercise or muscle contraction.
When the lymphatic system is congested, the cells become deprived of oxygen, affecting the body’s ability to rid itself of its own waste material. Over time, other body systems that rely on the lymphatic
It takes only two minutes of rebounding to flush the entire lymphatic system, while cleansing and strengthening cells and lymph nodes. A further benefit to the body is that during this brief time span the white blood cells of the immune system triple in number and remain elevated for an hour. These specialized cells play a major role in the body’s defense against illness and disease.
At this point another two-minute rebound session would increase the demand for white blood cells as the process of cleansing, strengthening, and the flushing away of spent cells and other cancerous debris is repeated.
When beginning a program of regular rebounding it’s best to gradually increase time and intensity as the body – including bones and internal organs – adjusts to the increased gravitational load and becomes stronger.
The lymphatic system, a major part of the body’s immune system, is a network of lymph nodes, ducts, and vessels that transport lymphatic fluid from the tissues to the bloodstream.
Lymph nodes act as filters and remove bacteria and toxins. Their role is vital in maintaining health and the lymph system must be kept flowing in order to function correctly, especially for those suffering from chronic fatigue syndrome.
People with chronic fatigue syndrome often have depressed immune systems, and a healthy lymphatic system will reduce the symptoms.
Unlike the circulatory system which uses the heart as a pump, the lymph system relies on body movement, that is, exercise to circulate lymph around the body.
When you don’t exercise sufficiently, the lymph system becomes stagnant and blocked. For those with chronic fatigue syndrome, it means your body is unable to efficiently dispose of toxins and bacteria and begin to heal.
When you are feeling dragged down by cancer-related fatigue syndrome, exercise is the furthest thing from your mind. However, to reduce the symptoms of this syndrome you need to exercise to get your lymph system moving and rid your body of harmful toxins and waste.
Lymph fluid is activated in three ways: muscular contraction from exercise, gravitational pressure, and internal massage to the valves of the lymph ducts.
You don’t have to run marathons in order to get the exercise you need. In fact, a mini exercise trampoline called a rebounder is the perfect exercise tool for you.
For chronic fatigue sufferers, mini exercise trampoline rebounding is the most efficient and effective form of exercise to get your lymph system flowing.
Mini Exercise Trampoline AdvantagesMore Efficient Exercise: For those with cancer-related fatigue, mini exercise trampoline rebounding is a very efficient form of exercise.
With most forms of exercise, you have to spend as much energy decelerating as you do accelerating. But when you exercise with a rebounder, at the bottom of a bounce the force is recycled upwards without you having to expend extra energy. For those with chronic fatigue syndrome, this energy saving is a godsend.
When you bounce downwards, the mat absorbs the impact. Even though the impact is cushioned, it still strengthens the entire body more thoroughly than any other form of exercise. If you suffer from cancer-related fatigue syndrome, a strong body is your goal.
Doreen Puglisi, MS is the Founder and Executive Director of Pink Ribbon Program. The Pink Ribbon program works to give every woman the ability to regain a sense of well-being that had been lost from diagnosis through surgery into recovery.
Exercise is important in keeping the mind/body healthy for many reasons. Individuals, with Rosacea, however, must be careful not to cause permanent inflammation of the skin. Inflammation from this condition may be linked to Basal Cell Carcinoma.
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 based on the individual’s needs and is safe and effective.
Research has shown that exercise can reduce the risk of getting some types of cancers. There are numerous published studies on the benefits of exercise for those with colon cancer, breast cancer, and endometrial cancer. An American Cancer Society’s newsletter stated: “Among breast cancer survivors, a recent analysis shows that getting exercise after diagnosis was associated with a 34% lowered risk of breast cancer death, a 41% lower risk of dying from all causes, and a 24% lowered risk of breast cancer recurrence. Among colon cancer, studies suggest exercise cuts death from colon cancer and all causes, and cuts the risk of the cancer coming back by up to 50%.”
The Journal of the American Medical Association reported that exercise lowers the risk of 13 types of cancers. Since there is limited research on exercise and bladder cancer, it is important to note that the results of the study showed that those who exercised the most had a 13 percent lower risk of bladder cancer. The JAMA study is empowering because it provides further ammunition as to the importance of exercise for additional types of cancers.
Studies suggest that exercise is safe and helpful for many people who are suffering from cancer and may lower the risk of some cancers. Other health benefits of exercise are weight control, cardiovascular health, increased bone density, and decreased fatigue, stress, anxiety and depression. Exercise can improve range of motion, improve endurance, and decrease the risk of lymphedema.
Exercise helps to control obesity, which is positively correlated with several cancers. Studies have shown that weight gain increases the risk of cancer and the risk of recurrence during and after treatment. Since exercise is a crucial component of weight control which effects cancer risk, exercise needs to be considered as part of the treatment plan.
It has been observed that exercise can improve outcomes for those with bladder cancer. Research conducted by J. Vallance suggests that strength training and aerobic exercise can improve psychological and physical issues for those with bladder cancer and increases the chance of survival.
In May of 2007, “Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study” by Kristina H. Karvinen et al was published in Cancer Epidemiology and Biomarkers. The authors examined the association between exercise and quality of life in a sample of 525 bladder cancer survivors. They found exercise to be negatively associated with several aspects of fatigue. The study also suggested that active bladder cancer survivors have improved mood and energy and quality of life.
In 2016, “Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review” by Gopalakrishna, reviewed the literature on the associations between lifestyle factors and quality of life in bladder cancer survivors. Their conclusion was that there is some evidence for a positive association between quality of life and physical activity.
Kellogg Parsons, MD, an associate professor of Surgery at the University of California, San Diego, discusses modifiable lifestyle factors associated with bladder cancer on onclive.com. Parsons and his team found that participants who had any amount of physical activity had improved survivorship compared to those with no physical activity.
A recent study in by Cannioto et al in Cancer Epidemiology reports an association between living a life with little to no recreational physical activity and an increased risk for bladder cancer. The study suggests a connection between being inactive and increased risk of cancer.
In summary, we know that physical activity reduces the risk of numerous diseases. Now we have additional evidence, that it may also reduce the risk of bladder cancer.
The sooner the patient starts to exercise the better. Starting before surgery and treatments and continuing during treatment can lead to a better recovery with less complications and medications.
Survivorship can serve as a strong motivator to make positive lifestyle changes. Everyone’s situation is unique. Accordingly, exercise needs to be tailored to individual people, taking into account their overall fitness, diagnosis, and other factors that could affect safety.
Regular physical activity can help rebuild a patient’s strength and energy level and help manage other health related issues. Health issues like diabetes, and cardiovascular diseases are a leading cause of death in cancer survivors and those without cancer. Managing health related issues through exercise could increase survival.
Some cancers and cancer treatments may result in incontinence. A side effect of biologic treatment may include irritation of the bladder, an urgent need to urinate, frequent urination, or incontinence.
Incontinence can occur in men or women with bladder cancer and last for a short time or longer. There are different types of incontinence, ranging from mild to severe. Some examples are: stress incontinence can cause a person to leak urine during activities such as coughing, laughing, sneezing, or exercising, urge incontinence is a sudden, urgent need to urinate and continuous incontinence is not being able to control the bladder at all.
Kegel exercises strengthen your pelvic floor muscles to control urine flow. The pelvic floor muscles are comprised of the bladder, sphincter and the pubococcyges muscle. These muscles are used to stop the flow of urine. You can find your pelvic floor muscles by squeezing your sphincter and contracting the urethra to stop the flow of urine when using the bathroom.
Exercise can help control incontinence without medication or surgery. It is wise to start Kegel exercises before surgery and treatments and to work with a pelvic floor specialist.
Perform the Kegel 10 times holding for 5 seconds each. Try to do this four times per day. Take a 5-second break between each repetition. It may take several weeks or months to be able to contract your muscles for 5 seconds at a time, or to repeat it 10 times. If you perform the Kegel several times per day, your pelvic floor strength should improve.
Tips
Part 2 will focus on thyroid cancer. Contact me at caroljmichaels@gmail or go to www.CarolMichaelsFitness.com or https://www.nfpt.com/product/cancer-recovery-specialist to find out about cancer exercise programs in New Jersey and cancer continuing education courses.
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.
References
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 PeterVenner, 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): 51
