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Chemotherapy and Exercise

When you go through chemotherapy, in addition to the preoccupation of whether or not it will effectively destroy the cancer cells, you may be concerned about how to retain your physical fitness during treatment.

If you are an endorphin junkie like I am, you’ll find that keeping up with an exercise program during chemotherapy, if you are physically able to, is a good way to maintain mental health during a stressful time. Whether you are a runner, a cyclist, a walker, or any other type of athlete, continuing those activities is key to staying fit and mentally healthy.

Without a doubt, going through chemotherapy interferes with your regular exercise program. Between traveling to and from oncologist appointments, sitting through an intravenous drip, and then overcoming the related fatigue and nausea, it will be hard to find time to exercise. Fatigue and nausea alone will hamper any sincere athletic goals.

But chemotherapy does not mean you have to give up on running or other aerobic activity, or that you need to ditch your exercise goals. Quite frankly, running during treatment was my nirvana for maintaining health. As soon as the nausea wore off and my energy came back, I was out there on the trails, pounding out the miles. My pace surely slowed down, and it took longer to get warmed up, but my endurance was still there.

The feeling of being strong and healthy is reassurance that cancer is just a footnote to your otherwise active and healthy life. Aerobic exercise strengthens the heart, minimizes weight gain, and supports blood flow to the extremities that may be at risk of numbness and stiffness during chemotherapy.

There are certain rules of thumb that you need to think about before continuing an exercise program during chemotherapy.

1.  Don’t exercise without telling the oncologist. You need to get his or her okay on your exercise plans. Certain chemotherapy drugs are known to stress the heart muscle or cause bone damage.  There may be times in your chemotherapy cycle when you are at greatest risk of illness and infection due to a decrease in white blood cells. Your oncologist will be able to tell you when, in your treatment cycle, you can exercise.

2.  If you’ve had lymph nodes removed, don’t exercise without first consulting your surgeon and possibly a physical therapist specializing in treating lymphedema — swelling that can develop when lymph nodes have been removed. The swelling can be temporary or permanent. Overworking the affected arm too quickly can pose a risk for developing lymphedema. A physical therapist trained in lymphedema diagnosis and treatment can give you a baseline evaluation and go over your plan with you. You can also read the National Lymphedema Network’s Position Statement on Exercise (PDF) to learn about their recommended precautions.

3.  Stay hydrated. A lack of hydration could make you feel dizzy or nauseous and cause the heart to work harder. Staying hydrated during times of intense exercise could stave off these feelings.

4.  Avoid running or exercising immediately after receiving chemotherapy unless your oncologist gives you the go-ahead. While those chemicals, anti-nausea medications, and steroids are flowing through your bloodstream, you may not have the ability to recognize physical signs of distress.

5.  Check your pulse often and keep it within your usual limits.

6.  If you go out to exercise (running, bike riding), bring a cell phone in case you can’t make it back home.

7.  Lower your expectations and don’t be too hard on yourself. This is not the time to try to run a 7-minute mile if you are used to running 10-minute miles. If you are used to running 20 or 30 miles per week, don’t beat yourself up if you need to take off a few days to recover from treatments. Some days you may need to skip it if you still feel like you’re dragging or overtired.

While you have very little control over the drugs that are prescribed, or the dosage given of a certain drug, you do have some control over your physical fitness. Sarah W. from White Plains, New York told me that she continued training for mountain bike races during chemotherapy and rarely felt fatigued. Exercise is definitely an energy booster and a natural way to minimize some of the side effects of treatments.

Laura Wong-Pan is an attorney with Thomas, Drohan, Waxman, Petigrow & Mayle LLP, specializing in employment and labor law, and is a cancer survivor.

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