Did you know?

Did you know? Exercise reduces side effects of radiotherapy.

The worlds first study linking an association between radiotherapy side effects and exercise levels was completed in June this year. The study sponsored by Macmillan Cancer support evaluated 440 men who had survived prostate cancer and had been successfully treated by radiotherapy between 2000-2010 at Addenbrooke’s Hospital, Cambridge University.

The data was analysied at The Primrose Lifestyle Research Unit and the bio-statistical department at Cranfield University. It clearly showed that men who were active as measured by the Practitioner Physical Activity Questionnaire (GPPAQ) were twice as likely to maintain erectile function.

It is strongly advisable to encourage men to exercise after prostate cancer.

Tips for sustaining exercise as a long term goal

Establish a routine: The trick with exercise is that it must be performed regularly. Try to be organized; it is very easy to make excuses for not exercising, if an evening is missed out consider going lunch time instead, if a day is missed consider going twice the next day to catch up. All too often people who say they exercise regularly, when asked closely have excuses, often legitimate, for missing most of the days of the week. It may be worth keeping a wall chart or exercise diary as an aide memoir.

If you have trouble getting to a gym or class consider investing in some of the many useful gadgets available to make it more feasible and enjoyable to exercise at home (exercise bikes, treadmills, rowing machines, etc).

Increasing exercise as part of daily activities; Even before you go to the gym or dance classes, you can exercise at home, in the office or on the way to work. It is important that it is enjoyable and stimulating so you really want to exercise regularly and not just as a passing fad. Even before you consider a gym or dance class an increased level of physical activity can also be achieved by changing simple daily routines.

At work; if possible get up from your desk every 30 minutes and walk for 2 minutes, try to take a walk or some other exercise at lunchtime, if walking is unfeasible consider desk exercises – you may look odd but they can keep you alert especially when you get tired or sleepy; do not worry about the comments – people will secretly admire your enthusiasm.

Exercise as a social activity. Exercising in a group is a healthy and beneficial alternative to an evening spent in a pub or in front of TV. It can and should be sociable and enjoyable – find something which is fun otherwise you will give it up very quickly. Dances and exercise classes are very cordial places and particularly if performed regularly are a forum to make new friendships and acquaintances.

It is a question of changing the habits, changing the frame of mind and adopting a fresh approach to socializing. The majority of recreational activities and sports have a strong social aspect to them. There are a lot of choices, perhaps arrange a gathering with family and friends, look at the availability of activities in your area and then decide which one, as a group, you prefer.

If you have the financial means you may wish to consider a personal trainer who could some to your home – search for a registered Personal trainer in your area.

Underlying mechanisms of how exercise fights cancer.

A number of important physiological changes occur in the body during and after exercise which have specific anticancer properties. As well as helping reduce weight which in the long term has anti-cancer benefits these include:

Other issues to consider during exercise .

Specific exercises: After specific treatments such as surgery and radiotherapy, as well as generally improving exercise levels it is advisable to perform the specific stretches and exercise advised by the nurses/physiotherapist or doctors. You should have been given a specific sheet to follow in these situations. If you feel you unexpected problems on or after treatment or have any worries or barriers to exercise you can asked to be referred to a physiotherapist. Otherwise, advice sheets can be found by clicking on the headings below:

Worries and concerns Exercise is generally save of course people can fall off tread mills or sprain an ankle running but the benefits completely outweigh the risks. Nevertheless there are some special precautions which should be taken after cancer. If concerned in the first instance, the best way to get started is to ask your doctor or GP to refer to an exercise professional who has qualification in cancer rehabilitation (level 4) on the national exercise referral scheme.

This will ensure you are supervised by a a professional who is sympathetic and aware of the limitations and symptoms which are common after cancer; know what to look out for and know what to do if a problem were to arise during exercise.

About exercise during chemotherapy; Vigorous exercise will be difficult during chemotherapy and may actually increase the level of fatigue. However regular light exercise and avoiding periods of inactivity will improve fatigue digestion and reduce the risk of thrombosis (blood clots). In September 2010, various newspapers reported the results of a laboratory trial from Ohio and some made the inappropriate conclusion that exercise before chemotherapy is ill-advised. They based this around issues with a chemical called Heat Stock Proteins (HSP) which are activated by the body in response to cellular stress such as attack from chemicals, high temperature, infection or lack of oxygen (hypoxia).

More specifically the heat shock protein-1 activates another protein called Hsp-27 that helps to block cell death. It also interacts with a third protein, p21, which allows cells to repair themselves and keep dividing. Much of the research up to now has concentrated on how this mechanism protects normal issues such as the heart in times of hypoxic stress. The main stimulus for the body to produce HSP is a raised temperature (associated with infection), lack of oxygen (such as a heart attack), steroid injections such as dexamethasone (routinely given with chemotherapy) and indeed chemical attack from chemotherapy.

Researches recently have found that people who exercise regularly tend to have higher baseline HSP levels, and is one of the explanations why they tend to look younger and this protein encourages cellular repair. This seems all good up to now however experiments involving breast cancer cells from Ohio, showed that adding HSP to the cancer cells in the petri dish made them more resistant to chemotherapy because it was also encouraging the cancer cell to repair – which we do not want.

Following this there was a media frenzy warning that exercise could diminish the killing effect of chemotherapy. They made no comment on the fact that, if indeed HSP were increased in the body, it also would also diminish the harmful side effect, including heart damage. And, although this has not been proven, I suspect the benefit in terms tissue protection would out way the tumour sparing effect – thus actually increasing the therapeutic ratio of chemotherapy. Certainly a therapeutic procedure called hyperthermia (used with chemotherapy and radiotherapy) suggests that heating the tissue actually kills more cancer cells without killing the normal cells.

In summary There is no evidence, at all, that in humans exercise diminishes the chemotherapy effect. There are several benefits of exercising during chemotherapy. In view of the new Ohio experimental data more research is necessary to see if exercise may actually be a way to further increase the therapeutic ratio. We advise regular exercise during chemotherapy and afterward – consider joining a gym or/and a personal trainer. However, although the evidence is poor for any risk, we advise avoiding extreme aerobic exercise (sprinting) 48 hours before chemotherapy especially in very hot climates/ rooms especially if you do not exercise regularly.

What are the benefits of exercise?

Worldwide published evidence clearly demonstrates that regular exercise helps well-being and cancer in four main ways:-

1. Exercise prevents cancer In terms of prevention, its has been estimated that being sedentary and overweight could account for 14% of male and 20% of female cancer deaths in the UK. For bowel cancer, for example, most environmental studies have demonstrated a reduction in the order of 40–50% for those at the highest levels of physical activity, with many demonstrating a dose-response relationship.
The Harvard Centre for Cancer Control, for example, estimates that at least 15% of colon cancers could have been prevented by 30 minutes daily exercise a week. These data suggest that increasing physical activity is one of the major factors that is amenable to modification by individuals wishing to reduce their risks of cancer.

2. Exercise helps to fight established cancer. Regular exercise after a diagnosis of cancer has been shown; to slow the growth rate of some cancers such as prostate or low grade leukemia’s; reduces the risk of cancer coming back and improves cure rates.

3. Exercise after cancer reduces relapse rates and improves survival. Several large international studies have clearly shown that individuals who exercise regularly after cancer have better outcome sin terms of relapse rates and overall survival.

4. For breast and bowel cancer between 2.5 – 3 hours a week of vigorous exercise appeared to to be the target level, for prostate cancer the target was 3- 5 hours – read full evidence
Exercise has been proven to helps side effects and risks during and after cancer treatments. Regular exercise increases the sense of self empowerment for both the patients and carers who can also join in with the activities.

It improves social integration and can make you feel good about yourself. Many patients reported that exercise restored their confidence earlier after cancer treatments finished. As well as these general measured, the is strong evidence that exercise has major benefits on many of the symptoms and side effects experienced during and after cancer treatments:

10 Facts about Head & Neck Cancer.
  1. Tobacco and alcohol use are leading causes of tongue and voice box cancers.
  2. Men are affected about twice as often as women with oral cancer.
  3. Signs of Oral, Head and Neck Cancer: a sore in your mouth that doesn’t heal, constant pain in your mouth, lumps or patches in your mouth, pain around your teeth, changes in your voice, and a lump in your neck.
  4. Surgery, radiation therapy and chemotherapy are the most common treatments designed to stop the spread of cancer by destorying and/or removing the cancerous cells.
  5. Thyroid cancer is more common in women than in men.
  6. Several types of cancer can start in the salivary glands.
  7. Regular check-ups can detect the early stages of oral cancer or conditions that may lead to oral cancer.
  8. Because of the location of head and neck cancer, it often affects breathing, eating, voice, speaking and appearance.
  9. Cancers of the nasal and paranasal cancers are rare: about 2000 people develop these cancers every year.
  10. Patients with cancers treated in the early stages may have little post treatment disfigurement.