Exercise and Chemotherapy

Over the next 6 posts, we are going to focus on different aspects of how Physiotherapy care and treatment can help patients with their post-op cancer care. 

The following are the topics you can expect:

1. Exercise and Chemotherapy

2. Scar Tissue After Cancer Surgery  

3. Vestibular Issues with Chemotherapy

4. Lymphatics and Arm Swelling after Mastectomy

5. Return to Cardiovascular Exercise

6. Getting Back into the Gym

Today we will address Exercise and Chemotherapy. 

Upon your first visit to the Physiotherapy clinic, you can expect a warm welcome from our clinic staff and practitioners. 

The Physiotherapist working with you will take time to get a detailed history of your journey, current medical treatments, past treatments, current restrictions, and together we will make a plan to reach the goals that are important to you. 

BreastCancer.org: Exercise During and After Chemotherapy or Targeted Therapies notes “chemotherapy is used to weaken and destroy cancer cells that are rapidly dividing. An unfortunate side effect is that it also affects healthy cells that divide quickly; hair follicle cells, nails, mouth and digestive tract cells, and bone marrow cells (responsible for making red blood cells)”. 

While undergoing or after the completion of chemotherapy treatment, the MayoClinic: Your Secret Weapon During Cancer Treatment? Exercise! reports the following benefits of exercise can be completed with some important restrictions. 

Benefits of Exercise

• Reduced depression and anxiety.

• Increased energy and strength.

• Reduced pain.

Benefits of Exercise while Having Chemotherapy Treatment

• Can help ease side effects such as fatigue and nausea. 

• Can help boost your immune system. 

As a side note, chemotherapy side effects can sometimes make exercising tough, but try to be as active as you’re able to be. Again, walking is a good way to start.

BreastCancer.org: Exercise During and After Chemotherapy or Targeted Therapies reports on the following very important restrictions. It is important that each patient follow these closely to maintain their safety and health.

Important Restrictions for Cancer Patients

• Must be cleared to exercise by Surgeon or Oncologist.

• Ask your Oncologist, Surgeon or Doctor what exercises are safe to complete and what things should be avoided, as this information will be important for your Physiotherapist at your first appointment. Additionally, as each patient heals and improves, these previous restrictions will change. This will be important for you and your Physiotherapist to stay on top of to progress your exercises accordingly.

• If you’re experiencing extreme fatigue, anemia (low red blood cell count), or a lack of muscle coordination (ataxia), don’t exercise.

• If your immune system is compromised and your white blood cell count is low (lower than 3,500 white blood cells per microliter of blood), avoid public gyms, yoga studios, and other public places until your white blood cell count is at a safe level.

• If you have neuropathy (pain or numbness from peripheral nerve damage) or tingling in your hands or feet from chemotherapy, make sure you take precaution to reduce your risk of falling or injuring yourself. You may want to have a spotter with you when you exercise.

• If you’re getting chemotherapy to treat breast cancer that has spread to the bone, you may have a higher risk of breaking a bone, and you may have to lower the intensity and duration of your workout. Talk to your doctor about the exercises you plan to do. You also may want to talk to a Physiotherapist or a Certified Trainer who has experience working with breast cancer survivors.

• If you’re on a chemotherapy or targeted therapy that may cause heart damage, make sure you ask your Doctor or your Cardiologist what type of exercise modifications, if any, are right for you. It’s a good idea also to ask what the intensity level should be for your workouts. You may have to follow a low intensity exercise program.

• If Adriamycin (chemical name: doxorubicin) is part of your chemotherapy regimen, you shouldn’t exercise on the day you get chemotherapy, and should do only very low intensity exercise (your heart rate is no greater than 15 to 20 beats above your resting heart rate) for 24 to 48 hours after you receive chemotherapy. This is because Adriamycin can make your heart beat irregularly for about 24 hours after you receive it.

• If you have any shortness of breath, pain, or tightness in your chest, stop exercising immediately. Tell your doctor what happened and work with him or her to develop a plan of movements that are right for you.

• If you have any changes in your arm, hand, trunk, breast, or shoulder, including swelling, stop doing upper body exercises and see your doctor or lymphedema specialist. 

• If you’ve been diagnosed with lymphedema after breast cancer treatment, there are precautions you should take before you exercise. These precautions include wearing a well-fitted compression garment or possibly wearing protective gloves.

Paying close attention to the above restrictions, as well as how your body is feeling, will be important indicators for your Physiotherapist in determining the frequency and intensity of the exercise plan.

Together with your Oncologist, Doctor, Surgeon, Physiotherapist, Massage Therapist, and the support of your friends and family, exercising safely to help ease the side effects of chemotherapy treatment will be an achievable goal. 

If you have any questions please feel free to send us an email. 

References

BreastCancer.org

MayoClinic

Ashleigh Low, Registered Physiotherapist