Anyone diagnosed with a serious illness may think that getting fit could be out of the question. But when faced with major health issues, exercise can be beneficial. From managing some of the common side effects of cancer treatment to helping cancer patients stay focused on a rehabilitation prescription, exercise may help to improve health outcomes for those with a serious illness. However, given the aggressive side effects that come with some treatments and their toll on the body, exercising within sensible boundaries is key.
Why stay active
Complete rest may not be the best option for anyone recovering from a serious illness. The Christie NHS Foundation Trust, a large cancer treatment centre in Manchester, recommends staying physically active (in moderation) when diagnosed with or undergoing treatment for cancer.
The National Comprehensive Cancer Network claims that regular moderate exercise may reduce fatigue in cancer patients by 40 to 50 per cent. It also claims that exercise improves outcomes for patients and survivors and leads to less chance of recurrence of illness. Exercise, such as running, may help to prevent weight gain which can raise the risk of cancer returning after treatment.
Macmillan Cancer Support says exercise should be part of standard cancer care and can manage some of the common side effects of cancer treatment. We know exercise boosts heart health, and some chemotherapy drugs may cause heart problems in later life.
Even moderate exercise during treatment can provide physical and physiological benefits. “There are lots of studies to support the use of exercise in recovery from illness,” says Dr Ben Kelly, Head of Preventative Medicine at Nuffield Health (nuffieldhealth.com) and a Fellow of the Royal Society of Medicine. “Exercise can be as effective as lots of drugs and we need to only look to the world of type II diabetes to see that exercise is the best course of treatment. Equally, we see lots of benefits in other areas, such as cardiac and pulmonary diseases and, of course, cancer. With cancer, if exercise is undertaken between the point of treatment and diagnosis, patients stand to see superior clinical outcomes over the long-term.”
“So long as there is no medical reason why you cannot exercise, the mental and physical benefits from exercise such as running greatly enhance recovery after a serious illness,” says Professor John Brewer, Head of School of Sport, Health & Applied Science, at St Mary’s University (stmarys.ac.uk). “I have run marathons with people who have recovered from cancer, and while it may not always be possible to regain the fitness [a person had] before an illness, it should still be possible to run well and regain physical fitness and self-confidence.”
The mental benefits
The mental benefits of exercise during illness are significant. “We all know you can move mountains with a positive frame of mind and, when you’re running, you’re releasing endorphins,” says Dr Rupert Critchley, a GP based in Surrey. “Exercise reduces stress components, including cortisol. We also know there’s been a link between the stress hormone cortisol and cancer. The adrenal glands produce cortisol and increase your blood pressure. They have negative impacts on the immune system. When you exercise, your cardiovascular health and lung health are going to improve.”
“There is a vast amount of work going on to decipher the links between emotional and physical health,” says Kelly. “There isn’t anything conclusive to prove that mindset independently drives recovery. But those with a positive mindset tend to maintain motivation. Motivation is a critical factor in what can often be a long road to recovery. If you stay engaged and focused on a rehabilitation prescription then you certainly have a higher chance of improved clinical outcomes.”
Exercising within sensible boundaries
When going through treatment, however, it’s important to respect and look after your body, and experts warn against doing too much exercise. “Don’t go past a sensible boundary,” says Critchley. “A marathon is going to cause some stress to your body, so I’d say, be careful.”
The NHS Christie Trust Foundation says that the type of cancer you have and your cancer treatment will affect your ability to exercise. It recommends starting with one session a week and adding another session each week, building up to three to five days a week of exercise. It advises against exercise if you have an irregular pulse, leg pains or cramps, chest pain, have been vomiting in the last 36 hours, have difficulty breathing or numbness in the hands and feet.
“The amount of exercise you do has to be relative to how you feel,” says Kelly. “For those recovering from an illness, 30 to 60 minutes of exercise a day should be the progression target. This doesn’t have to be all completed in one sitting. So long as you can achieve 10 minutes at a time then you will see benefits. Make sure you have plenty of rest between sessions. Consider a variety of exercise such as aerobic, resistance and stretching to help avoid overuse issues.”
All exercise causes some tiredness, but it’s important to know when you’re overdoing it. You may feel a bit sore or stiff when you first exercise after illness. However, with rest, you should feel better in a few days. “There are some signs to watch out for,” says Kelly. “If you have recently had any surgery, [if you have] any pain in that region or evidence of a wound becoming inflamed or re-opened then you should stop exercising and see your doctor as soon as possible. Should any of your symptoms reoccur then see your doctor.”
Signs of overdoing it include persistent muscle soreness lasting more than four days, feeling that your heart rate is faster than usual or feelings of cold, flu or joint pain. “Anything that doesn’t feel right and is persistent is probably something that needs to be looked at by your doctor,” says Kelly.