Getting in Shape and Staying Fit After Cancer
It used to be that it was enough just to survive cancer. As more people live longer with this disease, survivors are asking for more: They want their fitness back.
And they’re getting it, as more organizations, private gyms and clinics offer conditioning programs for the 9 million Americans who undergo treatment or are recovering from cancer therapy each year. Many patients discover that after surgery and during treatments that may last several months, they lack the energy to do what they used to do routinely. Chemotherapy can lower blood counts and sap the energy that patients once had for cycling or long runs; surgery, say, for breast cancer, may limit the ability to lift one’s arms or cause swelling in the hands, making weight training or activities such as tennis difficult. Radiation treatment of the head or neck can affect a person’s sense of balance, making it difficult even to try walking for exercise.
A troublesome cycle may begin. A person who feels rundown isn’t inclined to exercise, eventually losing muscle tone and whatever level of fitness he once had. Plus, chemotherapy drugs may cause weight gain and hair loss, making one feel embarrassed to return to the gym or rejoin an exercise group of healthy people.
It’s the ongoing fatigue and muscle weakness that undermines the well-being of more than 90% of cancer patients who undergo surgery, chemotherapy, radiation or other treatments. Chemotherapy, for example, targets not only cancer cells; it can destroy other cells, including muscle cells, said Carole Schneider, a founder of the Rocky Mountain Cancer Rehabilitation Institute at the University of Northern Colorado in Greeley.
Schneider was her own first patient at the Institute, which opened in 1996. Schneider, who a year earlier had completed treatment for cervical cancer, was frustrated by her constant weakness and fatigue.
“When I started asking my colleagues about exercising, no one knew what activity I should or could do,” she said. “All the focus was on prevention.”
The institute includes a clinic that creates fitness programs for about 200 people a year. Schneider and her staff are also doing research into how cancer survivors respond to exercise, and they hold workshops to educate fitness instructors and help other medical professionals set up rehab programs.
Karen Van Kirk, 38, a trainer in Los Angeles for Team Survivor, a national association that offers programs for women cancer survivors that include strength training, gentle exercise, spinning, swimming and walking.
The programs help survivors manage the side effects of treatment, provide emotional support from others with similar medical experiences and help “put women back in control of their bodies,” she says. “They’re not passively having some procedure done to them, they’re actively engaged in activity that improves them physically.”
Diana Carone, 68, has been exercising with Van Kirk’s group once a week for nearly two years. She’s come a long way considering that after she was hospitalized with ovarian cancer seven years ago, doctors told her she’d never leave the hospital, and that if she did, she’d live only six months.
Although she’s been on chemotherapy for 11 months now, Carone rarely misses her workout.
“I’m doing a mile on the treadmill each week and exercising with the 5-pound weights,” she says. “No matter how tired I am, I always feel 100% improved after I’ve been to the gym.”
Mimi Rosenblatt, 47, of Chatsworth lost a lung to cancer last fall and has come to rely on the emotional support in Van Kirk’s walking group.
“The exercise is good,” she says, “but the fact that we’re all cancer survivors makes it a lot easier for us to understand feelings we have. We can be more candid; we laugh and joke about things that might make some people uncomfortable. We’re all facing our own mortality, but we’re all survivors too.”
The YWCA’s nationwide EncorePlus program, which started in the ‘70s, focuses on water exercise for breast cancer survivors who want to restore strength in the upper body and regain range of motion. The group welcomes women of any age and at any stage of treatment or recovery. Carol Sipple, director of EncorePlus for the YWCA of North Orange County, says the classes are suitable for nonswimmers.
“The women are in the water to their shoulders, and we use equipment such as Frisbees, batons and kick boards to create resistance in the water.”
She agrees that peer support is an essential part of the program.
“We have trained physical fitness instructors, but they’re also encouraged to draw the women out--to get them to chatter and exchange ideas and concerns,” she says.
Fitness trainer Paula Lilly, who works with the Cancer Well-Fit program operated jointly by the Santa Barbara Cancer Center and Santa Barbara Athletic Club, gauges the success of the 7-year-old program by the 85% attendance rate of participants in the twice weekly, 10-week sessions.
“People get addicted to the good results,” she says. “Some say they didn’t want to join a ‘cancer group’ because they didn’t want to come to a place where everyone was complaining. But here at the gym, they’re off-site and away from the hospital, and they feel very positive about the workouts.”
