Practicality of exercising through cancer treatment from a practitioner turned patient
Benefits
Improved sleep, hospital days are very long and very repetitive. You’ll sleep better if you’re physically fatigued.
Evidence suggests exercise may be associated with improved treatment completion (1)
Improved mood and motivation, once you get moving, as much as you may not feel like it you will feel better for it, both physically and mentally once having completed a task for the day.
Exercise may attenuate treatment-related side effects (e.g. fatigue) (2)
When it comes to exercise before, during (i.e. during treatment periods, not while hooked up to an IV) or after treatment, exercise is recommended as a standard component of care, especially if programmed by an Exercise Physiologist or Physiotherapist with knowledge of cancer. A trained health professional assisting you in exercise with cancer is there to help you work towards your goals (e.g. maintain current health, get back to an activity) in a safe and supportive environment. Supervision from an EP or physio during exercise enhances safety as they ensure you are working at an intensity that is best for you (to avoid injury or overworking), ensure you are performing movements in a safe manner, especially considering side-effects of treatment (e.g. scars, surgery, radio burns).
An EP or Physio is able to adapt your session based on how you are feeling each day. These health professionals also have a thorough understanding surrounding cancer, it’s treatment and side-effects. All of this will be taken into consideration during your exercise session.
If you are interested, please see below some literature starting to look into the potential for exercise during chemotherapy infusion.
As mentioned previously, this is not something we would recommend yet.
https://link.springer.com/article/10.1007/s00520-019-04871-5
‘Aerobic exercise during chemotherapy infusion for cancer treatment: a novel randomised crossover safety and feasibility trial’ Vanessa J. Thomas, Catherine Seet-Lee, Michael Marthick, Birinder S. Cheema, Michael Boyer & Kate M. Edwards
https://www.sciencedirect.com/science/article/pii/S0749208120300838
‘’Physical Exercise and Cancer: Exploring Chemotherapy Infusion as an Opportunity for Movement’ Roxanne Miller BExPhys & Rehaba, Joseph Northey B Exercise Sc/B Human Nutr (Hon), Ph Dab Kellie Toohey PhD, MCEP, BSc, PG Cert Research, PG Cert Tertiary Ed, AEPac
‘Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial’ https://ascopubs.org/doi/pdf/10.1200/JCO.2014.59.1081
Clinical Oncology Society of Australia Position Stand on Exercise in Cancer Care: https://www.cosa.org.au/media/332757/cosa-position-statement-v3-dec2020-web-
Chemo sucks. It honestly, truly sucks the life out of you and as tough as you are, chemo is tougher.
The best description I can give you of what it’s like to exercise on chemo is if someone stole all your red blood cells. Your body is doing its best but there just isn’t the means to get the oxygen around. You feel light headed, breathless, exhausted and weak.
Having said that, there are hundreds of types of chemotherapy, each have their own side effects and each individual will respond differently. For every one of my treatment cycles I received 3 different types of chemo and I had my favorite. After every infusion of my least favorite chemo I was bed ridden for days, however on my favorite of the three I could swim, exercise, socialise and felt completely myself.
Obstacles
Fatigue
This is extra challenging with prolonged periods in hospital. As well as battling chemo fatigue you are also limited to a maximum of 4 hours of uninterrupted sleep. There are however some benefits to longer hospital stays, I found that I allowed myself to nap more throughout the day while in hospital because I did not fear I was missing out on as much.
Physical exhaustion
As well as feeling mentally exhausted while receiving chemotherapy I found my body felt like a run down version of what I was used to. Trust your judgment, if you need to rest, give yourself time to do so, if you’re feeling good for a week, a day or even an hour try and get outside and move more while you can. Structure is not your friend with chemo.
Exercising with tubes and ports
I was given a port-a-cath as my chemo spanned over 8 months with very frequent hospital admissions.
For me this was a great option and I am grateful for it. Once implanted I barely notice it and can participate in my regular activities without the concerns which often accompany frequent needles.
Exercising while connected to an IV drip
To preface this concept, as far as we are aware there is very limited evidence to date exploring exercise during chemotherapy infusion. As more research emerges, this could potentially be an opportunity for exercise during treatment. As an accredited Exercise Physiologist (EP) myself, with the guidance of EP Sam and support from nurses on the wards in which I’m regularly being treated, exercising while connected to a drip is something I’ve been trialing. We want it known this is not yet evidence based and not something we would recommend at this stage. This has been an experimental experience and personal recount of barriers I faced trialing exercise while connected to an IV drip.
Based on my experiences to date, it is tricky but it can be done. Jumping, moving in any direction or changing position frequently is made nearly impossible by the tubes connecting your access site to the chemo or fluids.
Fast or jerky movements often pause transfusion as the machines are very sensitive to backflow and air bubbles for safety purposes, if either of these are detected the machine will start beeping and immediately cease flow until a nurse corrects the error. I would recommend pilates style exercises, anything supine (on your back) or in a plank, kneeling position is a good option. Again, we do not think it is a good idea to trial any exercise during infusion without the guidance of a health professional.
Other Inconveniences
Navigating movement when nurses need to check your urine output 24/7
Staying close enough to a power point when connected to an IV drip
Not doing anything that will move your drip too much and cause the alarm to go off and flow to stop
Getting through a set of any exercise without being interrupted by nursing staff
Having available space to move around
