Exercise

My chiropractor has been great with trying to get them back in alignment. They were so off after chemo.

I also took it easy on exercising after chemo, started small and built up.

Kathleen,

Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):

1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)

Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.


Exercise
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* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.

* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.

* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.

* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.

* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:

Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.

Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.

* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.

Nutritionally
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* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.

* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.

* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!

* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.

* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)

I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!

Social media and online communities are a rich source of social support, information, and tips about weight loss and exercise. Twitter is a great forum to find others to connect with about your weight loss journey or just an interest in exercise, fitness, or nutrition. I follow many of these people, so I suggest you scan the people I follow to find such folks. I am @DrSherryPagoto (http://twitter.com/DrSherryPagoto) on Twitter. You might also try relevant search terms like “losing weight,” “fitness,” or “nutrition” to turn up users who share these interests. For a more formal online community, try Sparkpeople. They also have a weight loss mobile application. In terms of mobile applications, I recommend My Fitness Pal, Lose it, Weight Watchers, or Sparkpeople. There are many weight loss mobile apps and it may be best to play around with 2 or 3 to see which you like the best. Plenty of them are free of cost so there is no need to pay for an app, I have not found the paid apps to offer any advantages, unless they come with a formalized program. I also recommend looking into blogs as a source of support and information. There are 2 kinds of blogs, those written by professionals and those written by people attempting to lose weight. Both are extremely useful. I have a professional blog called FUdiet.com (http://FUdiet.com) in which I write posts about evidence-based weight loss strategies. Numerous dietitians and exercise professionals also write blogs and have much to offer by way of advice and support. Many bloggers will answer your questions too. Blogs written by individuals attempting to lose weight may also be helpful especially if you are feeling very alone in the process. Reading about someone else’s struggles and triumphs may remind you that you aren’t alone, and the vast majority of bloggers are very interactive with their readers. The blog community (including both bloggers and readers) is extremely welcoming and supportive.

No, because moving always makes me feel better. Maybe we should stop call it exercise. The notion of going of trying to get psyched up to do something unpleasant doesn't work. Instead, I'd ask survivors, how would you like to help yourself feel better...and it's free? Take a walk. I walked all during treatment until I had difficulty while taking Taxotere and steroids. That was difficult, and it was during daily radiation as well, since I drove an hour to and from.

Healthy survivorship calls for exercise. It's good for the body, soul and mind. Intense aerobic exercise - as opposed to just walking - does a kick charge for the brain. After survivorship I also started cycling, which I enjoy immensely.

But everyone knows this. The essential thing is to do it.
jms

I was fairly active before my diagnosis -- running, tap dancing, swing dancing, etc -- and found that keeping up with my exercise/activities as much as possible was crucial to both my mental health and my recovery during treatment. I had four chemo infusions of taxotere/cytoxan (one infusion every 3 weeks) and was able to run through two of them (although not during the first week when the bone pain was too intense). After the third infusion, I had to dial it down to walking (I also had to let the dancing go). But once chemo was over and I was able to get rid of the excess water weight from the steroids, I was able to get back to running and even attain my old mileage within a couple of months. I also ran, danced, walked, etc. during 6.5 weeks of radiation which I believe is the number one reason why I didn't have too many issues with fatigue.

As far as motivation goes, running and dancing and doing all the things that made me feel normal and healthy and whole was my way of telling cancer it could suck it. It was also a way to stay in touch with my body and to appreciate what it could do, even under duress, even with a couple of essential parts missing.

The sooner you can resume normal activities the better off you are. I don't mean push it, and I don't mean start doing jumping jacks. Start walking and add distance incrementally. And do this every day. One block, two, three, until you're comfortably walking a mile or so.

Equally important is the rehabilitation of your arm. If you haven't had physical therapy many excellent resources are mentioned above. You can run through arm exercises in fifteen minutes or so. I still do so to this day. After full lymph dissection and radiation the natural tendency of the arm and skin is to retract and tighten.

One of the best things I'e found is yoga. Many cancer treatment centers (in Houston through MD Anderson and Memorial Hermann) now offer yoga for cancer survivors. It's excellent and a gentle way to reduce stress.

Thank you for this great question. Pardon me while I get on my soap box. :)

When we are diagnosed with breast cancer everything changes. Emotionally, we are faced with our own mortality, physically, we are faced with many treatment decisions that will forever effect the way our bodies look and feel. Then the treatment starts and we start experiencing all sorts of strange and uncomfortable things going on.

I know when I went through treatment for breast cancer, I felt like I lost control over my body. Exercise helped me get control back. I found that through exercise, I was able to increase my energy levels, lessen my anxiety and stress, relieve my aches and pains and in general start to feel like a whole person again.

I didn't start with a strenuous, weight lifting program. I started on the floor, trying to raise my arms over my head, just to see how far I could get them. When I finally raised my arms over my head and touched the floor behind me, I was so happy and proud of my self. I haven't stopped moving since. Of course, I went a little overboard and started a rehabilitative exercise program called MovingOn. But that's just me.

I encourage all cancer survivors to start moving. Whether you are in-treatment or out of treatment, get your doctor's approval and get moving. Some like yoga, some like running or Zumba, whatever you like, start moving. You will be surprised at the benefits of exercise, even if you start for just a few minutes a day.

I challenge the TalkAboutHealth community to get out there and get moving!! Drop me a note on facebook at http://www.facebook.com/LockeysMovingOn and tell me what you are doing to get moving!!

For more information about exercise, go to http://www.movingonfromcancer.com

One of the best ways to fight fatigue, nausea and the body aches that come with chemotherapy is exercise. Emotionally, exercise can lift your spirits, help regain self-esteem and, my personal favorite, help regain control over your own body!

A couple of precautions:
1. Get doctor approval before starting any exercise program.
2. If you are vomiting or have diarrhea, no exercise for 24 hours, you may be dehydrated.
3. Start slow. Incorporate low reps, light weight and lots of flexibility exercises in your program.

A good place to start would be with a few stretches to open your chest area and your hips, then move to body weight exercises like squats and wall pushups, then if you feel really good that day, add some resistance band exercises, like bicep curls and tricep presses.

I hope this has been helpful. For more information on exercise go to http://www.movingonfromcancer.com

First and most importantly, check with your doctor, get his/her permission to begin an exercise program.

This is a great question because fatigue is such a big part of cancer treatment. Everyone is different, I know I really struggled with fatigue issues when I went through chemotherapy. My best advice is to learn your energy cycles. Typically when a patient is going through chemo or radiation, there are days following treatment that you are more tired and have less energy. If you have chemo every 3 weeks, you might be the most tired the first week. During that week, concentrate on gentle stretches. Week two might bring a bit more energy, do a little more, add a walk and some body weight exercises (squats and wall push ups). Week three you will have more energy, keep walking and stretching, then add some exercises that include resistance bands.

If you are getting radiation treatments, you may feel fatigue towards the end of the week, use the same formula as above, just be careful using resistance bands. Again, check with your doctor before beginning an exercise program.

The bottom line is just try to move a little bit everyday and be kind to yourself!

For more information about exercise and MovingOn programs go to http://www.movingonfromcancer.com

When I can't make it to a live yoga class, I use DVDs. I particularly like Barbara Benagh's Yoga for Stress Relief, which has a menu of short segments so you can custom-design your own class each time you use it. The section for managing lower-back pain has been very beneficial for my sorry spine.

Another thing I've found helpful: After I've been to a yoga class that I particularly liked, I try to recall the sequence and jot it down so I can repeat it at home. Ditto with specific instructions that seemed especially enlightening.

I've also developed a small collection of yoga posters with some basic sequences. Just looking at them makes me feel the benefits!

I am a cancer exercise specialist and a breast cancer survivor. I can say from personal experience and from the cancer survivors I've trained, exercise is crucial to recovery. Everyone will have different range of motion and a different experience with returning to an exercise program. Once you have your physician's approval to begin an exercise program, I would recommend finding a rehabilitative exercise program that starts with stretching and flexibility exercises. Performing stretching exercises frequently will increase range of motion and get you ready for a strength training program.

I am working with a client now who is 3 weeks out of mastectomy surgery. Her range of motion is increasing by the day. I am fortunate enough to get to support her in increasing her flexibility, but I'm also watching her empower herself by learning something that she can do to improve her situation and get some control over her cancer. I consider myself very fortunate to be a part of her recovery.

For more information about rehabilitative exercise, go to http://movingonfromcancer.com/

I waitedd the recommended 4 to 6 weeks post-surgery, but I never stopped even during chemo and radioation. I slowed down or cut down on time when I felt at my lowest energy point, but overall, I forced myself to do it everyday. Post surgery, I waited for my surgeon thumbs up an I was back on the bycicle, running and walking, whiever felt best at the time.

I also took the time to see a physiotherapist specialising in pre-ops and post-ops assessment to provide me with different exercise to gain my strength back with the most efficiency. Also, strangely, what helped me most was an osteopath after my mastectomy that lossened my pectoral muscles that were really thight following reconstruction and radiotherapy. In a few treatment, he took care of a lot of pain I have in my arms and shoulders.

Most breast cancer survivors experience tightness in the chest, weakness or pain in the back and some neck pain. Most of these aches and pains are pretty common because when we are diagnosed with breast cancer and experience the treatments/procedures that go along with breast cancer. We also sort of hunch our shoulders up and forward in a protective position further causing back, neck and shoulder discomfort.

There are some simple stretches (that can be done anywhere) to alleviate tightness and pain that associates mastectomies and/lat flap treatments. The easiest one I can describe here is a simple shoulder roll. Sit up straight, with your feet on the floor, pull your shoulders up (like you are shrugging them), then pull them back as if you are squeezing your shoulder blades together, then drop them down, as if you are pressing your shoulders towards the floor.

This simple exercise can correct your posture, which will cause you to open up your chest and activate your shoulder muscles. Thus, starting you on the path of MovingOn from cancer.

For more rehabilitative exercise information go to http://www.movingonfromcancer.com

Starting an exercise program after treatment is a great way to regain mobility and increase energy levels. I would suggest a rehabilitative exercise program that will correct any postural imbalances caused by treatment/surgical procedures and in general get you moving in a safe environment. Begin with simple stretches focusing on the areas affected by surgery. For example, if you had a mastectomy, start by performing gentle stretches that will open up your chest muscles and strengthen your back muscles. By performing exercises that rebuild your foundation first, you will be able to progress to more challenging programs before you know it.

For more information on rehabilitative exercise programs go to http://www.movingonfromcancer.com

This is a great question. Most of us don't want to appear un-motivated so we don't talk about how difficult it is to muster up the energy to do anything at all, let alone exercise.

After my first mastectomy, I was very frustrated at all the things I couldn't do. I couldn't blow dry my hair (although chemo took care of that little problem), lift a cup of coffee, put on a tshirt, raise my arm over my head. I was very discouraged, then I started chemo and didn't have the energy to even be discouraged about what I couldn't do. At some point, I got tired of not moving. I started (very slowly) focusing on what I could do. Any small gain was a big deal for me. I kept doing the stretches the doctor prescribed and before I knew it, I was able to lift my coffee cup. A small victory, but I really enjoyed that cup of coffee.

So in answer to your question, I would say focusing on what you can do versus what you are unable to do will provide motivation to get you moving! Every day do a little more than you did yesterday and soon you will be unrecognizable to yourself.

I'm glad you asked this! I am thinking about the same thing..... My daughter started practicing Tai Chi and the movements seem much more gentle and appear to require deliberate concentration. Curious what our experts may say.....

Exercise is a wonderful way to cope with chemotherapy, if one has the stamina to do it. Good for you that you were able to exercise to maintain a healthy appetite even during treatments!

To be honest, I wasn't as successful at maintaining an exercise regime, nor maintaining an appetite during chemotherapy and radiation, and fitness was a way of life for me before chemo. Each time I attempted exercise, I paid for it later with a faint feeling. I also couldn't get rid of the metallic taste in my mouth, so I hardly ate much.

I think it depends on the physiology of the person, as well as the treatment regimen, circumstances, etc. I had chemotherapy and radiation simultaneously, while I was dealing with stress at home and working a full-time and part-time job. I used all my energy in keeping my life together.

Yes but you must find an instructor who has specific training in dealing with back injuries and pain. This is not part of every certification. The other option is to use meditation in order to induce deep states of relaxation and help to expedite healing of the body. I have several meditations available on my website www.peacefullife.ca.
Jackie

The research measured quality of life indicators and showed that with the 8 week yoga program (1 session per week at the hospital (1.5hrs.) and 3-4 sessions at home with a DVD (20 or 40 minute sessions) the women improved their global quality of life and decreased their depressive symptoms compared to the control group. The results have been presented in a few conferences but are going to be officially published soon so I can add the link when they are.
What I observed as a teacher was that the benefits each woman received were very individual. One woman learned to live more in the present moment. She started out feeling fearful that she would not see her children grow up. When we talked about how fear is created by trying to anticipate the future - which no one can do - she realized that she felt good, her children were healthy and that everyday she would focus on and feel grateful for what she has now - in the moment.
Another woman learned to express her needs. She had spent a lifetime looking after everyone else but forgetting to put attention on her own needs. She had her husband rearrange the furniture so she could do her yoga at home. She told her family she needed the quiet time everyday and she took it. She even started being more aware of the effect of the energy of negative people around her and made changes to reduce it. She was a transformed woman - much more confident and expressive.
Other women enjoyed the physical part and felt stronger and more empowered. Another woman who was very athletic learned about the importance of deep relaxation to release tension and allow the body to heal at a deep level. A lot of women who said they felt too tired to do the home video would just watch it and relax or start gently doing the postures and would find they were more energized afterward.
One woman had lymphedema and wore a elastic sleeve when she started, by the end the swelling was down and she no longer needed the sleeve.
So the benefits were varied and usually quite significant. Overall though I would say the women felt empowered to impact their healing,able to relax more and they felt more hopeful/optimistic.