Michelle Jonck explains the benefits of cancer patients being physically active under the supervision of a biokineticist, using biokinetics.
WHO established that approximately one third of cancer-related deaths are due to five leading behavioural and dietary risks: high body mass index (overweight and obesity); low fruit and vegetable intake; lack of physical activity; tobacco use and alcohol use.3 Thus, cancer patients/survivors should be physically active during and after treatment.
While exercise may not cure cancer, it can improve prognosis and quality of life. Not only does it help to combat poor body composition (high fat mass and low muscle mass), low aerobic capacity and decreased range of movement, it also causes the release of endorphins and serotonin. Endorphins are hormones secreted by the brain which reduce the perception of pain while serotonin is a chemical in the body that contributes to well-being and happiness. Thus, the benefits of physical activity are physical and psychological.
Although precise recommendations for frequency, intensity, time and type of exercise (FITT principle) is yet to be established, there is ample evidence that exercise is safe during and after treatment for most cancers. This includes breast-, ovarian-, cervical-, uterine-, prostate-, colon cancer, leukaemia, lymphoma and myeloma.
Overall recommendations for people with cancer are consistent with general physical activity recommendations for healthy individuals. This is: participation in 30-60 minutes of moderate intensity aerobic physical activity at least five days a week, supplemented by activities increasing muscle strength and endurance at least twice a week. Exercise sessions should start with a 5-10 minute warm-up and end with a 5-10 minute cool down during which stretches are performed to help avoid injuries and maintain flexibility.
Benefits of biokinetics
Although exercising is generally safe, each cancer patient has a unique journey with different responses and experiences that will affect their ability to take part in certain activities.
Appropriate FITT recommendations will therefore vary from person to person depending on the type, site and severity of cancer; the treatment received; and other factors, such as previous injuries, comorbidities and exercise history.
Therefore engaging in physical activity under the supervision of a biokineticist is best. It gives the patient ease of mind as bios are competent to provide individualised exercise programmes, based on exercise test outcomes and scientific principles while continuously monitoring the overall well-being of the patient.
Biokineticists can also assist patients recovering from surgery, such as mastectomy and associated lymph node removal, in their final phase of rehabilitation to ensure they regain full capacity and functionality.
Working with a biokineticist to achieve certain goals gives the patient a sense of accomplishment, and re-assurance that they will get better again and be able to do most, if not all, the tasks they used to.
Special considerations for exercising:
- Most cancer patients will at some point experience cancer-related fatigue, restricting their ability to exercise. It’s important not to avoid physical activity during such periods, but to talk to your biokineticist so they can taper down on the intensity and increase rest periods while keeping you active.
- Many types of cancer also increase the risk of fragile bones and fractures. Individuals with metastatic bone disease therefore need to reduce the impact, intensity and volume of exercises. Be particularly careful of any jumping activities, running and heavy weight lifting.
- Treatment, such as immuno-suppressive medication, chemotherapy and radiation, can also suppress the immune system and there may be times when a home-based exercise programme, or telehealth would be more advisable than exercising at a public facility.
- Patients with central lines, feeding tubes, catheters and ostomies; and those who are immuno-suppressed or receiving radiation should avoid swimming.
- Slower progression and frequent adaptation of the exercise programme may be required as patients, particularly those receiving chemotherapy, may experience fluctuating periods of sickness and fatigue.
- Several short bouts of exercise daily may be more achievable and practical during active treatment than a single bout of continuous exercise.
- Heart rate may be a less reliable method of monitoring exercise intensity for those undergoing treatment. Getting familiar with the rating of perceived exertion (RPE) scale and how to use it may be particularly helpful to monitor exercise intensity.
- Stop exercise and seek medical advice when unusual symptoms, such as dizziness, nausea and chest pain are experienced.
- Always talk to your healthcare provider regarding special precautions relating to your specific type of cancer, cancer-treatment and other non-cancer factors.
- National Cancer Institute. Age and cancer risk. cancer.gov/about-cancer/causes-prevention/risk/age Date of access: 24 June 2020.
- Ness KK, Wall MM, Oakes JM, Robinson LL, Gurney JG. Physical performance limitations and participation restrictions among cancer survivors: a population-based study. Ann Epidemiol. 2006;16(3):197-205.
- WHO (World Health Organization). Cancer: key facts. who.int/news-room/fact-sheets/detail/cancer Date of access: 24 June 2020.
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