Keep moving – the benefits of exercise after a cancer diagnosis
The preventative aspects of exercise for health
Firstly, let’s talk generally. Physical activity is important for all of our health and wellbeing. It is believed that physical activity:
- Reduces hormones which promote cell growth and increasing mechanisms which protect the cell
- Boosts the immune system
- Reduces inflammation
- Boosts antioxidants’ pathways
- It also accelerates bowel transit, prevents obesity, and prevents metastasis.
- Improves mood
Public Health England recommends:
Adults in England should aim to take part in at least 150 minutes of moderate intensity physical activity each week, in bouts of 10 minutes or more.
However, this can be challenging to do if you are working full time. Furthermore work has increasingly become very sedentary. As a rule of thumb, we could all benefit from moving more and sitting less to gain significant health benefits, both from a physical and mental health perspective.
Exercise and Cancer
Now turning our focus to cancer, research shows that exercise has a positive effect on preventing and managing some cancers. Moderate physical activity, as well as vigorous physical activity, decreases the risk of colon, womb and post-menopausal breast cancer. Being vigorously physically active also lowers your risk of pre-menopausal breast cancer.
But, how is exercise beneficial after a cancer diagnosis? Historically patients with cancer were advised to rest and to avoid unnecessary exercise and activity. We now know from research evidence that this advice may be harmful and that every person with cancer would benefit from exercise, indeed exercise can be seen as medicine. Despite this few people are given any advice on general physical activity and exercise and referral to a cancer rehabilitation specialist is extremely rare.
The research shows that exercise should be engaged in throughout a person’s cancer journey and beyond. Putting it directly, people who exercise regularly post diagnosis experience fewer side effects from their treatments, they also have a lower relative risk of cancer recurrence and a lower relative risk of dying from their cancer.
Exercise can also improve surgical outcomes, reduce problems post-surgery, help control side effects of chemo, radio and hormonal therapy and improve the effectiveness of such treatments. Being physically active also helps to prevent deconditioning and can have a positive effect on mood and social engagement. Those who exercise are also more independent, have higher self-esteem and lower risk of anxiety and depression. This in turn can impact on return to work and back to a full and productive life.
Activity or exercise levels vary considerably amongst those diagnosed with cancer. For a few people, the cancer diagnosis itself is a trigger for health behaviour change in favour of increased activity and regular exercise. The majority of people though, tend to become less physically active and do not take regular exercise; key reasons cited are fear that they will make their condition worse, lack of knowledge about what to do, feeling unwell from treatments and overwhelming fatigue. The challenge for clinicians is to enable and support behaviour change so that increased activity and exercise becomes a lifestyle choice and priority.
At W2W our experience of working with people with cancer is that activity and exercise need to be designed so that it fits into someone’s lifestyle and treatment regime and to be flexible so that they can adjust the dose on days when they are not well. It must be:
- paced to prevent and manage fatigue and to prevent boom and bust behaviour
- graded to start out slowly and build up gradually so that fitness and stamina increase over time
- An activity that they enjoy doing and are motivated to engage in.
How employers can help:
As an employer you can have a significant role in helping and supporting your employee following a cancer diagnosis, to maintain and improve their exercise and fitness. We notice that often people have a very robust exercise programme when off work but this can get side-lined once they return to work. They may easily fall into the trap of not keeping up their exercise plans because of long commutes, day to day work pressures and demands and lengthy meetings. Employers can help:
- Firstly to share your understanding that exercise is beneficial generally and specifically in relation to cancer.
- Support your employees in accessing services like the W2W Cancer Work Support Service where exercise is a core component of the service.
- Keep exercise on the agenda when planning a phased return to work and beyond.
- Encourage talk about exercise/activity to keep it on the persons’ mind.
- Help someone identify what regular prompts and reminders at work will help them to keep moving.
- Encourage a walk at lunchtime.
- Support the continuation of exercises classes that have been started whilst the person is off work e.g. yoga and Pilates.
- Identify if sit/stand desks may help.
- Encourage taking the stairs not the lift – or as someone is recovering to do a bit of both.
- At work you can encourage people to stand up and move more and integrate this into job design.
- Encourage people that any level of activity is better than none.
These suggestions are discussed in the context of someone living with or beyond cancer, but some are just as applicable as part of employers general wellbeing, where activity and movement is a core component.
There are many resources to help employers and employees including:
- Exercise is Medicine Australia Cancer and exercise http://exerciseismedicine.com.au/wp-content/uploads/2016/11/2014-Cancer-FULL.pdf
Nicola Hunter – Director