New Workout Plan: Study Shows Patients Are Less Active after Cancer Diagnosis

By Andrew J. Roth,

Wednesday, January 25, 2017

Close-up photo of someone walking on the road
Summary

In a recent survey, 75% of people with cancer said they reduced their physical activity after their diagnosis. We spoke with two experts from the Integrative Medicine Service at MSK to learn more.

A new study led by Memorial Sloan Kettering researchers shows that 75% of people with cancer reported reducing their physical activity following their diagnosis, and that this lower activity often persisted for a year or more. Though the results are not entirely surprising, according to postdoctoral research fellow Sally Romero, the study’s first author, the data emphasize the need for new methods to get patients up and moving as they go through treatment and beyond.

We spoke with Dr. Romero and Jun Mao, Chief of the Integrative Medicine Service at MSK, for more on the findings and the relationship between exercise and cancer.

Drop-off after Cancer Diagnosis

As part of the study, Dr. Romero analyzed results from a survey of 662 cancer patients designed and conducted by Dr. Mao in his previous role as Director of Integrative Oncology Initiative at the University of Pennsylvania’s Abramson Cancer Center.

Being physically active can help maintain quality of life, prevent functional decline, and accelerate recovery once treatment is completed.
Jun J. Mao
Jun J. Mao Chief, Integrative Medicine Service

She and her team found that 75% of respondents reported decreasing their physical activity level after being diagnosed with cancer; 16% maintained the same level; and 4% increased it (the remaining 5% of patients did not respond to the survey question).

“Most of these patients — more than half — were a year out from their cancer diagnosis,” she says. “Knowing that most cancer treatments are completed within six months and these patients are still reporting that their physical activity is down — that was surprising to learn.”

Dr. Romero also says she was interested to learn why patients had trouble staying physically active. The most common barriers to exercise and activity reported were fatigue, pain, difficulty getting motivated, difficulty remaining disciplined, and treatment side effects. Other barriers such as nausea, sadness, and lack of time were all less commonly reported.

It is crucial that patients speak up about pain, fatigue, and other symptoms that prevent physical activity, she says. “We don’t want anyone to think that these things are just what they have to live with.”

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Incentives for Exertion

It’s well understood that staying active and maintaining one’s weight can reduce the risk of cancer. However, Dr. Mao says, exercise can have numerous benefits for people with cancer too.

“Being physically active can help maintain quality of life, prevent functional decline, and accelerate recovery once treatment is completed,” he says.

For some people with cancer, such as those with severe heart disease or physical pain and functional limitations, exercise may not be recommended. These patients, Dr. Mao says, should be evaluated by a cardiologist or a rehabilitation physician before doing any intense workouts or activities.

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On Your Feet

Dr. Mao says his advice to patients is in line with recommendations for the general population: “Stay physically active as much as possible, ideally 30 minutes of moderate physical activities five days a week,” with a goal to build up a light sweat or become just slightly out of breath.

The Integrative Medicine Service at MSK offers many resources for people with cancer who are willing and able to exercise.

“We have specialized fitness classes for men, for women, for building strong bones, or for increasing flexibility,” he says. “If a patient prefers more mind-body based physical activities, we also have yoga and Tai Chi.”

For patients who are struggling with pain or fatigue, Dr. Mao emphasizes that MSK offers acupuncture, massage, rehabilitation consultation, and physical therapy to alleviate these symptoms and more.

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Moving Forward

From here, Dr. Romero says she wants to focus her research on designing more effective interventions for patients to improve motivation.

“We need to increase awareness about the benefits of physical activity for patients and let them know that we can help,” she says.

Dr. Mao’s research into the benefits of exercise also continues. The work, some of which is being done by exercise scientist Lee Jones and his colleagues at MSK, is early, but it could have vast implications.

“Although it’s preliminary, some research suggests physical activities even may improve survival for specific types of cancer such as breast and colorectal cancers,” Dr. Mao says. 

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Comments

I trybut I get hammered physically after treatments and it takes at least 7-8 days after treatment to fell well enough to get back to working out and then I'm back in on day 10-11 for more treatments. Not sure if the people conducting the study actually know how it feels after treatment?? That might help.

Dear Sean, thanks for sharing your experiences. We understand that side effects that come from treatment, like fatigue and nausea, can be a major barrier to being able to exercise. We recommend you talk to your healthcare team about these side effects, because there may be treatment options that are available. Best wishes to you and thank you for your comment.

I am stage 4 met. Mel. In the liver. Being treated at Yale by Dr. Kluger with Opvido. A side effect is fatigue and joint aches. It is tough because I'm also anemic and I do not have a lot of energy. Any sugggestions?

Dear Meg, we are sorry to hear about your diagnosis. We recommend that you follow up with your oncologist to discuss how best to address the symptoms you are experiencing. Fatigue is a common side effect of cancer treatment. You may find it useful to read through our patient education materials to explore ways that may help you manage it:

Managing Cancer-Related Fatigue: https://www.mskcc.org/cancer-care/patient-education/managing-related-fa…

Managing Cancer-Related Fatigue for Survivors: https://www.mskcc.org/cancer-care/patient-education/managing-related-fa…

Thank you for reaching out to us.

After liver resection, and during chemo, I worked out daily- starting with basic movements and repetitions leg and arm movements. Made it a game , goal oriented to golf 8 weeks after resection and walk 18 during chemo- I felt better because I was active, kept me drinking water to be hydrated and also kept me mentally ready for each day-
Exercise was my savior-

Dear David, we are glad to know that you were able to incorporate exercise into your daily life and that it helped make you feel better. Thanks for sharing your thoughts and experience on our blog.

Exercise during chemo made me feel better.
Gave me a goal to reach, inhabited time in my mind that became more positive. I would recommend that everyone do as much as u can because it helps get thru the treatment.

It's very hard to motivate myself back into my past active life. I played golf four or five times a week, worked out with a trainer twice a week and after treatment I can't seem to make myself anything but passive. I am a five time survivor over twenty years, four huge surgeries, five different chemo, I am on Torisel infusions every week now for metastatic lesions in my lungs. I live from scan to scan. I try to recreate my life as it was but it's so hard when worry and lack of motivation get in the way. I am so lucky to be alive and I know it every day. But I'm really tired of fighting this endless war. Oh, my original site was in the pelvic torso area inside a supposedly benign fibroid.....it was a Leiomyosarcoma, as was my second one ten years later. What would you suggest?

Dear Ellen, we are sorry to hear about your diagnosis. The feelings you describe are common among people living with advanced cancer. You may find it helpful to read one of our past blogs on this topic for suggestions on how to cope:

Living and Coping with Advanced Cancer: https://www.mskcc.org/blog/living-and-coping-advanced

We hope this information is helpful. Thank you for sharing your thoughts on our blog.

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