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But I’m so tired! Why cancer patients should exercise anyway.

Note: This post is written by the team of The ONE Group (Oncology – Nutrition – Exercise) at Penn State College of Medicine as part of a first-person blog about their work. Learn more about the group here.

Close your eyes and conjure the image of a patient with cancer. Likely what you saw was someone with a bald head, sitting in an oversized chair with an intravenous catheter in their arm receiving chemotherapy. A key aspect of that image what that they were sitting. For a long time now, cancer patients have been told to rest, rest, rest. There is strong scientific evidence that going for a daily walk would be really helpful to many of the symptoms experienced during and after cancer treatment, including chemotherapy, but the “culture of cancer” is to rest, and so we rest.

This culture of rest used to exist for heart attacks, too. Back in the 1950s, then President Dwight Eisenhower had a heart attack. He was treated at Bethesda Naval Hospital by very skilled cardiologists. Those cardiologists were sharply criticized for getting the president out “so soon” — three weeks after his heart attack. Three weeks.

Today, we get those who’ve had a heart attack out of bed within a day, and we know that exercise strengthens the damaged heart and refer cardiac patients to specialty programming called cardiac rehabilitation. Nurses in the cardiac ward used to think that the patients sent to cardiac rehab would come back in body bags, they were so nervous about exercising their patients who’d had a heart attack. However, they soon learned that the patients who exercised recovered better than those who stayed in the chair, resting. Gradually the culture changed, and now, if you ask someone whether exercise is good for the heart, most people correctly answer, “Yes.”

We can tell similar stories about rest and back pain (we used to think rest was best) and pregnancy (women used to be told to rest and avoid exercise during pregnancy). Gradually, scientific studies have been translated so that the average person knows that exercise is good for the heart, for back pain and during pregnancy.

Now, it is time to change the culture of cancer. There are thousands of scientific studies that have documented the benefits of exercise during and after cancer treatment. There are more than 200 studies that have shown the benefits for cancer-related fatigue alone. In fact, there has been head-to-head comparisons between exercise and medications to treat cancer-related fatigue, and exercise won. That means there is not a drug on the market that is more powerful or effective than exercise to combat cancer-related fatigue. This could be hard to understand, given how difficult it is to motivate yourself to exercise while you are experiencing fatigue.

Therefore, here is the recommendation from the ONE group: Start with two minutes. Stand up, sway back and forth for two minutes. Walk to the mailbox and back, just move for a few minutes. Then really check in. Do you feel worse? It would be rare to answer yes. If you feel the same or better, keep going. Try 10 minutes the first day and increase a few minutes each day until you reach 30 minutes of exercise daily. I guarantee you are going to feel better.

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