“Exercise and/or psychological therapy work better than medications to reduce cancer-related fatigue and should be recommended first to patients.” It is an intervention that hasn’t been at the forefront, but in this big study has been proven to be more effective to fight fatigue than pharmaceutical drugs. When I read this in a recent meta-study done at the Wilmot Cancer Institue, I literally jumped out of my chair of excitement (such a nerd, I know!)
Cancer related fatigue during and after treatments is one of the most mentioned side effects. It affects between 70 to 80% of cancer patients and many say it's the most disruptive side effect of all. It can last for months or even years after treatments have finished and really effects your quality of life, could cause depression and hold you back from living life the way you want to. It’s the kind of tired that doesn’t go away by resting and the smallest activity can be exhausting.
It can be hard to predict, show up unexpectedly, be different every day and make it hard to plan your day or exercise. It might make exercise be the last thing you want to think about, but how amazing is it that exercise is actually the best treatment for it? Doing less will actually make fatigue worse and might bring you in a downwards spiral of feeling more and more tired. Let's dive a bit deeper in how exercise can help you and where this whole fatigue thing is coming from.
What exactly causes cancer related fatigue is not completely clear. There are a lot of factors that play a role in this and often more than one might be the cause. It could be the cancer itself and/or treatments, as they change the normal protein and hormone levels that are likely to cause inflammatory processes. The way your cells work might also be altered by toxic substances being formed in the body. ATP production (energy production responsible for muscle contractions and generating muscle mass) might be low because of muscle waste and weakness after being in-active for a longer period of time. And treatments kill both cancer and normal cells, which leads to build-up of cell waste and the body needing a lot of energy to clean up and repair the damaged tissue. But other factors are in play too:
If you have anemia, your red blood cell count is low. These cells caryy oxygen to the cells to turn into energy.
Emotional distress can be exhausting you.
Pain of surgery, tumors and/or treatments.
Not sleeping well, which is a common side effect.
Many medicins cause fatigue and problems with thinking.
But as much as you might not feel like exercising, it has been proven to improve your energy levels, sleep and quality of life. It also works ant-inflammatory, helps your body flush out toxins, improve cell function (healthy cell growth, cell improvement and eliminating unhealthy cells), your heart and lungs work better and your muscle and bone strength increases. All of this will improve your energy production and overall metabolic system.
Exercising doesn’t have to be going full out in the gym. If you have the energy for it, great, go ahead! But if you don’t, then don’t push yourself and get frustrated. Always listen to your body and if that means that you’re only doing some stretching in bed, that’s fine for that day. Try to do some movement daily for at least 30 minutes, even if it’s split up into different parts. Test for yourself which type of exercise suits you best right now and also at which part of the day. It might feel better for you to do it in the morning or in the afternoon. This can be any type of training, from yoga to walking or resistance training. There is no pressure to do a certain type of exercise, just make sure that you get your body moving and you will quickly start to feel improvement in your energy levels if you don’t push yourself too far (this might lead to further exhaustion).
Even though the main focus when being challenged with fatigue is to get moving as much as your energy levels allow, not what type of exercise you do, the combination of resistance training and aerobic exercise has been studied to be the most effective. This has let to the following guidelines:
10-90 minutes, 3-7 days per week at a moderate intensity (55-75% of heart rate maximum).
3 times per week, moderate to vigorous intensity (60-90% of one-repetition maximum). You can progressively increase this up to 2-4 sets of 8-15 repetitions of an exercise.