Category Archives: cancer

A Case for Exercise Throughout Cancer

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November 2015. In the studio 1 day after chemo, and looking a little nauseated. In fact, I’m quite sure I was nauseated, but moving around always lessened it a bit.

It will come as a shock to no one that I’m a huge believer that movement heals, and should be considered an integral part of almost all cancer treatment programs with rare exception. The human body is a dynamic machine whose mechanisms thrive on the power derived from the processes initiated by physical activity. Last year, the following headline validated much of what I have preached throughout my cancer experience: Exercise is the Best Cure for Fatigue Caused by Cancer. I believe my exact response was an eloquent “duh,” and from there I dove down the rabbit hole of investigating the importance of exercise before, during, and after cancer treatment. What a thrill it was to find myriad scientific articles and studies proclaiming that not only was exercise a good thing for cancer patients, but that oncology rehabilitation “must” be a component of survivorship programs.

I learned that in places like New Zealand and Australia, depending on the chemo drug administered, they will escort patients directly from the infusion clinic to physical therapy because there is evidence to show that exercise may increase blood flow to tumors at the time when the drugs are most readily available in your body. That there is irrefutable evidence that exercising during treatment reduces the severity of side effects with certain types of cancer, increases the likelihood that the full treatment regimen will be completed, and increases life expectancy by up to 28-44% after particular cancer diagnoses. On multiple occasions, I have been nonchalantly informed that because of the 29 rounds of radiation to my pelvis during the summer of 2015 and subsequent chemotherapy, I have an almost 100% chance of suffering a spontaneous hip fracture by the time I’m 75. This sounds horrifically painful. Apparently, chemotherapy may cause a woman to lose as much bone density in one year as she would in a decade. What is the best way to maintain or improve bone density? Weight bearing exercises. Many patients suffer from peripheral neuropathy, an uncomfortable and potentially dangerous side effect of chemotherapy, in their hands and feet. The condition may cause tingling or burning in the extremities, making sleep elusive, and/or loss of sensation leading to falls and fall-related injuries. One of the best ways to treat peripheral neuropathy, especially early on, are exercises that increase blood flow to the peripheral nerves to improve sensation, and activities that improve strength and mobility to decrease fall risk. Infinitely more simple than the drugs often prescribed with side effects like drowsiness and dizziness. Cancer patients don’t really need anymore of that.

To boot, exercise may also lessen nausea (woohoo!), decrease feelings of anxiety and depression, improve your ability to maintain a social life, decrease fatigue, and improve your ability to take care of your own needs. While it is always lovely and heart warming to have friends and family care for us, it’s important to your spirit and sanity to maintain a sense of independence, even if it’s just doing your own laundry and grocery shopping. Exercise is proactive, and inspires a sense of self care and personal empowerment that helped me to feel in control in a situation that often makes you feel vulnerable and helpless. And please keep in mind, that while I have written the word “exercise” roughly 1,001 times in this post, that could mean a languid walk around the block, or perhaps even the infusion clinic. It’s all relative, but as you can see, the clinical evidence for oncology rehab is screaming at us, and it’s screaming at us to move.

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January 7, 2016. I was wearing my chemo pump this day. I can see that blurry, dulled look in my eyes, but it was a beautiful winter afternoon, and those should always be given the appreciation they deserve.

To most people all this jumping up and down (haha) about movement seems like a no-brainer. Of course it makes sense, but for many, many years of cancer treatment, patients were told not to tax themselves, and everyone knows the treatments make you profoundly exhausted. Exercise becomes counterintuitive, but the less you move the less you want to move. I really, really love Sir Isaac Newton’s first law of motion:

Every object will remain at rest or in uniform motion in a straight line unless compelled to change its state by the action of an external force.

Or, bodies at rest stay at rest, bodies in motion stay in motion. If you’ve been at rest too long, you must exert a little external force to get moving again. It’s science. As well, in the midst of the insanity following a cancer diagnosis, exercise often takes a back seat to all of your appointments, treatments, and general life management. Hear me when I say that in many cases exercise is NOT a luxury, it’s treatment. Refer to clinical evidence above.

It is important to consult with your doctor before beginning any exercise program, and this is even more true for cancer patients. Certain types of bone cancers increase risk of fractures, some chemo’s are known to lower blood pressure for a few days following infusion, some people develop peripheral neuropathy that may increase risk of falls or injury, and some people might have compromised immune systems that preclude time in the gym. For these and numerous other reasons, you want to speak with your doctor and make sure you’re safe, but once that’s done, there are many advantages to implementing a program, keeping in mind that for the cancer patient the intensity and/or types of activities may change daily based on their ever changing cancer body.

In the following weeks we will look at how to get started, different types of exercise that might benefit you or your friend with cancer, and some general guidelines on movement.

As always, thank you for reading!

Being the Mess

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A sample of the things that made having someone dig around in my lung not quite so bad.

“Sometimes, I’m the mess. Sometimes, I’m the broom. On the hardest days, I have to be both.”–Rudy Francisco

The cancer metastasized. One little nodule that popped up on the peripheral edge of the lower lobe of my left lung in October, and was growing by late April. The risk of metastasis was always there. The correlation between how low your rectal tumor is and spread to the lungs is significant, and the late stage diagnosis meant that quite probably more than one microscopic cell had caught a ride on the lymphatic highway leading to my liver and/or lungs. Despite knowing all this, it never crossed my mind that the adjuvant chemotherapy they did following surgery hadn’t annihilated each of those tiny invaders. It had most certainly come close to annihilating me. They aren’t really invaders, though, are they? Isn’t it just the same process that makes us grow in the womb? Cells dividing multiple times over, except for these are altered, and they are the enemy.

Initially, because of the positioning of the nodule above my diaphragm, my doctors didn’t know if the lesion was cancerous or not, but it was growing, they had confidence that they could locate and resect it, and eventually consensus was that it needed to come out. I imagined them apologizing profusely for cutting me open only to find a benign spot of pollen on my lung, and pushed the thoughts of malignancy so far down that for a couple of weeks I thought I might go crazy with the effort it took to conceal this possibility from myself. Always pragmatic to the outside observer, I told those who were bold enough to ask that I was prepared for it to be malignant, because that’s what strong, courageous people say, when in truth I was telling myself completely the opposite. You see, I’m actually a bit fragile, and I wasn’t mentally prepared for this, but losing one’s mind isn’t an option for the middle class.

Hearing the lesion was metastatic threw me into a dark tailspin, the greatest fear being that this is the beginning of them cutting pieces out of me bit by bit until there’s no more left, because doesn’t every tragic cancer story begin with mets to the lungs? And the greatest frustration being that this was one more setback to overcome. I was mad and sulky and apocalyptic about my life. This was supposed to be over. I had done my time and been paroled only to be thrown into the clink again. Except cancer is more like the super-max New Mexico state penitentiary in Santa Fe than anything that could ever be called the “clink.” It has a dark, heavy current of pain, grief, and fear that I had purposefully chosen not to explore my first time around. I was a goddess! I was going to rise above! Whether I was chronically nauseated, cut from pubic bone to sternum, or stumbling around because I couldn’t feel my feet, I grabbed onto any sliver of light I could find and created a blinding sun. It worked at the time, but apparently the universe felt that I hadn’t fully examined the shadows of my emotional depth, and decided to invoke it’s no stone left unturned clause. Tyrant.

Last week the word “submit” kept coming up: in an article written by a young woman who recently died of Ewing’s Sarcoma, by a dear friend at her book signing (“White Fur” by Jardine Libaire is this summer’s must read), by the Dalai Lama in an audiobook. I know how to take a hint. I’m practicing submission to this new rhythm of my life, anger and annoyance included. There will be scans every three months for a long time, if they cut me open I will heal, we will watch and wait, and in the meantime I will keep myself as healthy as possible because that is probably what has gotten me this far in the first place. Somedays I will be the mess, and I’m alright with that because I’ve been the broom for a long time. I continue to believe that this will potentially be the last cell to activate, but I won’t delude myself with the possibility that it won’t. Those tiny little microscopic cells are lying cozy and dormant in my spongy lung tissue, we are traveling companions, and I can accept this, but they don’t get to take over. I love what Elizabeth Gilbert once wrote about fear:

I recognize and respect that you are part of this family, and so I will never exclude you from our activities, but still—your suggestions will never be followed. You’re allowed to have a seat, and you’re allowed to have a voice, but you are not allowed to have a vote. You’re not allowed to touch the road maps; you’re not allowed to suggest detours; you’re not allowed to fiddle with the temperature. Dude, you’re not even allowed to touch the radio. But above all else, my dear old familiar friend, you are absolutely forbidden to drive.

Currently, I’m getting focused on exercise oncology. My brilliant lung capacity made this surgery possible, the fact that I rehabilitated myself past pre-cancer strength allows me to recover not only quickly, but well, and I’m reading some fascinating articles about how exercising during certain types of chemo is actually recommended to help the drugs do their job. I have developed a very specific skill set (when life gives you lemons) revolving around surgical recovery, exercising through fatigue, and how to do Pilates with a chemo pump. I’ll be writing more about all of these things, and probably more about how I’m learning to submit. Rome certainly wasn’t built in a day.

Xo, Shelby