The difficult matter at hand is, when you are exhausted, nauseated and anemic from conventional cancer therapy (surgery/chemotherapy/radiation) it seems impossible to exercise:
- Physically impossible because you already are starved of oxygen if you are anemic, have low blood sugar from nausea and haven't eaten much, and as a result of not eating, have lost muscle mass. You may also be unsteady on your feet and need some form of mobility/stability help from a wheelchair or a walker or a cane.
- Mentally impossible because you want to feel good before starting to exercise, so you can actually exercise. This is a common thought process with many conditions and not just cancer.
This is a blog post about boosting your energy and keeping your muscles after a cancer diagnosis before, during and after treatment. You may know someone who is getting older or someone who has been diagnosed, and if you do please forward to them. We all have setbacks that affect our ability to move our bodies. We also have the willpower and grace to pick ourselves up and make that first step to regaining our ability to exercise and use it as a tool to fight cancer and the fatigue it causes.
Keeping our muscles intact during the cancer journey is key to lower drug toxicity from conventional treatment, and can improve overall survival. Did you know that muscle wasting starts at the same time as cancer starts growing, and that your muscles are hijacked for their protein content to support cancer growth? It is because of an inflammatory mediator called Interleukin-6 and this is also a prognostic indicator.
A side note: Muscle mass loss due to aging is also known as sarcopenia, and can be recovered with dietary changes and resistance exercise. Due to our declining DHEA and other hormones it is a harder process to maintain our muscles as we age, but it is possible with dedication and willpower.
The medical word for losing muscle mass due to the malignant growth processes at work in cancer is cachexia. The very word itself sounds bad. It carries a poor prognosis and is responsible for 1 in 3 cancer deaths. Research has found drug treatment targets for both IL-6 and Activin-A but nothing to date in research is as effective at stopping cachexia as exercise.
How does cancer do this to my muscles?
It raises IL-6 and slows down skeletal muscle protein regulation in muscle cells called Myotubes and is measured in research through the expression of COP9 signalosome complex subunit 2 (COPS2). That's just a fancy way for saying it hijacks signals that maintain muscle cells. This process is measured using a protein study method that works in human, cell line, and animal model research. To illustrate this in human research, in a lung cancer study, the expression of COPS2 is lower than in the age-matched control (no lung cancer) group, resulting in loss of muscle. Bottom line from that study: Exercise will normalize your COPS2 cell signals and keep your muscles from wasting.
Research has shown that exercise is the solution for both lowering IL-6, slowing the loss of muscle, and reducing the fatigue that cancer causes. Exercise is actually anti-inflammatory, more potent than anti-inflammatory drugs, and that effect is proposed to be what reduces cachexia. The type of exercise doesn't matter too much but WHEN you do the exercise does. Any type of exercise with the most effect/benefit is that which keeps your muscles and it is what you like to do, but the link above has more to say on that. It could be hiking outdoors, walking, dancing, cycling, running, swimming, water running, water aerobics, boxing, body weight workouts like yoga, Pilates or tai chi, and it could be actual weight lifting or other forms of resistance training like Bootcamps, Cross-fit, and High Intensity Interval Training (HIIT). It can be a combination. The effect is the same. As long as it is an exercise you like to do, that will work to keep your muscles.
When to do Exercise:
In the all out fight against cancer, there have been advances in the research to understand how cancer cell growth happens. The theories include mutated cell signaling pathways, abnormal fuel metabolism, and abnormal cellular growth, as the main ones. When you exercise matters most because of the abnormal fuel metabolism theory. To move what you just ate to your healthy cells rather than to your cancer cells, it makes natural sense that the best time to exercise is after you eat. Do this and you rob cancer of a fuel source and keep your muscles at the same time, further improving your overall survival time.
Willpower and grace may not always be there after each meal so that you do some form of movement. Recall the last time you exercised and how you felt afterwards, and keep that in mind as you start this time. We all want to feel the great effects of exercise before we exercise, when that is physically not possible until exercise happens. Focus instead on how you want to feel, and use that to motivate this exercise session. When in active cancer treatment, reward yourself with gentle movement because you don't feel both physically and mentally 100% able to exercise. It still counts as long as you are using the large muscle groups. Give yourself 10 minutes after each meal for some walking laps around the house, some squats while holding onto the back of a chair, and some arm and leg raises from a seated position. They all contribute to keeping your muscles and if you can do this consistently after a meal, you will notice a change in your energy levels and also some good return of muscle.