The Benefits of Physical Activity During Cancer Treatment

Cancer treatment recommendations can be daunting and overwhelming for many patients.
From a patient’s perspective, much of treatment is “passive” – with advice from their care team  to “have this operation,” “take this medicine” or “get this radiation.” It’s understandable that from their point of view there’s very little input or engagement.

But many of my patients ask the question: “What else can I do before and/or after surgery to ease the recovery process?”

The answer is several things. Research has shown that complementary therapies like exercise, nutrition, mind-body practices such as yoga and meditation and various support structures are safe and may be effective for helping patients through the treatment process and aiding their recovery. However, there’s limited research on how other alternative therapies, such as herbal medicines, affect cancer treatment. Some therapies also may interfere or affect how well conventional cancer treatments work. Complementary therapies help many people, but it’s important that patients are transparent with their doctors about any other therapies, medications or treatments they are taking or plan to pursue outside their doctor’s recommended care plan.

There are so many complementary therapies out there, so it’s important to explain how they work. Over the coming weeks and months in an upcoming blog series, we’ll explore several complementary therapies that have been shown to improve responses to cancer surgery, the first of which is physical activity.

The Impact of Cancer Surgery

We typically decide on surgery once we discover the cancer is localized, meaning it is only found in one part of the body. After surgery, patients may undergo other treatments like chemotherapy or radiation to help us remove all of the cancer.

Surgery can be taxing on the body, so it’s critical for patients to prepare. We often advise them to stop taking certain prescribed and over-the-counter medications and to make lifestyle adjustments such as changing their diet, avoiding alcohol and restricting — or better yet — quitting smoking. Doing all these things can put a patient in the best position possible for a full recovery after surgery.

But research has shown that physical activity also has a positive impact on patients undergoing cancer treatment. For example, one study involving 220 patients who planned to undergo breast cancer surgery found that those who were more physically active before surgery had a faster recovery, while another study published in the Journal of the National Cancer Institute suggested that exercise also may improve the effectiveness of chemotherapy because it may slow tumor growth and increase the death of cancer cells. Other research published in the Journal of Clinical Oncology found women who were more physically active before and after their cancer diagnosis had a 45 percent lower risk of death than those who were inactive.

Physical Activity & Prehabilitation Before Cancer Surgery

As the previous studies indicate, exercise can help patients throughout their cancer journey, especially as they prepare for surgery. The goal of surgery is effective treatment of the patient’s cancer. However, from the patient’s perspective, other goals include a full recovery, such as a return to activities, limited complications and minimizing treatment-related side effects. Surgery causes a stress-related physiologic response, so just as an athlete prepares for an event, one can and probably should prepare for surgery. In our literature, this has become known as “prehabilitation.”

So, what’s an effective form of prehab before cancer surgery?

One of the simplest ways is to increase walking. This can be done anywhere, almost anytime, and without cost. Even increasing walking for a period of one week has been shown to elicit beneficial responses, including better heart and lung function, control of high blood pressure, and blood sugar. According to the American Cancer Society, physical activity also may improve balance and blood flow, reduce fatigue and nausea and decrease anxiety and depression that some patients experience during treatment.

Several oncology and health care programs across the country already have incorporated physical activity into their care approach for patients with cancer. The University of Michigan, for example, has developed a surgical optimization program of which walking is a key component. They encourage patients who are capable of walking to increase their steps per day, with a goal to increase this figure by about 300-500 steps a week. At Orlando Health, we also encourage patients to exercise, if they are able. Many patients have said that walking the labyrinth at UF Health Cancer Center – Orlando Health has reduced their stress and produced a calming effect. This is encouraging to hear because the facility was structured with this in mind.

Research clearly supports the benefits of walking for exercise during cancer treatment. A study from McGill University in Montreal demonstrated a quicker recovery after surgery in patients dedicated to a walking program before surgery. The university also conducted research last year that suggested a four-week prehabilitation program that included exercise, relaxation techniques and proper nutrition helped patients better prepare for surgery.

However, every patient isn’t able to walk for exercise. If someone can’t walk or is having difficulty increasing the amount they walk, this may reflect a need for additional help such as physical therapy. Anyone in either of these situations should discuss these challenges with their doctor before surgery.

Engaging in your health care can have positive effects, whether or not you undergo cancer treatment. However, for patients diagnosed with cancer, physical activity has several benefits, including making you stronger for surgery, improving recovery and it may even increase the odds of long-term survival, studies show. If you were active before your diagnosis, try to continue exercising — under the close supervision of your doctor. But even if you weren’t an athlete before, walking a few times a week (if you’re physically able) can have positive physical, emotional and mental effects throughout the cancer treatment process.