By Guest Blogger Sami Mansfield
Founder, Cancer Wellness for Life & Director of Oncology Wellness, Sarah Cannon Cancer Institute HCA Midwest Health
For many breast cancer survivors, cancer time is associated with sick time. This time in their life often referred to as to “when I was sick.” We use “chronic illness” for those living with metastatic disease so that too can have its own descriptive box. It’s no wonder survivors struggle with negative side effects and difficulty in getting back on track in their lives, one recent study stated that 80% have at least one symptom of post-traumatic stress disorder.
So when is it that we turn sickness into wellness? As who is “we?” As a cancer exercise specialist who is dedicated member of the health care (or perhaps better interpreted as sick care) community, I count that big we as me.
I regularly hear us say to a patient, it’s time to find your “new normal.” Again what exactly is that and how does one FIND it? Does that come with a road map? Because the rest of cancer actually does.
We have very specific guidelines post-diagnosis for surgeries, treatments and hormonal therapy. We tell patients when to show up, what surgeries or treatments are best, medications they need to take and how to manage side effects with very specific doses. But in areas such as exercise, the land of black and white comes across as a very different version of gray ambiguity.
It’s no wonder that survivors are struggling.
While clinically they receive positive news, many still struggle with physical and emotional side effects for years after their diagnosis contributing to feelings of sickness and continuing struggles. And while the outside world says “wow, you look great!” (which would lead me to wonder, did I look that awful?) so many of our women and men report that they don’t feel so great. Survivors report a daily with side effects such as fatigue, chemo brain, joint pain, anxiety and insomnia no to mention fear, does an ache mean that my cancer has spread?
One of the most side effects, fatigue, has often been overlooked as something that a patient can actually doing anything about. Recently a study published by JAMA Oncology reported that exercise does more than any medicines to improve cancer related fatigue. So why aren’t we prescribing that? My interpretation is that we are encouraging patients to move more, get active or take a walk. But it’s not enough and not specific enough.
Fortunately, we have basic guidelines. The American Cancer Society recommends 150 minutes of moderate physical activity per week for survivors per week with two days of strength training and full body stretching.
The key for survivors is healthy body composition and weight. While the scale isn’t totally telling of the story, it’s the basic barometer we all seem to use. Focus instead on body size and composition. Over 70% of cancer survivors aren’t meeting the basic amount of movement recommended. This lack of activity also leads to a loss of lean metabolically active muscle tissue. That important tissue is the stuff that burns calories not only when you are active but also when you are sleeping.
So what do you do? Move often and focus on exercises that will get you to your goals!
- Walking is great- it can be done with little equipment and is very easy to get started. A quick workday walk is a great way to combat chemo brain and improve your fatigue. Keep in mind that walking only burns calories when you do it (about 100 calories per mile) and it won’t make a change in your body composition to help with overall fat loss so I don’t recommend it as the primary form of exercise.
- Running – is a higher form of walking which means that it still only burns calories when you do it. It does improve your bone density and builds a little more muscle but for some the impact is strenuous on your joints and can be more painful than anything. And for many it’s a form of mental relaxation so try it on alternating days.
- Resistance exercise – is the sweet spot for improving body composition and improving fatigue long term. Strength training is simply defined as overload muscle to stimulate it to grow. This can be done with body weight (squats or countertop push-ups) or added resistance such as bands or free weights. An intense strength training session will increase your metabolism for hours which means that you are still burning calories after you have moved on to another activity. Because it is also very versatile you can use your own body and workout in a smaller space.
- Core & Posture – are the basics to everything that we do. This is also a significant issue for a lot of our breast community because of the significant impact on their chest muscles. This leads to tight tissue, hunched forward posture and a tight and weak back. Start with a simple focus on sitting tall, shoulders back and opening up the chest. Keep the same posture when you stand and when you move. Add some strengthening such as a modified plank or superwoman exercise. Both are low level and can be done on your bed.
- Yoga & Pilates – are great forms of exercise and have a lot of great benefit to each and many survivors enjoy this form of exercise. They are most often not of the level to build lean active muscle. If you are doing those forms, great- keep it up! But if your preferred is flow yoga or floor Pilates, make sure to include with some form of resistance training in your week!
Sami Mansfield is the Director of Oncology Wellness for the Sarah Cannon Cancer Institute HCA Midwest Health and is the founder of Cancer Wellness for Life, an organization focused on developing oncology exercise resources for individuals, hospitals, and corporations. She began her work in 2003 and was one of the first oncology exercise specialists in the US. She developed and leads BUILD, a functional exercise program for cancer survivors. This program offers onsite classes as well as encompasses a supportive community focused on fitness and wellness.
Sami is a certified cancer exercise trainer and a Crossfit Level 1 trainer. Her focus is to blend these together to help survivors meet their goals and live a healthier life. She currently leads a 8-week cancer exercise program called BUILD at Crossfit Memorial Hill .
The next BUILD classes begin on Tuesday, May 16 (Click here for details) or join Sami for Survivor Saturday on May 13. You’ll have the opportunity to learn more about BUILD, meet current participants, and participate in a fun group workout for all levels. This event is open to cancer survivors, allies, healthcare providers, family, and friends. (Click here for details).