Exercise During and After Cancer



hi I'm Alyssa Fanta here in the Johns Hopkins breast cancer survivorship program today we're joined by J Hudson here's a physical therapist and a certified exercise specialist hi J it's great to have you here thank you for having me can you start by telling me a little bit about why it's important for cancer patients to exercise after treatment there are many important reasons why it's important and as more research is being done it's starting to become the standard of care that physical patients be referred to physical therapy at the time of diagnosis for cancer there are many many reasons why it's important to exercise through the process several them include the fact that the actual treatment process is improved while patients going through an exercise program another reason is because it can help to prevent reoccurrence of that cancer or of new cancers and finally it is exceedingly beneficial in preventing and combating many of the side effects the cancer patients are going to go through such as why some of those side effects are going to include fatigue and research has recently shown that as many as few as one workout will help to reduce fatigue level and improve mood another one of the side effects is weight management issues some cancer patients will lose weight some cancer patients will gain weight just depending on where they are in the treatment cycle and exercise can be beneficial with either of those anxiety is another main problem anxiety and depression as a side effect of the cancer treatment and there's certainly physiological changes but also psychological changes that can be improved with exercise some of the other exercise advantages of exercise and cancer patients as it can help improve sleep and can also help to improve with cognitive clarity what are some of the barriers that patients face when they want to start an exercise program right unfortunately barriers are very effective reasons the recent studies show that as many as 35 percent of patients have had no exercise in the last 30 days and we know with all the research that shows the benefits you can see how important is to try to get patients started exercising earlier one of the main main barriers is just a fear barrier you know I'm do is this the right thing for me to do am I too fragile I might have I lost too much weight of a loss too much strength is this going to do any good for me am I gonna undo what the medicine is doing to me if I begin an exercise program through education that can be addressed another one of the barriers is just accessibility you know is it president practicality is it practical for me to drive 20 minutes to a gym do I even know what to do what I should or should not be doing based on the surgeries that I've had a final barrier and maybe one of the steepest is motivation and not that patients don't want to exercise but you know the quote that I use is that with a championship boxer he said everybody came into the ring with me with the plans I'd punched him in the face and unfortunately you know when you started going through the chemotherapy and radiation and surgery you know the hits sometimes keep on coming sure so the want to exercise when you're tired they want to exercise when you're sick can can be very difficult a tip that I have that I think that might help people you know is as I mentioned earlier you know your planning begins the time of diagnosis and you're gonna get a lot of people who are gonna come in and ask you what they can do select a few select a few that you know are into exercise and have this conversation with them and tell them I'm going to be sick I'm not going to want to walk I'm not going to want to exercise if you want to do something healthy when I get that way motivate me come over take two 10-minute walks with me make me do an exercise as the physical therapist gave me and that's something that's gonna pay dividends in the long run it's great suggestion are there risks involved that patients should be aware of for exercising there are risks involved with improper exercising more than there are risks involved with exercise and this is the breast cancer survivorship website and one of the big fears with exercise after breast cancer during breast cancer treatment is the developing of lymphedema it's actually been found that it through the proper exercise program lymphedema risks are decreased over exercising and immunosuppression is another significant concern and again the proper exercise program that a patient will follow with slow progression proper progression proper guidance that shouldn't be a problem how do you know if a patient's over exercising well you watch for a couple of different things and as a physical therapist we're constantly doing re-evaluation so I'm looking to see you know is there performance going in the wrong direction and that's one of the major signs that they may be over exercising what should be included in a regular routine for patients who want to start an exercise right that's a very good question there's two ways I want to answer that question because I want to answer what should be included in a daily workout and then an overall routine and why it's important to have all of those elements together and a daily workout you want to begin with about a 5 to 10 minute warm-up followed by the main bulk of your exercise course which we'll talk about in one second and then you want to finish with a cool-down if when the demon is a concern you may also want to finish with elevation of that limb now when you're designing a program for somebody you want to include the four the four basic elements of an exercise program so strength training cardiovascular training core stability training and balance training okay and it's important that an flexibility training – excuse me it's important that all four of those elements are included in everybody's exercise program and the main reason for that is just to try to prevent any overuse injury so if you're somebody who is concerned about weight gain all you want to do is cardio and cardio and cardio to try to control your weight there's a higher risk that you're going to break down and have an overuse injury or tendinitis that can be prevented through the strength training a flexibility training portion of a workout occasionally I hear from patients when I suggest weight training exercises that they don't want to bulk up are there strategies that you have that you would suggest for patiently and it's funny because sometimes with chemotherapy you know patients are gaining a weight but the reason they're gaining weights because they're losing so much muscle mass so strength training is sometimes a vital component of this overall exercise program and bulking up it's not going to happen especially if you cater the exercise program properly and you're doing higher repetitions lower weights more sets how do you help patients meet their goals it's the first thing that we do is physical therapist we sit down we have an in-depth interview with our patients and we try to get to know them as well as we can and we want to get to see what their goals are right immediately there they're often long term in nature I want to run a marathon I want to complete in a triathlon you know I want to do something like that and we tell them that those are important goals an important care at the end of the stick that we're going to work toward but now let's get him some short intermediate range goals so that we can see progress as we go through it once we talk with them and realize what their goals are – it's important that we then use that to decide which type of exercises we want to include in the program occasionally I hear from patients that I joined a G I joined a gym and I don't even know where to begin do you have suggestions about how to find a good provider that can help work help you work towards your goals yeah as a physical therapist we believe that we want the patients to start with us first because we want to do a complete evaluation of the patient to make sure that when they do begin their exercise program you know we're not going to leave something out that's going to lead to an alternate failure of the program so we want to evaluate the range of motion evaluate their strengths when I'm going with their flexibility and balance find where their weak parts are once we've established that and come up with a plan get them started on the plan what we're trying to do is partner with other facilities for long range options after they're finished with their the physical therapy portion of the treatment sometimes that's something like a health club and if you look for trainers these days many of the personal trainers are becoming certified cancer exercise specialists as well so a CES designation would be something that you want to look for the American College of Sports Medicine also has a cancer Athletic cancer training program as well and I would highly recommend if you are going to skip the step of a physical therapist and go to a trainer we're here already working with a trainer we're planning on doing so called mints and speak to them and find out if they've worked with patients like you your age your condition your symptoms talk to them first and if they're not comfortable with talking to you then I would probably look somewhere else because it's very important to get started the right way the other thing that's out there there are many like team and training and team failure there's two examples locally in the area here of once kind of you're through the treatment or even during the treatment but medically safe you can start train with some of those facilities as well it sounds like working with grip sometimes can be helpful for some patients absolutely you know that's a very very important one of the things I failed to mention earlier as far as the barrier is sometimes there is an isolation because there's a fear of you know when I go to the gym I'm different than everybody and I don't fit in and I'm only doing five minutes on the treadmill or I'm lifting the lightest weights and you know but when he went sometimes it's an absolute fact that when you're working on these other organizations other places you're with people that are going through the same thing that always is reassuring okay this has been so helpful thank you so much appreciated thank you for joining us today

4 Comments

  1. PLEASE HELP ME IF ANYONE KNOWS ABOUT PROSTATE PROBLEM OR PROSTRATE CANCER TELL ME PLZ WHAT TO DO MY BROTHER HAS THIS PROBLEM HIS AGE IS 67 YEARS OLD AND HE HAVE PROSTRATE PROBLEM HE HAVE NO BLOOD IN HIS URINE AND NO BURNING IN HIS URINE BUT HE Go's 9 To 10 Time For Urine During 24 hours,,,,little Pain In Both Legs,,,,Also Pain in Lower Back,,,little bit dizziness At Morning When Weak Up And After Noon And Also Sometimes High Blood Pressure And Stress Sometimes

    And Then We Will Go To The Doctor For Check Up And Doctor Advice For these TEST'S

    PSA TEST:
    CBC TEST:
    URINE EXAMINATTION:
    ULTRASOUND

    And These Are The Reports N Results

    PSA TEST:
    NORMAL VALUE LESS THEN 4
    RESLUT = 350.61

    HEMATOLOGY REPORT
    TEST:

    HB :
    Normal value 13-18 g/dl
    RESULT = 15.1

    Total RBC
    Normal value 4.5 – 6.5 x10^12/l
    RESULT = 6.3

    HCT :
    Normal value 38 – 52 %
    RESULT = 46

    MCV:
    Normal value 75 – 95 fl
    RESULT = ( 73 )

    MCH:
    Normal value 26 – 32 Pg
    RESULT = ( 23 )

    MCHC:
    Normal value 30 – 35 g/dl
    RESULT = 32

    Platelet count:
    Normal value 150 – 400 x10^9/l
    RESULT = 229

    WBC Count (TLC):
    Normal values 4 – 11 x10^9/l
    RESULT = 6.6

    Neutrophils:
    Normal values 40 – 75 %
    RESULT = 57

    Lymphocytes:
    Normal values 20 – 50 %
    RESULT = 32

    Monocytes:
    Normal values 02 – 10 %
    RESULT = 08

    Eosinophils:
    Normal values 01 – 06 %
    RESULT = 03

    RENAL FUNCTION REPORT
    TEST

    Urea (serum):
    Normal value 10 – 50 mg/dl
    RESULT = 39

    BUN (blood Urea Nitrogen):
    Norma value 8 – 22 mg/dl
    RESULT = 18

    CREATININE (SERUM):
    Normal value 0.72 – 1.25 mg/dl
    RESULT = 0.78

    MICROBIOLOGY REPORT

    URINE EXAMINATTION

    Colour: Yellow

    Specific Gravity
    RESULT 1.030

    Turbidity: Nil
    Deposit : Nil

    CHEMICAL EXAMINATION

    PH: 5.0
    sugar: NIl
    Ketones: Nil
    Proteins: Nil
    Blood / Hemoglobin: Nil
    Urobilinogen: Normal
    Bilirubin: Nil
    Nitrite: Nil

    MACROSCOPIC EXAMINATION

    Pus cells: 2 – 4 / HPF
    Red blood cells: Nil / HPF
    Epithelial cells: 1 – 2 / HPF
    Casts: Nil
    Crystals: Nil
    Amorphous: Nil / HPF
    Misc: Nil / HPF

    ULTRASOUND RESULT
    Prostate enlarge
    Prostate volume 49.53 ml
    Prevoid volume 19cc

    Liver enlarge approx 16.5
    Cbd + PV with in Normal range
    Right kidney 10 cm
    Left kidney 10.5 cm mild hydronepl
    Urinary bladder is 114 ml

    These Are All The Reports And Results
    So Plz Guide Me Should i go For Natural Way To Cure this problem or go with Doctor I'm Confused so Please tell me.

    And i Dont Really Know is This Cancer Or Prostrate problem so plz tell me god will vive u reward please

    And Doctor advised me for Bone Scan and n he Said Further Investigation After Bone Scan Result

    And plz Pray for His speedy recovery

  2. Wow only 2 comments on this subject. 🤔…. Why?

  3. I have stopped looking for at cancer/ exercise sites they spend half the time treating you like an idiot and I what exercise I suggest you do the same.exerise for beginners.

  4. Hope to see a demo video some day of a cancer doctor and their cancer patient using
    treadmills together. What a powerful message it would be send I am cancer
    survivor and can't say enough about the important of exercise. Thanks for your video
    which is so important!

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