Fitness and Exercise
I have written many times before about the importance of exercise. To be clear, I am not someone who especially enjoys it (I was brought up my a mother who liked to say: "Horses sweat, men perspire, and women glow."), but I have run a marathon, and I get myself to the gym almost every day. I have been convinced by the studies re the importance of exercise in weight maintenance and reducing the risk of recurrence. I have given up on losing weight, but I consider it a success to hold it steady.
This is an interview with Dr.Deborah Franklin from Living Beyond Breast Cancer. Per usual, here is the introduction and then a link:
September 2011 Ask the Expert:
Fitness and Exercise
Deborah Julie Franklin, MD, PhD
Deborah Julie Franklin, MD, PhD, is director of cancer rehabilitation at Thomas Jefferson University. She has written extensively on cancer rehabilitation and cancer related fatigue, as well as on the place of rehabilitation medicine in palliative care. In addition to conventional rehabilitation treatments, she is interested in the benefits of yoga, mindfulness meditation and related mind-body techniques for people with cancer.
Question: I'm a pretty hard core athlete who was recently diagnosed with triple-negative breast cancer. I am enrolled in a clinical trial (ISPY2), and I am currently in the beginning of neoadjuvant chemotherapy which will be followed by surgery. I will have 12 rounds of weekly paclitaxel (Taxol) with carboplatin added every third round, followed by four rounds of AC every other week. I'm also taking a PARP inhibitor twice daily. What can/should I do to maintain as much of my fitness as possible? What should be my markers for taking it easier or pushing myself? Should I push myself at all? Or should I maintain my exercise in the aerobic zones only? I know I need to exercise, and that's not a problem for me. My problem is more likely that I might try to do too much.
Dr. Franklin: You are right to identify doing too much as a potential problem for a committed athlete undergoing cancer treatment. You belong to a group of people who are used to making progress by pushing themselves. Even in the best of health, this is where we see overuse and related injuries.
Your body is already signed up for a decathlon as it tries to reverse the effects of chemotherapy, surgery and possibly radiation. A general recommendation for athletes is to reduce the duration and intensity of their program by at least 50 percent. So if you were running a 7-minute mile for 5 miles a day, your goal would be a 14-minute mile (brisk walk) for 15 minutes a day—basically a 1-mile walk. That is the goal, so there may be some days at what is called the nadir (lowest point) of a treatment cycle or if you are actively sick with fever when this will be too much.