Physical Activity: Introduction

Physical Activity ***

Taking regular exercise will have a positive impact on your health.

Overview

Physical activity means regular exercise: anything that increases your heart rate and breathing and works the muscles.  It could mean going for a walk, swim, or even simple exercises you can do at home.  Sports, dancing and activities like gardening also count.  Regular exercise improves the fitness of your body and has a positive impact on your health.

Approval score:

•             We gave this our maximum score of 3 stars, meaning there is good evidence of benefit and it can be recommended widely.

How does this work?

Taking regular exercise means your heart and lungs will work more efficiently and your circulation is improved.  These reactions can have a positive impact on your health helping you to manage better with your cancer.

Exercise is also a great way to work off stress.  When we are stressed (worried, frightened) the body prepares itself for exertion, tensing the muscles, speeding up the heart, changing the blood flow. These reactions can have a negative impact on health over time: raising the blood pressure, putting strain on the heart etc.  Exercise allows the body to wind down from stress, you feel better and your body can relax properly.

Thirdly, physical activity is an important part of fatigue management.  This may seem upside down but when you feel as though you have little energy to do anything, doing a little physical activity can turn that fatigue into sleepiness and allow your body the restorative sleep it needs.  Physical activity (if taken regularly and in correct amounts) will give you more energy.

What are the benefits of physical activity?

There are many benefits to being active during and after treatment, including:

•             Increased muscle strength

•             Improved cardiovascular fitness

•             Reduced fatigue

•             Improved wellbeing and quality of life

•             Improved physical function

•             Helps with weight control

What is the evidence?

There is a huge amount of research evidence showing that exercise and physical activity are beneficial and safe.  There is also evidence that maintaining a healthy weight and being active at the appropriate level may reduce the risk of some cancers returning.  Take a look at the Macmillan Cancer Support resources on physical activity or Cancer Research UK.

In addition, evidence shows that being active and maintaining a healthy weight can prevent or reduce the risk of developing coronary heart disease, stroke, diabetes mellitus, osteoporosis, obesity, some cancers and dementia.

Who would this be good for?

In recognition of the importance of physical activity for people living with cancer, The British Association of Sport and Exercise Sciences advises that ALL people with cancer should aim to be as active as their abilities and conditions allow.  There are lots of ways of becoming more active and it’s important to do an activity that’s enjoyable and which fits in with your life.

If you are having radiotherapy or chemotherapy or after surgery you may not feel like being particularly active but once such treatment is complete, you should try and build up your physical activity gradually working towards the recommended levels for yourself.

Who should be careful?

If you want to become more active, it’s important to know what the right level of exercise is for you. This will be influenced by your cancer type, what treatment you’ve had and any other conditions you may have which may affect your health.  In preparation for exercising you may note that if you have any of the below conditions, you would be advised to avoid certain types of exercise:

•             If you have cancer affecting the bones, exercises putting a strain on your bones, you could try swimming or exercising in water. The water supports your body weight so the skeleton is not stressed. Exercise such as yoga generally appears safe for everyone.

•             If your treatment has caused you to have altered sensation in your feet, you should avoid doing exercises where you could easily fall and may be better holding onto something.

•             If you have swelling in any of your limbs (lymphoedema) you should always wear your compression garment when exercising and if the exercise makes your limb feel heavy you should seek medical advice before continuing with that particular exercise.

•             If you have pain that is not well controlled either due to your cancer or due to other medical conditions then you will need to be cautious but this doesn’t mean that you can’t enjoy the benefits of physical activity with a little care.  First of all it will make sense to see if you pain control is as good as it can be.  You’ll need to discuss this with your doctor.  Secondly, you will need to start with very light exercise, listen carefully to your body and see what effects the exercise has.  Gradually increase the exercise if you find you can and its making you feel better.

If you’re unsure about taking a particular activity, always check with a health care professional first.

Myth busting

Q:  Can doing more exercise make the cancer worse?

A:  No, there is no reason to think that physical activity will increase the rate of cancer growth

Q:  If I feel tired, shouldn’t I simply rest

A:  Rest is very important but you will find that a combination of some physical activity and proper rest will give you more energy over time

How to start

First think about what kind of physical activity you would like to do regularly. 

There are many different types of physical activity, including: Aerobic exercises – walking, dancing, running, cycling or swimming – are good for heart health.  Resistance exercises – lifting small weights or ‘sit to stand’ exercises that you can do at home – help strengthen muscle. Flexibility exercises – stretches, yoga, Tai Chi/ Qi Gong – improve suppleness. Balance exercises – Yoga, Tai Chi, Pilates and Qi Gong – help with balance and strength.

Choose activities you enjoy and, if possible, do a mix of activities. 

Self- assessment:

Next, take our PlanBe Physical Activity self-assessment to help you decide what level of exercise to start with.

Which of the following best describes you?

1.            I feel generally well in myself, no significant symptoms or disabilities and I am used to taking regular physical activity

2.            I feel generally well in myself with no specific symptoms or disabilities but (at least in the last few years) I have not been sporty or particularly active usually.

3.            I used to be fit and active until recently but I’ve stopped because of the diagnosis of cancer and my treatments

4.            I’ve various health issues which prevent me being physically active

If you’re new to being active, it’s best to start slowly and build up to doing a little more each week. The below is a guide as to how you should be feeling depending on what level of activity you are doing

Light intensity exercise is when you’re breathing easily and can speak when you exercise

Moderate intensity exercise is when you’re still able to talk but you’re breathing is more rapid and deeper. You will feel yourself becoming warm and your heart racing faster

High intensity exercise is when you can no longer hold a conversation, your breathing and heart rate is rapid and you will probably be sweating

We advise that if you are in reasonable health (if you feel well) you aim  to work up to completing 150 minutes of moderate intensity physical activity each week – this could be broken down into 30 minutes of activity on five days of the week or could be broken down into smaller units and done more often.  

Higher levels of physical activity (longer or more intense) can be beneficial if you are able to tolerate it but it is important not to do too much and put yourself off, exhaust yourself or injure yourself.  Regular repetition is the desired goal.

Lower levels of physical activity are also helpful for those that are unable to make this target.  More or less anything that you can do will be helpful, and if regularly practiced may well lead you to being able to do more.  For example, for those who can walk with ease: walk briskly; for those who cannot walk briskly but can stand with ease: walk slowly; for those who cannot stand with ease, practice standing at least for a period of time each hour, for those who need to be in bed most of the time, try to sit out in a chair for at least some of the day.

Getting started

•             Decide on the level of exercise appropriate to you, and the type of exercise you’d like to do.

•             Get in touch with any local resources which may be appropriate.

•             Assess which tools, gadgets or apps you would like to use to help you with your exercise.

•             Set personal goals as part of your PlanBe.

Top tips before you exercise

•             Ensure correct footwear and loose clothing

•             Make sure you don’t get dehydrated by having plenty of water handy

•             Eat a healthy snack such as a banana or wholemeal toast at least one hour before exercise and within 30 minutes of finishing

•             Check with your doctor if you’re unsure whether you should be exercising

Setting goals and monitoring your progress

When exercising it is important to do so at an intensity that is right for you. Guidelines recommend a moderate intensity which means your breathing becomes deeper and quicker but you are able to talk. This is a good way of monitoring how hard you are working.

It is important to monitor your progress over a few weeks to help keep you motivated. One way of doing this is by setting goals. These goals should be personal and important to you, for example being able to hoover the living room, or walk around the park without stopping.

By reviewing your goals on a regular basis you can track your progress and also set new more advanced goals if needed.

Activity diaries including planners for goal setting are available from Macmillan.

Other ways of ensuring you keep up with exercise are, by joining an activity group or association.

Track your progress regularly by using your PlanBe diary and any apps you have chosen to use.

Summary

·      Follow our preparation guide and decide which type of exercise you’d like to participate in

·      Look up any relevant resources

·      Keep track of your activity in your PlanBe diary

Resources

·      Your GP – can provide information on local exercise referral schemes which you may be able to access, and give individualised medical advice about exercising

·      Your local leisure centre – for details on exercise classes, swimming and gym access. Some leisure centres have discounted rates for people claiming certain benefits

·      Your local council website – details of local exercise facilities, activities and exercise referral schemes can be found under the “sports and leisure” section

·      Ask your GP or oncologist for a referral to physiotherapy

There are many tools to assist patients to plan their goals including the Macmillan activity diary as well as plenty of web-based tools and apps, such as from NHS Choices .

One of the latest devices is a wearable fitness device designed to automatically track physical activity, sleep patterns, mood and calorie intake, among others.  This device, which comes in the form of wristbands, watches and earphones, can be a good option – albeit at a cost – for inactive people who need motivation to raise their game.

Many other internet tools and apps are free, easy to use and can be accessed using a smartphone, such as an Android or iPhone, or a basic home computer. These include:

·      MyFitnessPal , available in iTunes, Google Play and Windows Phone

·      Couch to 5k, a running podcast available through the NHS Choices website

·      Fitocracy, an app available on iTunes and Google Play

·      The Macmillan website provides a wide range of information and advice on being active during and after treatment .

·      The following leaflets and information packs can be ordered or downloaded from the be.macmillan website:

Ø Get active, feel good DVD

Ø Move more, your complete guide to becoming active

Ø Walk this way – walking for health

Ø Physical activity and cancer treatment

·      NHS–approved apps to help record and monitor your progress.