Why exercise is ‘medicine’ when it comes to taking on cancer

If you’re navigating cancer and the side effects of treatment, exercising may be the last thing you want to do. But the right kind of movement can actually help you feel better, exercise physiologist Natalie Fulton said.

Fulton helps cancer survivors preserve their function, get stronger, improve their outcomes and lower their risk of future disease through Novant Health’s Cancer Wellness Program in Charlotte. Here are some common questions people often ask.

Why should someone battling cancer exercise? Aren’t they dealing with enough already?

One of the worst symptoms people experience during and after cancer treatment is fatigue. Exercise fights fatigue.

Doesn’t exercise make you more tired?

Not if it’s done safely, with a focus on maintaining your function and energy.

Before cancer, a lot of your base level of fitness came from going about your day: washing your clothes. Going to work. Mowing your lawn. If you exercised on top of your daily activities, that made you even more fit.

During treatment, you’re not doing as many of those daily activities, and you’re devoting more time to resting, sleeping and appointments. Being less active over weeks, months or a year has a huge effect on your physical fitness. Then the side effects of treatment are layered on top of that.

If you needed surgery, you’ve lost physical strength and possibly introduced some new strength imbalances. You may have even had to stop or curtail whatever exercise you were doing. Because you’re weaker, daily activities are more draining, so you do fewer activities and become even weaker. This becomes a vicious cycle, making it hard for you to return your pre-disease state.

In contrast, if you maintain as much movement as feasible and keep that base level of fitness during treatment, you have less of a hole to dig out of at the end. Many participants find they gain strength and energy during the course of their participation, but our first goal is to preserve that baseline.

Does exercise help with energy day-to-day, or is it more of a long game?

Our goal for each workout session is that participants leave feeling better and more energetic than they did when they came in.

It takes trial and error on their part to determine how to safely expend energy while not exhausting themselves too much. We have everyone record their fatigue level before starting the session. We work on energy management and helping them pay attention to how the intensity of their exercise affects that fatigue level. They learn that sometimes, harder is not better and it can actually result in higher fatigue.

Once participants have been through our program, they have a better quality of life day-to-day because they're able to moderate their energy expenditure more effectively. And because their baseline level of fitness is higher, daily tasks don’t drain as much of their energy reserve.

Are there other reasons to exercise while being treated for cancer?

Exercise boosts mood and lowers anxiety and stress. It also improves your body image and self-esteem, which is helpful when you’re dealing with hair loss, the loss of a body part, weight gain or loss, or other body changes.

Every cancer survivor has a risk of recurrence or developing another unrelated cancer, and some cancer treatments increase your risk of cardiovascular disease. This is scary, but if you exercise, you can counteract some of that increased risk. And if you do get any of these illnesses, you’ll have a better outcome if you come into it physically stronger.

We also see great social and emotional benefits to exercising with people who have already been where you are right now — which is why we offer group classes. It’s encouraging to see someone further down the treatment road than you, and reassuring to see that things do get better and that there are things you can actively do to make that happen.

Although no one has the same exact diagnosis or treatment plan, everyone will understand how you might look perfectly fine on the outside but don’t feel good on the inside, or why you’re more emotionally fragile today than last week. It feels good to be understood.