Apr 21, 2015 — Even when you’re feeling your best, it can be difficult to get motivated to exercise, but it’s much more difficult when you feel fatigued and depressed because of cancer. But research has shown that physical activity is very important, especially with cancer. Pamela Hansen is the medical director of the wellness survivorship center at Huntsman Cancer Institute. She has some tips for finding the motivation to begin and continue an exercise program even when you’re feeling your worst.

Interview

Announcer: How to motivate yourself to exercise when you have cancer. We'll examine that next on The Scope. Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You are listening to The Scope.

Interviewer: You know, it's tough enough to exercise when you're feeling your best, but what about when you're depressed and fatigued? You have pain and maybe nausea or diarrhea, which are all symptoms of cancer and cancer treatment. You still have to exercise. Research shows that it's good for you. Pamela Hansen is the Medical Director of the Wellness Survivorship Center at Huntsman Cancer Institute. Do you have any tips or advice for someone in this situation? How to exercise when you just don't feel like it, when you have cancer.

Pamela: There are some advantages in this population, in that it's a life altering diagnosis. It's a time when people are willing to make big changes in their life. Some people are very motivated to start an exercise program and maximize their health and functioning at this time. It's a great time to do it. Anytime is a great time to get started. It can be very motivating for patients.

Interviewer: What are some other tips? Say maybe somebody is very motivated for a couple of weeks, but then the fatigue sets in or the nausea sets in. How do you work through that?

Pamela: I think it's really hard with the issues that cancer patients are experiencing, to continue an exercise program. I do think that coming to a facility, like the Power Program, can be helpful to be accountable to somebody. They know they are coming here to exercise. We give them exercises to do on their own at home on other days of the week. They know they're going to be coming back and meeting with us again. It gives them that sense of accountability.

Interviewer: So you find that is really important?

Pamela: I think that is very important for patients. Many of them tell us that frequently. The other thing about coming to a center like this, or in finding a group of friends, is that social aspect of exercise. Getting together with other people can be very motivating and help one stay on track.

Interviewer: I have to say that it does make it a lot more fun. I played in a softball league and I was a lot more likely to want to get out and run as a result of that than I would just normally. Sometimes what is really motivating for people is knowing that there are going to be some results. How long does it take before you can start seeing some results? I know it could vary from patient to patient.

Pamela: This is a really tough thing to say in this population, because some patients are coming in at the very beginning of their treatment or at the time of their diagnosis so we don't expect to make big gains during this time. We expect to try to mitigate losses. We want to minimize the amount of strength loss and fatigue they're going to experience, but they're not going to see gains during this period of time.

When they're coming in, maybe after their diagnosis or after their treatment, or even years out, some survivors come to our program seven years out after their treatment and I think three months is a good period of time. That's when we choose to do our reassessment, so we exercise with patients for 12 weeks before we'll complete a reassessment. We'll give them a print out of their pre- and post- numbers, so their aerobic capacity, strength, range of motion, balance, and agility. Really, the improvements that we see at that point can be pretty remarkable and very motivating for patients.

Interviewer: But, during treatment sometimes, they might not see any improvements at all?

Pamela: They might not see improvements . . .

Interviewer: That could be really demotivating, I can imagine.

Pamela: That can be demotivating, but I think a lot of patients know that they're expected to not feel so great during this period of time. The fact that they can do what they're doing can be great. There's some early evidence now that suggests that people who are exercising during their treatment are actually able to complete their treatments on time, which is a big factor in terms of actually recovering from cancer and curing cancer.

Interviewer: We know the physical benefits and some of the mental benefits. Can it help other symptoms like the nausea or those types of things?
Pamela: Yeah. We have a lot of anecdotal stories. It'd be nice to do a research study on it, but a lot of patients come in and exercise prior to their chemotherapy because they feel it helps reduce their nausea during the treatments.

Interviewer: Same for the diarrhea as well, if that's a symptom they have?

Pamela: Yes.

Interviewer: That's pretty incredible that exercise can do all of that, isn't it?

Pamela: It is.

Interviewer: Are there any dangers pushing through those things though? You're motivated. You still kind of got the symptoms. But you're like, "I've got to get up and exercise."

Pamela: As patients are going through treatment, we have to modify things quite a bit. Definitely that's an individualized approach that we use to patients, depending on their level of fatigue and what their other symptoms are. We certainly do a lot of modification of activity programs as people are going through treatment.

Interviewer: There again, it's great to have a team of people that know this, like yourself other people at Huntsman Med.

Pamela: Correct. I think it's very helpful to have that guidance and that understanding of what cancer patients are going through.

Interviewer: Do you have any additional resources you'd recommend for somebody that is done listening to this podcast and they want to learn a little bit more?

Pamela: We've got a nice website at huntsmancancer.org. You can look up the center under the Patient Care tabs. We've got a lot of information on our site regarding the different programs that the Wellness and Integrative Health Center have to offer. They include our Power Program. In addition to our one-on-one individualized programs, we also have a lot of group classes and you can see those under our site. When they're offered, these are free to patients and family members.

We also have other services, including outdoor recreational opportunities for patients and family. We have acupuncture, massage, and free nutrition services. The main thing is that people just maintain some level of exercise as they're going through treatment.

Interviewer: It sounds like exercise is really, really important when it comes to recovering from cancer or while you're going through treatment.

Pamela: I think exercise can be the most empowering thing that a patient can do when they're diagnosed with cancer. Not just physically, but for their mental health as well.

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