The Case for Exercise

March 21, 2010

Of the estimated 12 million American cancer survivors (120,000 in CT), studies estimate that 53-72% do not meet the American College of Sports Medicine and Centers for Disease Control and Prevention recommendations for exercise. Those recommendations are that each person (including cancer survivors) gets at least 150 minutes of exercise each week. This breaks down to be 30 minutes per day, 5 days per week.  When you think of it like that, it seems silly that we 9 million people can’t walk for 30 minutes before work in the morning. Or is it silly? Why don’t cancer survivors exercise?

Everyone, including cancer survivors, has normal life issues that can make finding time for exercise and exercise itself very difficult, but cancer survivors often face complicating factors. A breast cancer survivor might battle with lymphedema or a rectal cancer survivor might have discomfort or difficulty controlling bowel movements. Any survivor might simply have a complicated anxiety about stressing his/her body during exercise since the body seemed so fragile during treatment. I know a survivor who is currently coming back from treatment; she is (in her words) “digging out of such a big whole at work” that she has time for nothing but work, eating, and sleeping. The list undoubtedly can go on.

As I’m writing, I’m thinking I don’t want to sound like a motivational speaker because I never listen to cheesy motivational speakers. I listen to sound reason and logic. I imagine that many of the nine million American cancer survivors or 60,000 Connecticut cancer survivors who we fear are not exercising may  respond to the same – logic and reason. So this blog is for you, the survivor who is not exercising, or you, the survivor who is not exercising enough. First, I’m going to acknowledge a truth that doesn’t, on first glance, help the case I’m trying to make. Then, I’m going to lay some truth on you. It’s going to be the kind of truth you can’t ignore, so if you want to stay sedentary or if you like not exercising, then stop reading now. Because when I’m finished with you, you will be compelled to shake your booty. You will literally have no choice.

So here is the truth that doesn’t help my case (but of course I’m going to ask you think about this a bit deeper): The research community has not yet proven that exercise, in and of itself, improves outcomes for cancer survivors. Researchers, very talented researchers in fact, are working on it right now. That sort of evidence takes time. We have to take a whole bunch of cancer survivors and follow them for a long period of time (maybe as long as 20 years), and we use fancy statistics to determine whether exercise is associated with better outcomes (e.g., no recurrence, no second cancer, better quality of life, longer life, no heart disease). But I’m going to be a spoiler here. I already know the answer. Exercise is good for you, and it leads to better outcomes in survivorship. How do I know? Proper exercise strengthens one’s body; we know this to be true. Proper exercise helps to reduce the fat to other tissue ratio in one’s body; we know this to be true. Proper exercise releases endorphins which make us happier people; we know this to be true. Need I continue? We know survivors experience survivorship-related depression and anxiety (estimates between 10%-35%); we know obesity is a risk factor for cancer in the first place and second cancers among survivors, and we know that treatments can wage war on survivors’ bodies. Survivors definitely need to strengthen and repair their bodies after treatment, and they need to maintain that strengthening process for long-term survivorship. So while insurance is not yet covering exercise therapy for survivors because we don’t have the long-term evidence, we know exercise is beneficial for survivors.

So I promised you that you would have to get up and get moving after reading this blog. I hope I’m correct. Here are my David Letterman TOP 5 Truths About Exercise and Cancer Survivorship (I'm going to focus on walking here): 

5. Walking briskly with your dog for 30 minutes (instead of letting the dog run in the backyard) counts as your exercise.

4. If you talk on the phone for 30 minutes per day, you could do it while walking quickly, and you could have after dinner without feeling guilty.

3. Walking CAN lead to jogging which CAN lead to running. But it doesn’t have to…If you like walking, you can keep doing that.

2. You have time. If you don’t think you have time, email me christian@ctchallenge.org, and we will look over your daily schedule, and we will find time. I promise.

1. You are a cancer survivor, and among other things, that means that the cancer survivors who come behind you look to your example. What example are you going to set?

One question: Did it work?

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