Taking part in physical activity before, during and after cancer treatment can have many health benefits. It can help prevent and manage some of the effects of treatment, such as fatigue, depression and risks to your heart health.
Please watch the two videos below from Vicki Gilbert, a Leeds Cancer Support volunteer specialising in Exercise and Cancer.
Leeds Cancer Support: Exercise Part 1
Hi everybody, My name’s Vicki Gilbert, and I work as a volunteer at the Sir Robert Ogden Macmillan Centre at St. James University Hospital in Leeds. I’ve been treated for cancer twice myself, and the reason I started working with other people who are living with and beyond cancer is because they found the opportunities to access exercise were very limited when you’re being treated for cancer or afterwards to exercise with people who are in similar situations.
You can lose a lot of confidence, and it can really affect you. I’ve exercised all my life and been really involved in physical activity, but I found it really, really hard, especially recently, when I was treated for breast cancer. I also found that despite all the information that’s out there, just generally about how we should spend more time exercising and we should do a minimum of 150 minutes or two and a half hours per week. There’s very little service for people, and this is improving, and there’s more and more opportunities becoming available, but I felt, having been treated at least myself, that the treatment I received was brilliant, but the opportunities to exercise were limited.
In my everyday job, I’m a lecturer in physical education, and so I spend a lot of time teaching people about physical activity. I went away and did a specialist course in exercise and physical activity and cancer rehabilitation, so that I was able to work with people and offer the most up-to-date information. as well as my own experience of being treated for cancer, to understand a lot about other different types of cancer and what people go through and what people need.
What I’m going to do today is give you some examples of some of the things that we did or did in the face-to-face classes when we were able to meet. some of the things that you can do at home, and why they’re beneficial. There’s lots of evidence to show now that exercising while being treated for cancer can help relieve some of the symptoms of the disease itself and also the treatments. especially things like fatigue and also some information that shows if we do the minimum of 150 minutes a week, which sounds an awful lot, but I’ll explain more about that and show you more ideas as we go on.
It can help to reduce the chances of recurrence of some cancers, so there’s lots of just the general benefits, but especially if you’re living beyond cancer that you can take part in as adults and some older adults who are living with and beyond cancer. We need to think about improving cardiovascular health, or that you might hear that sometimes called aerobic health, that’s heart lungs and improving strength, so bone and muscle strength and improving balance and flexibility are really important as well.
Don’t forget that many of these exercises can be what you do anyway as part of your everyday life: gardening, shopping, and cleaning. They all contribute. If you get a bit hot and sweaty, if your heart rate rises, you feel like a little bit tired afterwards. All these things contribute. You’re probably doing a lot of them anyway. The most up-to-date information is for adults to take part in at least 150 minutes of moderate-intensity physical activity per week or 75 minutes of vigorous-intensity activity.
Moderate intensity consists of doing exercise where you can still hold a conversation that you’re not really heavily breathing and stop struggling to breathe, and this 150 minutes or two and a half hours that we’re talking about, which sounds like an awful lot, doesn’t have to be made up in large amounts of time so you don’t have to spend 20 minutes exercising. Any bout of activity that you do can contribute to that time, so if you walk bristly to the bus stop and it takes you 10 minutes and you do that five days a week there and back to go to work, that’s a huge amount of your time.
One of the things I always recommend is marching on the spot while the kettle’s boiling. You know your kettle might take three minutes to boil; you do it five times a day, seven days a week. Again, that’s a huge amount of time—that’s one hour and 45 minutes out of the two and a half hours of recommended exercise a week, can you believe it?—and you might not have even moved from where the kettle’s boiling.
It can be really frustrating if you’ve been very active when you’ve been diagnosed with cancer or before you were treated for cancer. It can be really frustrating for people because they’ll say to me, I used to run 10ks, and now I find it hard to walk up the stairs, or most likely, you have to think to yourself where you’re at now. You might be almost starting from scratch again and just gradually building up any amount of exercise according to national guidelines, especially for those who are used to only low levels of activity, which can have benefits.
Here’s another exercise that you can do to just keep moving, so you only need a very small amount of space and also either by the sides, like this stepping to the side; it’s entirely up to you how far you step. For some people, it might be a very short amount. Concentrate on transferring the weight from one foot to the other. It doesn’t need to be fast; it can be just nice and controlled. Okay, you can do it faster if you’re able to, which is great.
Flexibility is really an important part of keeping physically fit and physically active, and there’s been more and more evidence in recent years showing that what we call dynamic stretching is really the best way to go about it. doing stretches, for example, stretching like this while you’re moving rather than holding a stretch and holding it for a certain amount of time up to about 20 seconds, and that’s all very well, and that’s great. If we can do it for many of the patients that I work with and the clients that I work with, that can be really, really difficult because of all the restrictions they’ve got.
whether it be from cancer treatment or it be other what we call comorbidity issues that they’re dealing with, so we still will do what we call static stretching on the spot. What we’ll do first is do activities where it gets your heart rate raised, blood pumping around the body, it gets you warmer, and there’s less chance of injury. So first of all, we’ll do some of the activities that I have shown you, so either marching, standing, or sitting, starting to get that heart rate raised, either doing side steps, which we can do here like this sitting, and we can do our stretches while we’re moving, so reaching the arm over, keeping the tummy tucked in, don’t arch your back, and then the other one cheers, so stand. If you can sit with your feet shoulder width apart, or if you need to sit, you can just get your chair and again sit feet shoulder width apart, sitting up nice and straight.
Keep your bottom away from the back of the chair so that you don’t slump with your back sitting up nice and straight shoulders back. Let’s take one arm up if you can and reach it up towards the ceiling and hold that for up to about 20 seconds. You know you might only be able to get your arm to here; that’s absolutely fine, or here just as much as you can without arching your back. So either sitting or starting, and obviously if you can do one arm than the other or one side then the other or one leg than the other. If you’re able to turn your head to the side, keeping your shoulders back, put your shoulder blades not pinned together, and then to increase that stretch, drop your chin down towards your shoulder.
You should feel that on the opposite side, and doing the same again on the other side, turn your head to the side and drop your chin down. Don’t let your shoulders slump forwards because then you lose that stretch, and back to the front, you can also drop your ear towards your shoulder again. Don’t shrug your shoulders up; keep them down relaxed but back slightly and to the other side. While we’re moving, we can do some of these stretches reaching out to the front; don’t lean forward at the moment. You’re stretching from your shoulders and arms going forward. It might be that you’re going to get to here; that’s fine. Just do it to the best of your ability.
Some people may just be able to do it with one arm reaching your arms to the sides, opening your chest, stretching, and taking your arms up again. Just do what you can. It might just be with one arm that you can do it. Obviously, when we’re exercising, it’s important to exercise the whole body, whether that be flexibility, strengths, or any of those things, but let’s have a little think now about leg stretches that are achievable for people like yourselves that need that little bit of extra help, or you might be starting from scratch.
You might see people at the gym wanting to stretch their quadriceps muscles at the front of their thighs and quite easily getting hold of their ankles, and stretching that can be really, really difficult for people, so in order to stretch the front of our thigh, which can get very tight, I’ll scan the back. especially if you’re sitting a lot, so what we would advise is to do a little bit of activity, whether it’s walk around the block and then do some stretches to get your heart rate up, get the blood flowing, and then do some stretches so that exercise I showed you there you can do it sat on a chair. So you would sit side on and you would either get hold of your ankle, sitting up nice and straight and pushing back slightly through the hip. That can be really difficult, but for people, what you can do is hook your finger in the back of your shoe or you train them, and you get exactly the same effect if you’ve got a pair of trousers on. You can get hold of your trousers and use your trousers to lift your leg as well. We’ve had clients at the Sir Robert Ogden Centre in their 70s and 80s doing these types of exercises.
In these types of stretches, you can even do it on the floor or on the bed, but it’s not great because it’s not as a soft surface, but I’ll show you now how you can do it when you’re in the lying position. Obviously, this means that you’re much more stable when you’re doing it, so keeping your body in a straight line and bending your leg back and holding it for about 20 seconds, but if you can’t hold it for that long first, just do it for 10. You know if you can’t get your leg’s heel up towards your bottom, just bend it back and do it as much as you can. All of this, as you’ve seen, is adaptable; we can do it so that any of you can take part. We’ve just had a little look there at stretching the front of our thighs.
What about the back of your thigh? This can get very tight. Your hamstring muscles, hair at the top of your leg at the back, and also your calf muscles can get really, really tight again. You’ll see people. You know, you might look at an exercise video and you see where they put one foot in front of the other, sit back at your bottom, and bend your back straight. Put your hand on your bent leg, not your straight leg, pulling your toe up towards you, and this stretches the back of your leg well. That wasn’t stretching anything because that doesn’t get stretched. You do it sitting just as easily, and I find this really effective for the people that I’ve worked with, so you put one leg out, sitting up nice and straight again. The posture and the techniques are really important, and what you do is bend from your waist, and that will increase the stretch in the back of your leg. Pull your toe up towards you, not physically, but lifting it slightly just so you can feel that stretch. The further you go down, the more it stretches in the back of your thigh and also into your calf.
Leeds Cancer Support: Exercise Part 2
You’ll also have seen in the diagram earlier that the recommendations are for at least twice a week. to do some sort of strengthening exercise; these may look just like water bottles to you, but they’re really, really handy. not only for rehydrating when you’re exercising but also for using as weights. You can fill them half full to start with or fill them right up, and one litre of water equates to a kilogram. So this is something in your own home that you can use to help you exercise.
We feel it’s really important that you don’t need to use any special equipment when you’re strengthening and trying to do things in your own home. So like the water bottles, use other things that you have there; you might have a couple of tins. Again, we can do exercises to strengthen. This is strengthening our upper back, reaching up with the tins. You can even use the smaller tin as well.
To start off with, some people will want to do this while they’re moving and do both arms together, or you can do one then the other, lifting the arms out to the side. lifting the arms up towards the ceiling, keep your arms in the right angles, taking the arms back out and in again. Try not to let it be that your hands come together; do it so you bring them as far as you can without letting them come together, all your elbows coming together. The technique is always really important.
I’d rather you do fewer and do them well, then you do more with a really bad technique. You can do this sitting down as well; just try and get a dining room chair if you can or something that’s got a straight back. Again, don’t put your back against it and slump down. Sit up nice and tall, and we can do it sitting. all these exercises, triceps, one arm than the other two arms together, but just using the things that we’ve got at home, I even bring these into the centres to show people, like I’ve said, the important thing is to just keep moving as much as you can.
If it’s just walking around the block from your house, that’s fantastic. Anything in the fresh air is great, so doing these exercises outside is fantastic as well. So again, all the exercises that we do in the sessions at the Robert Ogden Centre, or that we’ll possibly be doing online, you can do them standing or setting them out; it just needs a little bit of adaptation. I’ve also mentioned that improving balance for everybody, but certainly as we get older, it is really, really important.
To help prevent falls, we need to be stronger, but we also need to have good balance, and we can just do this again in our own homes. So maybe if you stand by the wall, just use your fingertips, tuck your tummy in, don’t hold your back there, and then just standing on one leg and holding it, you might do it for a set amount of time (10 seconds, for example) and relaxing and doing it on the other leg. If you can even take one hand away, you can take two hands away. You can do it while you’re brushing your teeth. While you’re brushing your teeth, try and stand on one leg as you’re brushing them.
There’s lots of activities that you can incorporate, like I’ve said, into your everyday life, but it’s just thinking about those things, so doing some stretching and strengthening exercises while you’re moving so you can reach out to the front again. If you can only do it with one arm, that’s absolutely fine. Just do what’s easiest for you. You might only get to here, but that’s okay too. Just do it to the best of your ability.
So, reaching forward and reaching your arms out to the side, you can reach up as well. You can also put some of these moves to music as well, because that always helps to motivate us and to keep going, you know. Set yourself a time of 30 seconds, for example, to start with, so let’s put some music on, so just those exercises that we were doing before, and you can just do them stepping side to side. You might want to bring your arms into. Do them together. Any of these types of movements that contact this can do them slower.
There are lots of different variations that you can do. As I’ve said, keeping on moving or getting started to get moving again is the really important factor. Some is good, but more is better, so whether you just accumulate it in small bouts and gradually increase that over time, or if that’s what you stick to, that’s fine, but certainly do some exercise; it’s brilliant to do some physical activity and incorporate it into your everyday life, but the more, the better. What I’ve shown you and described here are just a few examples of some of the things that we do at the surrounding Ogden Macmillan Centre through the service that they provide to support people living with and beyond cancer, and we’re desperately hoping we will be able to offer those services in some form again soon.
How should we keep active?
The current guidance of physical activity levels for all adults is 150 minutes per week. It has been previously advised that this is achieved by doing 30 minutes of activity a day, five days a week or for a minimum of 10 minutes but the most recent guidelines from the Department of Health & Social Care suggest that these 150 minutes can in fact be accumulated in bouts of any length. This means even three or four minutes of activity, for example marching on the spot whilst the kettle boils, accumulates and can contribute to the overall 150 minutes.
The activity is to be of moderate pace, such as walking. The guidance now includes doing balance and strength exercises at least twice a week. This level of activity is helpful for people even during cancer treatment. However, everyone is different and exercise needs to be tailored to you, taking into account your overall fitness, diagnosis and other factors that could affect your health.
Benefits of physical activity include:
- Managing side effects of treatment
- Healthy heart function
- Reducing anxiety and depression
- Maintaining a healthy weight
- Strengthening muscles and improving bone health
- Improving flexibility and balance
- Increasing confidence and self-esteem
- Reducing the risk of cancer recurring
How can we manage fatigue?
Exercise has been shown to be the most effective way to improve fatigue. Please click on the following link for more information on managing fatigue. View more information on cancer and fatigue
Physical Activity Doesn’t Always Mean Exercise
The type of activity or exercise you do may depend on what stage you are at in your recovery. It may also depend on what type of activity you enjoy doing, this could include your everyday activities.
Everyday activities that can be incorporated into an active lifestyle:
More energetic activities could include dancing, jogging, cycling and digging the garden.
Macmillan Move More exercise
MACMILLAN GET ACTIVE FEEL GOOD
We’re going to work the legs and get ready to do the lunges. We’re going to start with the right leg forward and bring it forward, and you can use the hands to give you some balance. You’re ready. Three, two, one off. We go bring it forward and back. The other leg forward and back. Make sure the knee doesn’t go further forward than the feet forward and back forward and back. Using the hands, if you want to control and back forward and back, that’s nice and controlled. Last turn nice and controlled, and back. Give a little break.
We’re going to do 10 more. 4 3 2 right foot forwards and back nine more and five and eight, good seven six five and four. Okay, now if you can use the weights, you can put them away. We’re going to work with the hips. Now the important thing is here: you keep the feet pointing forward, toes forward, no doubt to the side, hands on the hips, three of the egos, right was out for two and in for two, hold back in. That’s good. Nice small moves don’t need to be very big moves. Concentrate your breathing.
That’s great halfway through. No five more and hold squeeze, and we’re good last three and squeeze little moves. remember of the hip muscles last one now we’re going to do ten fast are you ready out and in out and in nearly halfway five more hang on in there four three last two last one give it a little rub a little step ready to do the other side hands on the hips off we go take it out stretch it to the side nice and controlled toes pointing forward not out to the side it’s not a huge swing to the side the slow increase stretching and working the muscles in the hip half we hold on there and out slowly in last three last two last one and now we’re going to do ten faster you ready off we go out and in that’s good keep it going not big swings Remember toes pointing forward halfway through four more, three last two, and one. Give a shake. Well done.
Okay, now we’re going to work on the upper body. We were to start by working the muscles at the front of the arm by sets, and I want you to start by putting the hands out to the sides. palms open off we go slowly up for two back for two keep the elbows tucked in nice and tightly just spending the lower arms slowly up and down a strong body that’s good halfway there nice and smooth slowly up and back down concentrating you’re breathing you’re working the muscles in the front of the arm that’s all don’t sway the body keep the tummy and the lower back nice and strong last one here and then we’re going to do ten fast are you ready We go up and down.
Don’t sway the body, and try to keep it nice and strong up and down. Last three, two, and last one, have a break. Let’s start again. palms out, elbows tucked into the side, nice, strong body, make sure the belly button is separating away from the t-shirt, you’re ready. We’re going to do 10 slow starts, starting now slowly up, back down, keeping it going, concentrating on your breathing, taking deep breaths in and out, and working that muscle in front.
nice and strong, arms half way, four more and three, last two. Now we’re going to do ten faster. You’re ready. We go one and two, three control the arms, half way, five more, four, three, last two, and last one. Well done. Now we’re going to work the back of the arms. The triceps bring the right hand up, and I want you to bend the elbow so that the wheat goes to the back of your head and back up again. Are you ready down for two back ups now you’re only bending from the elbow keeping the upper part of the arm nice and still keep that going nice and controlled slowly up back down halfway through nice and controlled Three more slowly up Feel that muscle at the back getting a good workout last one here and then we’re going to do ten fast off we go and one two three four nearly halfway five more four three last two last one give that imma shake and let’s do the other side left hand up bring it back to back up nice and controlled Slow moves down don’t back up that’s good to the back of the neck remember keep the elbow nice and high you’re just working up muscle at the back concentrate on your breathing three more up Hold back down the last one, and then we’re going to do ten fast.
Are you ready? Bring it up and down low. Remember to keep it nice and controlled. Concentrate on your breathing halfway there. Fine for the three last two ones. Give it a chic. Well done. Now we’re going to work the muscles on the shoulder. The deltoids. Make sure you’re in a nice, strong position. Hands in front. You’re going to bring it out to shoulder height no higher than that. Back in again. You’re ready. Three last two one and out. We go bring it out slowly back down to centre out, concentrate your breathing, nice strong core muscles needed for this one, control it. This is number four, halfway excellent. Keep it going.
Five more strong bodies. Keep the lower back and the tummy nice and strong. Three more excellent, no higher than shoulder height. If you want a little bit of a lawyer, that’s okay as well. Last one, and now we’re going to do ten fast. Are you ready off? We go one. Now remember, don’t swing the body; control the arms. Just let the arms do the work. If the weights are too much, drop the weight completely. Last fine. And for the last two and one, give a little break, a little shake. We’re going to do ten more. Get your position correct feet hip-width distance apart lock the muscles get the ribcage away from the hips nice and tall three two off we go slowly up back down hold it nice and easy which controlled movements.
Excellent, this is us halfway through five more last for control the arms. nice smooth movement up last to concentrate on your breathing Ten fast one and two, three half way, keep it going for three last two last one, well done. The last exercise for the arms is going to work the back muscles. What I’d like you to do is get into position if you’re standing one foot back, the other foot forward. Now try and get a nice diagonal line from the heel right up to the top of the head, gonna stretch the arms and the upper body forward, bring them back, and bring the shoulder blades together down and squeeze back down and squeeze down stretching back. We go head and chin up halfway through this and squeeze my strong body so you’re not rocking back and forth and shoulder-back doing the work. Three and two.
Last one, you have a break. If you want, you can change legs. Last one here, get into position one leg back, other ones forward. A nice diagonal line from the heel up to the head leaning forward straight chart. You’re ready. Three and two off. We go bring it back, squeeze back forward, squeeze back forward, and squeeze. Bring it back excellent, nice, and controlled halfway through these five more. Keep it going and squeeze. Remember, you can drop the weights if it feels as if it’s getting too much. Last three, last two, last one, and now we’re going to do ten fasts off. We go in and out, squeeze, and stretch, doing well halfway through this one. Last five and four, three, two, and one, well done.
Now we’re going to work our tummy. Our chest on our back. Okay, standing. I want you to put your hands up quite high on the wall, and I want you to bring the knee up to the chest. The chest comes down to the knee. Start with the right leg. Three two one off. We go up. We really feel the chest coming down to meet the stomach coming up. Working those stomach muscles up.
halfway through, concentrate on your breathing four more times, squeeze the last two, hold it, and stretch up just to stretch out the muscles we’re going to do that one more time, and space and wait legs hip distance apart, bringing the knee up, squeeze back we threw up and back down, up, squeeze, back down.
Good when you get two more to go off we go bring it up squeeze down last one up and greet just stretch up now we’re going to work the muscles in the back stand near the wall of the door when your boss hangs up you’re going to bring opposite hand and lead our way through the door you ready the start of the right hand left leg off people Hold back out, hold back in, and hold back in.
Feel the muscles in the back getting a good stretch. Keep it going. I’ll hold back in out pull and back in pull back in out hold and back in pull back. Keep it going for more out, hold back in last to hold back in last one out and back.
The last exercise is for the chest muscles, the pectoral muscles. What I’d like you to do is face the wall, hands nice and wide, bring the feet a little bit further back, you’re going to use the elbows going out to the side as the Lewis goes towards the door, and then you’re going to push back with the hands. You don’t swing the body; you’re working the pectoral muscles. Are you ready off? We go take it down, hold up nice and controlled, using the body, not just the arms up, down, and up. Concentrate on your breathing. Breathe out in the rear. Concentrate on the breathing. Take it down. Hold nice and controlled using the body, not just the arms up. Concentrate on your breathing. breathe out on the way up, concentrate in the breathing, three more, two last ones, well done. That’s the end of our strengthening exercises. We’re now going to move on to our final stretch.
Physical activity support online
We Are Undefeatable
‘We Are Undefeatable’ is a movement supporting people with a range of long-term health conditions, developed by 16 leading health and social care charities and backed by expertise, insight and significant National Lottery funding from Sport England. Their purpose is to support and encourage finding ways to be active that work with each person’s conditions, not against them.
Being Undefeatable is understanding that how you feel can change from day-to-day, that everybody’s situation is unique and that moving more when you can is just as important as accepting when you can’t. Every achievement, no matter how small it might seem to someone else, is worth celebrating.
‘We Are Undefeatable’ have a wide range of online advice and support available to anyone to help get people moving in a way that’s right for them.
Leeds Let’s Get Active
Leeds Let’s Get Active aims to encourage and support people who do not do any physical activity to be more active. The community programme provides free physical activity opportunities to help people get active. they develop sessions with community organisations and groups and have a timetable of a variety of activities which include:
- Zumba
- Walking group
- Chair Based Exercises
- Tai Chi