• Alex Conboy

How keeping active helped me through cancer treatment:

When I was diagnosed with breast cancer in November 2015, I was fitter and healthier than I had ever been in my life. I was training for a half marathon, was running around 25 miles per week, and went out for a 10-mile run the day before my surgery, fully expecting this to be the last run I would do for a long while, if not for ever. I had no idea what to expect – little did I know that my life was going to be changed forever in ways I would never have believed.

I had 2 tumours in my right breast, and 2 lymph nodes were affected, so my treatment consisted of a mastectomy with full axillary lymph node clearance followed by 6 months of chemotherapy, 3 weeks of radiotherapy and finally 10 years daily tamoxifen was proposed.

Until then, I had no real experience of cancer – none of my close friends or family had ever been affected, so my understanding of what treatment would be like was limited to what I’d seen on the TV. I thought that in addition to making my hair fall out chemo would make me pretty sick, and I was anticipating spending the next 6 months in bed. My family assumed that I would be advised to rest and conserve energy.

The reality was completely different – and I am the first to admit that I was very lucky. I was up and about within a couple of hours after coming round from surgery and was allowed to go for walks around the hospital – carrying my catheter bag and surgery drain bag with me as I went. My surgeon encouraged me to do as much as possible and within 10 days of the mastectomy I was walking 3 miles a day with my dog.

Chemotherapy started a month after surgery. I remember that the first thing I asked my chemo nurse was “Will I still be able to run?” “Of course” – she replied – “so long as you are feeling up to it”. She then went on to tell me that she had been working as a chemo nurse for 30 years, and in all that time she’d lost count of the number of times she’d been asked that question, and had yet to meet anyone who had been physically able to do so. For me that was a red rag to a bull, and I immediately told her that she had just met her first…

About 5 weeks after my surgery I went out for my first run, a couple of days after my first cycle of chemo. I did just over a mile, slowly, and immediately felt better. And so it continued – although I was not able to run as far or fast as I could before, I averaged a three mile run three or four times a week during my chemo and radiotherapy, in addition to walking the dog at least once a day. It worked out that on most days I was running or walking 4 or 5 miles in total. At the time I had no idea if this was the right thing to do – all I was aware of was how it made me feel. If I sat on the sofa for too long I felt pretty rough, but if I got up and went out for a walk or a run I felt so much better. Friends and family – and some medical professionals – kept telling me I was doing too much and should rest, but I listened to my body and did what I thought was right for me. I was able to keep on living my life pretty much as normal – I kept on working (at the time I worked as a corporate soft skills trainer), socialising with friends, flying my glider and teaching others to fly. I am fully aware how desperately lucky I was not to suffer the debilitating sickness that so many others have to go through. I was pretty tired when it came to an end – and had put on a couple of stone and lost all my hair – but that was about it.

Since I finished treatment my life has completely changed. In 2017 I started retraining as a personal trainer, finished the basic qualification and the exercise referral course in 2018, and in June 2019 I qualified as a level 4 Cancer and Exercise Rehabilitation specialist with CanRehab. I am now a freelance personal trainer – I work with quite a few people affected by cancer, some actively going through treatment and others living beyond. I train my clients either in local parks or in the privacy of their homes. I love what I do – it is so rewarding helping people affected by cancer get fitter and feel better, and when the opportunity came along to start up the Basingstoke group of 5k Your Way I jumped at it. We’ve been going since September – and our biggest turnout was 26, just before we had to stop temporarily due to Covid-19. I love the way that getting out in the fresh air and keeping active puts a smile on people’s faces – like personal training my involvement with 5k Your Way really enables me to make a difference in the lives of people affected by cancer.

I’d like to finish by sharing with you what I learned on my level 4 course – that what I was intuitively doing by keeping as active as possible during my treatment was probably the best thing I could have done, and – in combination with my initial good levels of fitness – may have helped me get through the 9 months of surgery, chemo and radiotherapy relatively unscathed.

Keeping as active as possible during treatment brings many benefits. There is increasing evidence to suggest that exercise and physical activity during treatment:

· Helps to maintain or sometimes even develop physical fitness and function, both muscular strength and endurance and cardiovascular fitness. It is important during treatment not to expect too much progress, and just do what feels right on a day to day basis.

· Helps with body composition. Some cancer treatments are known to lead to loss of muscle mass and an increase in body fat. By keeping active, and by doing some gentle strength training, we will be able to minimise these effects.

· Helps to manage and reduce treatment-related fatigue. Recent research shows that keeping active and doing some aerobic or resistance exercise has a beneficial effect by reducing levels of fatigue. Speaking from my own experience this was certainly very true for me, and some of my clients have also reported feeling so much better after doing something active.

· May reduce other treatment-related side effects, such as reducing risk of lymphoedema after surgery, reducing risk of osteoporosis, and can lower the risk of infections due to improved immune system function.

· Has a positive effect on well-being. Physical activity and exercise can help lift mood, improve sleep quality, manage stress, and if the activity involves being outdoors then this brings so many other benefits as well. For me – being out and about helped me retain some sense of normality which made such a difference to how I felt, and enabled me to reduce worry by focusing my attention on things I could control.

· Can also reduce the risk of developing other health conditions such as high blood pressure, heart disease and diabetes.

So if you currently going through cancer treatment what can you do? Depending on the type of cancer, the treatment involved and any other medical conditions present, there may be specific types of exercise that you should not do during and after their treatment. Before doing something new it is important to check with a medical professional to make sure that it is safe to do so. For example, it might be sensible to stay away from gyms or swimming pools if your immune system is compromised. If you currently exercise then great – so long as your specialist team say it is safe to do so then carry on with caution, but remember don’t push yourself too hard, exercise at a moderate intensity, do what you feel like on a day-to-day basis and don’t expect any form of linear progression in your fitness. If you are new to exercise then remember to build up what you are doing gradually, any activity is better than none, and moving is better than sitting. There is absolutely no reason why – with your doctor’s ok to do so –you can’t work towards the government weekly guidelines of 150 minutes of aerobic activity, plus a couple of strength sessions and some flexibility work such as yoga or stretching. Going for a walk is one of the best things you can do. A cancer-specialist personal trainer can point you in the right direction and make sure that you are exercising safely.

There are some times where it might be appropriate not to exercise – for example on the day of chemo, or if your blood count is so low that you have been refused treatment, you have a temperature, you are feeling dizzy or have recently fainted, have an irregular heartbeat, your blood pressure is high, or if you are suffering from any unexplained bleeding, muscular weakness or persistent headaches.

And – of course – there are so many benefits of exercise for people living with and beyond cancer, and for those preparing for cancer treatment. Those however are topics for another day. Good luck – and keep moving!

Ref: Physical Activity and Cancer: A Concise Evidence Review, Macmillan, 2017.

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