Exercise Therapy (p.28)
Cancer Survivors Get Active

By Alan M. Wolf

Leslie Gates easily admits she's not the type of person who will exercise on her own and enjoy it. "I'm not driven to go out and run on a treadmill and sweat my brains out," said Gates, a breast cancer survivor of nearly 11 years. But she recognizes the importance of exercise to improve her physical and mental health. That's why for the past few years, she's participated in a "Survivor Fit" program offered at Rex Wellness Center of Wakefield. "I like having the camaraderie, and it's become a bit of a support group," said Gates, a 65-year-old who lives in Wake Forest. "The instructors recognize that each one of us has different limits, different needs."

The classes offer a range of activities, including stretching, strength training, walking, water aerobics, and more. It's also a chance to bond with other cancer survivors who may have gone through similar challenges. "Some nights we won't mention cancer at all," Gates said. "Other times someone might need a little TLC."

Exercise Benefits

The six-week program is just one in a range of exercise resources Rex Healthcare offers cancer patients, including physical therapy, rehabilitation, and more. One top goal is to encourage patients to adopt a regular exercise routine as soon as physically possible, said Lola Olajide, M.D., of Rex Hematology Oncology Associates. In some cases, that may be shortly after chemotherapy.

"Exercise enables patients to recover faster from certain side effects, as well as boost their immune systems and build muscle mass, all of which help the recovery effort," Olajide said. "Simple activities like walking and lifting light weights go a long way in maintaining energy and stamina levels."

Olajide and other Rex oncologists also are participating, in conjunction with the UNC Health Care System, in several clinical trials related to exercise for breast cancer patients.

Patients who were very active prior to starting cancer treatments tend to tolerate chemotherapy and radiation better than those with a sedentary lifestyle. But even someone who wasn't active before can recover faster by starting some level of exercise. Olajide and other physicians typically refer patients to the Rex Cancer Rehabilitation program. An assessment by a physical therapist can help determine an appropriate exercise regimen.

Start With Rehab

Ruth Konde of Raleigh started her rehab in late October after surgery to treat breast cancer on her left side. She was having trouble raising her left arm and was worried about lymphadema, the swelling that often afflicts cancer patients whose lymph nodes are damaged during treatment.

After just a few sessions with physical therapist Al Terlaje, "It's like night and day," Konde said. "When my arm and shoulder are tender, I do the exercises and I can tell the difference. It gives me peace of mind, knowing I can keep doing simple things." As she worked with Terlaje, Konde also started walking, and plans to continue her rehab and exercise routines as she begins radiation treatments. The walking gave her more energy, which will help her keep up with her two young sons. Eventually, she hopes to be able to resume going to her gym in Knightdale. "I'm ready to get out of couch potato mode," she said.

Exercise and rehab programs can help patients deal with fatigue that's common among cancer patients, as well as range-of-motion problems, Terlaje said. "All cancer patients tend to improve their quality of life with some sort of exercise program," he added. "We help teach patients about what they can and can't do. It has to come in phases." Typically, Terlaje and other physical therapists want to see patients shift to some type of structured exercise program, either on their own or with a wellness center.

Restoring Confidence

At Rex Wellness Center of Wakefield, a group of breast cancer survivors meet twice a week for the Survivor Fit program. Most classes begin with each survivor writing a note about something bothering them and putting it into a "worry bucket." "You can put your worries on a shelf for an hour, and focus on what your body can do, not what's failing," said Jessica Tucker, the Center's manager who started the Survivor Fit program two years ago.

At the end of the class, participants try to write something positive that they want to remember as they head back into the real world. "Part of the restoration process is learning some stress management," said wellness instructor Ronnie Neal.

During a recent evening session, Angela Jamison, who was diagnosed with breast cancer in October 2008, stretched and warmed up with Wanda Barbour, who was operated on in February of 2007. They encouraged each other, bantered with Neal, and laughed frequently. During one lap walking around the track together, they chatted and caught up on their outside lives. Neal gently pushed the class to do the various routines designed to build strength, improve balance, and restore confidence. He was careful to emphasize that it shouldn't hurt, that they shouldn't do too much.

When Barbour had trouble lifting small weights while balancing on a stability trainer, Neal lent his shoulder for support. "It's really an hour of fun," Barbour said. "When I can't come, I'm miserable. This should be a standard part of recovery. No matter where you are in the process, you can fit into this."

Exercise Tips For Cancer Patients

– A variety of factors can determine the type and amount of exercise that's appropriate, including where a patient is in the treatment process. Consult with your physician about what you should or shouldn't do. Patients with injuries, who have had certain surgical procedures, or who are extremely debilitated, should be evaluated by a physical therapist before starting a regimen.

– Incorporate aerobic exercise such as walking with strength training. Restoring muscle mass is important.

– While exercise can help alleviate fatigue, a physical therapist or trainer can also help a patient determine ways to improve energy conservation.

– Don't rush or overdo it. A patient who has undergone cancer treatment won't be able to jump right back into the same exercise routine or pace as before.

– Get some support. Group exercise programs can help keep people motivated and offer a chance to meet other survivors.

For more information, call Rex's Cancer Rehabililtation program at 919-784-4696 or the Survivor Fit program at Rex Wellness Center of Wakefield at 919-570-1511.