Being diagnosed with blood cancer can leave people feeling overwhelmed and mentally and physically drained. Unsurprisingly, the thought of exercising while enduring blood cancer and the often invasive treatments may be the last thing you want to do.
However, our research team demonstrates that exercise is exactly what you should be doing to support your physical and mental recovery during and after blood cancer.
As one participant in our published studies put it:
“I felt so tired that I thought there was no way to do all of this, but then I realized that exercising was the thing that was going to get me over the fatigue”.
However, exercising when you feel unwell requires professional guidance and support to help you manage your symptoms and judge how difficult it is to push yourself.
Every day in Australia, 50 people are diagnosed with blood cancers such as leukaemia, lymphoma or myeloma. Although medical treatments have improved dramatically over the past 30 years, they can be traumatic and have the potential to cause serious side effects.
Our research team focused on people with blood cancer who undergo bone marrow transplantation (also called stem cell transplantation). It is an intensive treatment that often requires an extended recovery period in hospital – it temporarily weakens the immune system, leaving patients at high risk of side effects such as infection and dysfunction of the organs.
Many of our research participants describe symptoms such as debilitating fatigue, pain and weakness. As one of them told us:
I’m really so tired all I want to do is sleep, and my bones hurt so much I can’t even exercise. And it’s extremely frustrating.
Previous research has shown that some of the symptoms and side effects associated with blood cancers can be improved by exercise. However, it is difficult to know how and when to start exercising.
To better understand when it is safe to exercise and what kinds of support people may need, we conducted two patient studies. We hypothesized that a group approach to exercise during treatment for blood cancers might help improve motivation and participation.
In the first study, we introduced a group exercise program – supervised by a physiotherapist and a specialist nurse – in the outpatient physiotherapy gymnasium of a Melbourne hospital. There were 43 participants, each starting the program two months after their bone marrow transplant.
The eight-week program was found to be safe and feasible, and we saw signs of recovery in physical and mental well-being among participants.
However, the overwhelming feedback was that the participants had already lost much of their fitness and strength by the time they started and wanted to start the structured exercise program sooner.
In the second study of 42 participants, we started a group exercise program as soon as the participants were admitted to the hospital for their transplant and for the duration of their admission, which varied from two to 10 weeks.
Although people feel worse on admission to hospital, this program has been very well received and has demonstrated improved psychological well-being, which we suspect is due to the peer support provided. through the group approach.
Participants in our programs overwhelmingly reported enjoying exercising in a group.
Receiving treatment for blood cancer can be isolating and mentally draining – and so exercise was a way to bring back some semblance of control or normalcy.
“I think [the exercise program] provides such a great opportunity… to meet people and talk to people and see where everyone is at and see that you’re still a person… It takes you away from the medical stuff and you can just be yourself and do exercise…that‘is really important mentally and physically. – study participant.
Participants appreciated the importance of the support they received from a physiotherapist to help them take responsibility and monitor their symptoms when they were not feeling well.
Since each person is different and will respond to treatment differently, an individualized approach to supervised exercise is paramount.
“… when I was in the service…feeling bad, you know that [physiotherapy staff] were there to get you out of bed and into your session, and it just helps you keep that momentum going…” – study participant
“…as long as it suits the person [and] their limits, because there are‘s all kinds of ages and health issues and no matter, who‘this is the main…” – study participant
Our research establishes that physiotherapy-guided exercise is safe at any point in the blood cancer treatment journey.
There are also various physical and psychological benefits associated with physiotherapy-guided exercise, and we now have increased knowledge to develop and implement structured exercise programs into routine clinical care in Australia.
Complementing our work, behavioral psychologist Dr. Camille Short and physiotherapy professor Linda Denehy are developing models to provide exercise supervision, diet and behavior change support to bone marrow transplant patients at home, before and after treatment.
By developing high-quality home-based programs, they hope to expand access to include patients in regional and rural areas.
However, currently these programs are unfunded in most hospitals and only occur as a result of research. We need the support of policy makers and funders to integrate evidence-based programs that provide professionally guided exercise support as part of routine care for blood cancers.
It can not only improve patients’ quality of life, but also reduce hospital costs.
International evidence has shown that supervised exercise can reduce the length of a hospital stay, potentially reducing the long-term burden and cost to the healthcare system.
So if you, or someone you know, is undergoing treatment for blood cancer – no matter where you are in your treatment journey – here are some general tips to get you started:
- Reduce the amount of time you spend sitting or sedentary – get up every one to two hours to walk around the house or perform a few simple arm and leg movements for two to five minutes.
- Start slow and build gradually.
- Listen to your body; when you are tired, short, gentle bouts of physical activity can help.
- Staying physically active doesn’t have to be boring, consider the activities you enjoy.
- Hire an exercise buddy and share your desire to exercise with others to hold you accountable.
- Seek help from an exercise professional if you’re not sure where to start or how to progress. A physiotherapist or exercise physiologist with expertise in oncology would be ideal.
As one participant told us:
“…it’s not like we’re doing intense gym sessions, but just moving your body makes a difference…”.
May 28 is World Blood Cancer Day.
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