Special Considerations for Cancer Survivors

this page is under construction and may contain some errors. BJ 01/08/11

Fatigue

The most commonly reported side effect of cancer treatment is fatigue.
 
Some considerations
  • Plan a progressive programme and try to stick to it, this means that youshould try to avoid overdoing it at times when you feel at your best.
  • Make a list of chores that you need doing, prioritise them and then ask friends and family to help you out. This will prevent you from becoming unnecessarily tired and from being unable to complete your exercise programme.
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Pain

Nausea

On their own, or in combination, chemotherapy and radiation can cause nausea and/or sickness which is why it is important for survivors to take anti-nausea medication if it is prescribed. If this medication is not working then it is important to let the healthcare team know so they might make adjustments to the dose or prescription. Some other tips that might work are as follows:
  • Hot foods can have stronger odours, so eating cold or room temperature foods can sometimes help.
  • Drink lots of fluids and try a range of flavours as some may be more palatable than others.
  • Avoid fatty, spicy, fried or excessively sweet foods as these may increase the feeling of nausea.
  • Bland foods such as crackers, rice and pasta may help.
  • Keeping the mouth clean by brushing twice a day and rinsing the mouth with salt water can help.

Mouth Sores

Many of treatments used in chemotherpay and immunotherapy are unable to target only the Cancer cells and target a broad range of rapidly dividing cells in the body. This can result in the hair follicles and lining of the mouth and stomach from being damaged leaving the digestive tract red and painful. Some tips for managing this side effect are as follows:
  • Gently brush the gums, tongue and top of the mouth.
  • Keep the lips coated with a water-based lip moisturiser.
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Lymphedema

Lymph nodes are important in the proper functioning of the immune system and are found all over the body. They act as filters or traps for foreign particles and are packed full of white blood cells. Lymphedema is caused by a blockage of the lymph nodes and is a swelling that is usually found in the armpit or groin area.
  • It's a good idea to monitor any changes by measuring the extremity in question regularly.
  • Any swollen extremity can be elevated at least 20 minutes, 3 to 4 times a day.
  • Exercise, self-massage and gentle stretching can move the fluid toward the body.
  • Unaccustomed heavy lifting should be avoided although with careful exercise programming on a cautious timescale, lifting weights can still be possible.
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  • Click here or here for more on lymphedema and exercise.

Peripheral Neuropathy

This is a loss of sensation that usually occurs in the fingers, hands, toes and feet and can make tasks such as dressing, eating and walking difficult.
 

Radiation Dermititis

Radiation therapy can result in skin irritation, itchiness, redness and peeling. If an exerciser has patches of dermititis then activity can result in sweat aggravating these areas. It may be beneficial to take steps to avoid sweating excessively such as exercising outdoors or in shorter bouts, or to cover the area with a gauze.

Constipation

Whilst some medications can cause constipation, it can be a result of reduced activity levels, dietary changes or decreased fluid intake. Some ideas for avoiding constipation are below:
  • Eat foods that are high in fibre, and lots of fruit and vegetables.
  • Try to develop a daily routine so there is a regular time for bowel movements.
  • Drink plenty of fluids

Diarrhoea

Radiation therapy to the bowel area or certain forms of chemotherapy can cause diarrhoea. There are some actions one can take to reduce the incidence of diarrhoea below:
  • Avoid eating foods high in fibre, fatty foods, rich desserts, or other foods that increase boewl activity.
  • If diarrhoea occurs after meals, plan activities accordingly.
  • Increase the intake of fluids.

Infection

chemotherapy and immunotherapy can cause low blood counts and immunosupression. At times where the blood count is low it may be sensible to ensure high levels of personal hygiene are maintained and that large group situations, or classes, are avoided.

Mode of activity

  • As a result of disease, some patients may have weakness to their bones. Those with disease to the pelvis or lower legs should avoid high-impact exercise and may benefit from seated exercise such as cycling or chair exercises. Exercising in the water may also be an option for these individuals.
  • Water-based activities will be suitable for some and not for others. Those with intravenous catheters, nephrostomy tubes, and urinary bladder catheters may not be able to use a pool but those with indwelling central venous catheters, continent urinary devices, or colostomies may be able to. (Ehrman, 2009)

Additional considerations

  • An exercise buddy system that pairs up a novice survivor/exerciser with a more experienced partner can provide support and improve initial adherence to any programme.
  • Identifying barriers to exercise and jointly devising some strategies to overcome these barriers can be an efficient use of time at the start of any exercise programme.
References & Further Reading
Ehrman, J., Gordon, P., Visich, P.S., Keteyianby, S. (2009) Clinical Exercise Physiology (2nd Ed). Champaign IL: Human Kinetics [google books]

Schwartz, A.J. (2005) Cancer Fitness: Exercise Programmes for patients and survivors. New York, NY: Fireside [amazon][amazon preview]