When diagnosed with a blood cancer, people can feel overwhelmed and exhausted both mentally and physically. Unsurprisingly, the idea of exercising while you have blood cancers and the often invasive treatments is the last thing you feel like doing.
However, our research team shows that exercise is exactly what you should be doing to support your physical and mental recovery during and after blood cancer.
As one of the participants in our published studies said:
“I felt so tired that I thought I would never be able to do this, but then I realized that actually doing the exercise was the thing that would get me over the fatigue”†
However, exercising when you’re not feeling well requires guidance and support from professionals to help you manage your symptoms and assess how hard you should push yourself.
Every day in Australia, 50 people are diagnosed with blood cancer such as leukemia, lymphoma, or myeloma. While medical treatments have improved dramatically over the past 30 years, they can be traumatic and cause serious side effects.
Our research team focused on people with blood cancer who are undergoing a bone marrow transplant (also known as a stem cell transplant). This is an intensive treatment that often requires a long hospital recovery period – it temporarily weakens the immune system, putting patients at high risk for side effects such as infection and organ malfunction.
Many of our research participants describe symptoms such as debilitating fatigue, pain and weakness. As one of them told us:
I really get so tired I just want to sleep, and my bones hurt so bad I can’t even exercise. And it is extremely frustrating.
Last Research has shown that some of the symptoms and side effects associated with blood cancer can be improved with exercise. However, it is difficult to know how and when to start exercising.
To better understand when it is safe to exercise and what types of support people may need, we conducted two patient studies. We hypothesized that a group-based approach to exercise during blood cancer treatment may help to improve motivation and participation.
In the first study, we introduced a group-based exercise program – supervised by a physiotherapist and nurse specialist – in the physiotherapy outpatient clinic of a Melbourne hospital. There were 43 participants, each of whom started the program two months after their bone marrow transplant.
The eight-week program proved safe and feasible, and we saw signs of recovery in participants’ physical and mental well-being.
However, the overwhelming feedback was that participants had already lost much of their fitness and strength when they started and wanted to start the structured training program earlier.
In the second study of 42 participants, we began a group-based exercise program once the participants were hospitalized for their transplant and for the duration of their hospitalization, which ranged from two to ten weeks.
Despite people feeling their worst during their hospitalization, this program was well received and showed an improvement in psychological well-being, which we suspect was due to the peer support provided by the group-based approach .
Participants in our programs overwhelmingly reported that they enjoyed exercising in a group.
Getting treatment for a blood cancer can be isolating and mentally draining — and so exercise was one way to bring back some semblance of control or normalcy.
“I think [the exercise program] provides such a good opportunity… to meet and talk to people and see where everyone is and see that you’re actually still a person… It takes it away from the medical stuff and you can just be yourself and practice … that†is really important mentally and physically.” – study participant.
Participants appreciated the importance of the support they received from a physiotherapist to help them be accountable and monitor their symptoms when they feel unwell.
Since each person is different and will respond differently to treatment, an individualized approach to guided exercise is paramount.
“…when I was in the ward†feel awful, you know that [physiotherapy staff] were there to get you out of bed and into your session, and that just helps keep that momentum going…† study participant
“…as long as it is tailored to the person [and] their limitations, because there†s all kinds of ages and health problems and whatever, that†is the most important…” – study participant
Our study finds that physical therapy-led exercise is safe at all times of the treatment journey for blood cancers.
There are also several physical and psychological benefits associated with physical therapy guided exercise, and we now have more knowledge to develop and implement structured training programs in daily clinical care in Australia.
As a supplement to our work, behavioral psychologist Dr Camille Short and professor of physiotherapy Linda Denehy develop models to provide support for exercise, diet and behavioral change to bone marrow transplant patients at home, before and after therapy.
By developing high-quality home programs, they hope to expand access to patients in regional and rural areas.
Currently, however, these programs are not funded in most hospitals and only take place as a result of research. We need support from policymakers and funders to embed evidence-based programs that provide professionally supervised exercise support as part of routine care for blood cancers.
Not only can this improve the patient’s quality of life, it can also reduce hospital costs.
International evidence has shown that supervised exercise can shorten the length of a hospital stay, which in the long run can reduce the burden and costs on the health 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 just a few general tips to get you started:
- Reduce the amount of time you spend sitting or sitting — get up every one to two hours to walk around the house or do some simple arm and leg movements for two to five minutes.
- Start slow and build up gradually.
- Listen to your body; if you’re fatigued, short, gentle bursts of physical activity can help.
- Staying physically active doesn’t have to be boring, think about the activities you enjoy.
- Engage an exercise buddy and share your desire to exercise with others to hold you accountable.
- Seek support from a practice professional if you’re not sure where to start or how to progress. A physiotherapist or exercise physiologist with oncology expertise would be ideal.
As one participant told us:
“…it’s not like we’re doing hard, intense sessions like gym sessions, but just moving your body makes a difference…”.
May 28 is World Blood Cancer Day†
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