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Fatigue fighter
Cancer patients encouraged to exercise in order to maintain muscle mass, stamina

By CATHY BREITENBUCHER

 

Kevin Crowley combated fatigue from cancer treatment by continuing to ride his bike.


A three-sport athlete in high school, Kevin Crowley, 25, was eager to stay active during cancer treatments that lasted nearly all of 2010.

Thanks to physical therapy and miles of indoor cycling workouts on a trainer, Crowley is back at work and wrapping up graduate school at UW-Milwaukee. He’s also hoping to hit the roads and resume a 50-miles-per-week biking regimen.

Crowley was diagnosed with sarcoma, a cancer of the cells that form muscle and connective tissue, in his left leg. He underwent chemotherapy, surgery to replace his femur and hip, more chemo and then radiation.

"By being active during chemo, the fatigue wasn’t so bad," says Crowley, an accounting student who lives in Brookfield. "The last few rounds of chemo, when I could get on the bike again, it definitely, definitely helped."

Experts say therapy and exercise can restore range of motion and build muscle mass — important components of both daily activities and fitness.

According to Crowley’s physical therapist, Chris Walczak of Froedtert & Medical College of Wisconsin Cancer Center, aerobic exercise is documented to reduce cancer-related fatigue.

Besides, she adds, "It gives them some control over their disease. They’re actively doing something to make themselves feel better."

Fitness organizations and health clubs are offering specialized workouts, too. The YMCA and the Lance Armstrong Foundation co-sponsor "LiveStrong at the Y," a 12-week program held locally at the Tri-County branch in Menomonee Falls and the Feith Ozaukee branch in Port Washington.

The focus is on small classes and individualized plans for patients, some of whom may still be involved in their hospital-based PT. Workouts can include zumba, pilates, yoga, weights or cardiovascular training.

"People get familiar with the machines and how to do different routines," explains Stephanie Navarro, area director of healthy lifestyles for the YMCA of Metro Milwaukee. "If they haven’t been exercisers, it’s getting them to make it part of their lifestyle routine."

As for Crowley, he sees cycling, swimming and softball in his future, and he encourages other cancer patients to pursue exercise.

"Try to be as active as possible," he says. "Sitting around isn’t the best way to pass the time — it can just drag on."

Here are some exercise programs geared to cancer patients. Some have specific start dates, while others are ongoing. Be sure to ask if a referral from your physician or physical therapist is needed.

• Yoga, 4-5 p.m., Thursdays, Waukesha Memorial Hospital Professional Office Building, Suite 305, 725 American Ave., Waukesha. Free. Call Collette LaFrancis, (262) 928-7221.

• Look Good Feel Better, 1-3 p.m., April 18, Oconomowoc Memorial Hospital; May 16, PHCMA Menomonee Falls; and June 20, Waukesha Memorial Hospital. These single-session classes are designed to help women who are undergoing cancer treatment develop skills to improve their appearance and self-image. Free (registration required). Call American Cancer Society, (800) 227-2345.

• Breath, Body & Stretch, 6-7:30 p.m., Tuesdays starting April 19, The Pavlic Center at Wheaton Franciscan Healthcare-Elmbrook Memorial, 19333 W. North Ave., Brookfield. Six-week sessions include activities designed to calm the mind and lengthen the body. $65 (registration required). Call (262) 785-2254.

• Graceful Yoga, 7-8 p.m., April 28, Westwood Health and Fitness, 2900 Golf Road, Pewaukee. Free (registration required). Go to www.westwoodfitness.org or call (262) 650-8000.

• Movin’ and Groovin’ After Cancer Treatment begins in September, Women’s Pavilion of Aurora West Allis Medical Center, 8901 W. Lincoln Ave., West Allis. Eight-week sessions will cover goal-setting, body mechanics and more. $45 (registration required). Call (414) 328-6640.

Myth Busters

Treating cancer is far different from a generation ago. To separate fact from fiction, M writer Cathy Breitenbucher turned to two local experts — Dr. Peter H. Johnson, medical oncologist and medical director at ProHealth Care Regional Cancer Center; and Dr. Craig Schulz, radiation oncologist and medical director of oncology services at Columbia St. Mary’s Cancer Center.

M: Is high-dose chemotherapy the best treatment?

Johnson: It depends on the specific type of cancer, even the specific sub-type of cancer, and the patient’s other medical conditions. Post-operative therapy for Stage 3 colon cancer or Stage 2 or Stage 3 breast cancer may often involve taking pills or undergoing intravenous therapy. By most traditional definitions, this would not be considered quote-unquote high-dose therapy.

Schulz: There is certainly data that would support what we call dose-dense (treatment) — meaning (chemo) doses given rapidly, together or close together. They have a survival benefit in patients with breast cancer. There are also high-dose treatments with chemotherapy for lymphomas, leukemias and myelomas (for patients) in preparation for transplants.
 

M: Does a standard protocol based on chemo and radiation show better results than 30 or 40 years ago?

Johnson: Yes. The systemic therapy is not all chemo these days. Some of it is classic cytotoxic chemo that we may have been using for the last 30 years or more; some of those drugs are still quite useful. And yet, the broader term of system therapy encompasses not just those agents but other drugs (such as) oral therapy that may have few if any side effects.

Schulz: Radiation is very different than 30 to 40 years ago, at least in terms of how we deliver it — how we can better analyze how the radiation dose is distributed to the tumor target area. Clearly, by having better drugs and better ability to deliver targeted therapy with radiation, in many cancers results have been very favorable.
 

M: Is there an accepted number of years for a patient in remission to be considered safe from recurrence?

Johnson: As long as you are living, your odds of a recurrence never go to zero but they approach that line over time.

Schulz: That "c" word — cured — always is a hard one to cough up. We tell our head and neck cancer patients, if they make it beyond that two years after the completion of therapy, they have a very good chance of being long-term survivors. Breast cancer, five years; prostate, seven to 10; and lung cancer, after three years they certainly may be long-term survivors.
 

M: Are alternative treatments found outside the United States a realistic option to help a patient go into remission?

Johnson: The term ‘alternative therapy’ has a lot of meanings. It may mean something like herbal therapy taken orally, acupuncture or reiki. Being a U.S.-trained oncologist, we tend to employ medications and techniques we are familiar and comfortable with, and which have undergone pretty intense scrutiny by the FDA and other organizations.

Schulz: Certainly, there are some alternative treatments that are offered elsewhere or are in an experimental form right now, that are reasonable. There are some chemotherapy drugs that are approved for some disease sites overseas and are not approved here. It is a realistic option in some circumstances.
 

M: Any other myths about cancer treatment out there?

Johnson: We do bump up frequently into perceptions that the chemotherapy today is no better than or different than what was given 30 or 40 years ago where patients, as a matter of routine, were violently ill with nausea and vomiting, had profound weight loss, fatigue, hair loss, etc., and many of those instances required extensive and intensive hospitalizations for weeks on end. Fortunately, nowadays that’s the rare exception and not the rule.

There is also the notion that cancer is driven by sugar, and if you can just cut out all the sugar in your diet you’ll cure your cancer. Unfortunately, that’s not true. It would be great if it were.

Schulz: The same goes with the bad effects of radiation. We have ways of pinpointing radiation beams or sculpting radiation treatments very precisely to treat what we want to treat and minimize the doses to the surrounding tissue, therefore keeping side effects very manageable. The other big myth is that cancer patients are contagious. I hear it all the time.