Getting Fit after Chemotherapy
Some frequently asked questions.
Is it possible to regain fitness after chemotherapy and/or radiotherapy?
YES. It is certainly possible - always remember - anything is possible when you put your mind to it!
Will it take a long time?
PROBABLY. There will be some exceptions to this but for the majority of people it will take a long time to rebuild their fitness alongside rebuilding their health. For some this could be months, for others, like me it could be a number of years. I know from first hand experience how difficult this can be but try to be patient and kind to yourself. It’s a process that you can only hurry so much as going too fast has the potential to set you back.
Are there things to be cautious about?
YES. The impact of conventional cancer treatment on the body can be devastating. One major consideration during and in the months following conventional treatment is energy availability. In order to recover, repair and rebuild your health, the body needs a large amount of energy. Exercising requires energy too, so you will need to ensure that you are fuelling your body with the necessary calories (whilst being conscious that not all calories are equal) to enable both. It is therefore recommended that you seek advice from a qualified health professional, such as a nutritional therapist who is experienced in this area, as it is crucial that your energy intake is sufficient to meet these additional needs whilst also providing the essential macro and micronutrients to facilitate a return to health.
Should this stop me from exercising?
NO. Please do not be put off exercising*, as there is an ever growing body of research clearly supporting the many benefits of exercise in relation to cancer, such as, reduced cancer recurrence rates, reduced conventional treatment side effects, improved immune health, reduced lean muscle mass loss, better bone health (see previous blog post for more details). It is now even being considered as a ‘targeted medicine’ in relation to cancer given the latest evidence (1) suggesting:
exercise may actually improve a person’s response to conventional cancer treatment.
exercise can kick-start the immune system to help it to eliminate cancer cells.
exercise can slow disease progression.
exercise can improve survival rates.
In combination with exercise, making better food choices is one of the many positive steps that you can make to improve your health. Whether you are interested in understanding more about how to reduce your risk of cancer occurring in the first place or you already have a diagnosis and want to improve your chances of surviving cancer, then we can support you.
If you would also like to understand more about which other diet and lifestyle modifications can significantly reduce your risk of cancer recurrence, support you through your cancer journey, and reduce your risk of recurrence, then register for our 90 Day Cancer Support Programme. Through this programme we help empower you through increased knowledge, how to implement the necessary changes in a sustainable manner. Lifelong changes that will make a huge difference to your overall health and disease risk profile. We aim to:
Improve your knowledge of what to eat & why: Giving you greater confidence and control over your potential outcome.
Support your immune system: To keep you feeling well, improve your potential outcome, and to reduce the risk of cancer recurrence.
Improve your energy levels and mood: Thereby improving your overall sense of wellbeing, and enabling you to put your energy into improving your health.
Optimise your nutritional status: To keep you feeling well, improve your potential outcome, and to reduce your risk of cancer recurrence.
Improve your healing after surgery: Through better nutritional choices.
Support your gut health: To reduce any adverse digestive symptoms and side effects, and to improve nutrient absorption.
Maintain your muscle mass: To keep you physically strong, better able to cope with any treatments offered, and improve your potential outcome.
Minimise treatment side effects: Aiming to mitigate the negative impact of any standard treatment received.
Reduce your risk of cancer recurrence: Through better nutrition and lifestyle choices.
Improve your quality of life: Through holistic support, helping you to thrive long after your cancer diagnosis.
If you don’t have an active or recent cancer diagnosis and are interested in ensuring that you stay this way, then we can help support you . Check out our 90 Day Health and Wellbeing programme for more information, or alternatively, if you have any questions then send us a message and we will get back to you as soon as possible.
2014: Ironman World Championships (Hawaii)
A little bit of my background story
In 2014 I was at the peak of fitness. I was training for and competing in long distance triathlons, which consist of a 2.4 mile swim, a 112 mile cycle, with a 26.2 mile run to finish. So not a particularly easy day out! In July of that year I won my age group at the UK Ironman in Bolton, and as a result I competed at the Ironman World Championships in Hawaii in the October (see pic). And soon after that…
…the wheels completely fell off both my health and my fitness.
First I was struck down with a virus (Epstein-Barr Virus it turned out to be) leading on to chronic fatigue, which ended my exercising almost overnight. Then, after a hazy 18 months of ongoing brain and body fog, and with a rather miraculous pregnancy thrown into the mix, I was diagnosed with invasive breast cancer at 41 weeks pregnant. What should have been one of the hightest points of my life became one of the most challenging times that I have had to negotiate my way through (for more on this please read My Story).
The birth, major surgery and 4 rounds of chemotherapy set my health back even further, but never one to give up, I simply became more determined that I would do everything in my power to regain not only my health but my fitness too.
I knew that it was not going to be easy, but I also knew that not moving/exercising was not an option. I had been so fit, I had felt invincible (which I clearly wasn’t..), and I really struggled with no longer being physically able to do the things that I loved.
So it was around this time, that I set myself the rather ambitious (some may say delusional…) long term goal of running the London Marathon when I'm 100. I was barely able to walk, I’d not been able to exercise properly for 2 years and at this point my outlook seemed rather bleak, yet despite this, I was confident that I’d not only be able to fully regain my health and fitness, but I’d also be living healthily for very long time to come.
“We fall, we break, we fail... But then we rise, we heal, we overcome.”
— Unknown
It’s 9 years on now - have I managed to regain my health & fitness?
It’s 9 years since I became chronically unwell and almost 7 years since my cancer diagnosis, and I’m delighted to say that I’m not just alive and well, but I’m physically and emotionally thriving! Timewise, I am over one tenth of the way towards my goal of being around at 100 years old to run said marathon. Physically, I’m in great shape (see below), but running remains to be my nemesis.
It’s been one crazy rollercoaster of a ride, but slowly and steadily I have become healthier and stronger. Initially, after the birth, operation and chemotherapy I just didn’t have the strength to run, cycle or swim, and I was really conscious that I didn’t want to overdo the exercise and set myself back even further (if that was possible). My immune system was seriously compromised and I suffered with all too frequent colds and viruses that would floor me for weeks at a time. During those periods, I didn’t really ‘exercise’ per se, I simply kept moving as much as I could, short walks with my new baby, gentle stretching, whatever I could manage. The days when I felt better I would walk a bit further, ride my bike occasionally, and go to a yoga class.
Kundalini Yoga
In January 2017, I found a new love after I chanced upon a Kundalini yoga class. This type of yoga is very different to all other types of yoga that I’d practiced previously and I absolutely loved it.. There Is exercise, there Is meditation and there is a lot of chanting! It’s not for everyone, but it was most definitely for me. Each session left me energised rather than leaving me feeling spent, and I threw myself into the practice wholeheartedly. By 2018, I had signed up for the Level 1 KRI teacher training course which was an amazing experience, and I gained so much from the required regular daily yoga practice, and the weekend teachings. I felt myself growing stronger - physically, emotionally and spiritually - throughout the year long course. I am now teaching an in-person class weekly (click here for more details) and will be launching on-line classes shortly.
Swimming
Initially, I struggled with swimming. I lost so much weight after chemotherapy that I just couldn’t stay warm in the pool. Looking back now, I was wasting precious energy in doing this at a time when my body needed all the energy possible to repair and recover from the onslaught I had just endured. Whilst I didn’t fully appreciate the implications at the time, the fact that I was freezing in the pool certainly put me off going.
Another big factor in me staying away from the pool was that I had begun to suffer from a chlorine intolerance which manifested as severe hay-fever type reactions a few hours after swimming in a chlorinated pool that would last for hours. I’ve swam for most of my life and never had this issue, it was totally debilitating and seemed to negate any possible health gains from the actual swim. This reaction started around the time when my health deteriorated and I now understand that this was due to my severely dysregulated immune system at the time. Clearly, the pool wasn’t a great place for me in the early days so I avoided it for a long while.
Nine years on and I can now swim again (yeah! 😊😊) in a chlorinated swimming pool (boo! 👎) - I say this as I would rather that our swimming pools weren’t chlorinated to the extent that they are but that’s a topic for another day. In fact this year I have managed 2 rather epic swims - a 9 kilometre swim in the pool with Manchester Triathlon Club in March 2023, followed by a 8.5 kilometre end to end swim of Lake Coniston in June 2023. I am super pleased with both of these achievements as it shows just how far my health and my immune system has come since 2018 when I was freezing and sneezing in and after a pool swim!
March 2023: 90 * 100meters with MTC
June 2023: 8.5km Coniston swim
May 2022: Tour of Wessex 3-day sportive (335miles)
Cycling
Cycling - it’s low impact, gets me out into the fresh air and I love it! It was also the easiest of my 3 former loves to get back into. In the early days after chemo, in 2017 and 2018, I kept the volume (miles) and intensity (effort) low and I was happy to just get out into the sunshine and head to the local National Trust park for a coffee. It really helped my mental health.
By 2020, I was back cycling much longer distances, up hills and down dales, and in 2021 and 2022 I completed the multi day sportive - The Tour of Wessex - which consisted of 335 miles over 3 days. I did it twice because of Covid as the event entry was rolled forward. I was feeling good again! And while I’m not quite as fast or as strong as I was back in 2014, I’m really not that far off, which given I’m almost 10 years older and I’ve been through the mill, I’m pretty happy with that.
Running
On the flip side, running is high impact with significant force being generated with each foot strike. To minimise the risk of injury you need sufficient muscular strength to support your skeletal structure throughout.
Unfortunately, I lost far too much weight and lean muscle mass after chemo, and so did not have the required muscular strength. I just wasn’t given adequate nutritional information at the time (lesson 1 learnt). I also didn’t incorporate strength training after losing this muscle mass and before starting to increase my running mileage (lesson 2 learnt).
Consequently, over the last 7 years, I’ve been plagued with injury - the worst being a sacral stress fracture that became acute in August 2021, and once diagnosed, I realised that I’d actually been carrying this fracture at a sub-acute level for at least 2 years. I had been to various physios during this time but these types of fractures are apparently notoriously difficult to spot..
As a result, over the last 2 years I have incorporated strength work into my training to ensure that I have sufficient muscular strength where it’s needed (lower & upper legs, glute, back) which will enable me to run consistently again (and hopefully set myself up well for my big London Marathon run when I’m very old and very grey!).
I have however had some high points, such as completing a tough, hilly 15 mile run in North Yorkshire (see pic) in 2022. However, soon afterwards, another low point when I had to defer my 2023 Manchester Marathon place due to yet another injury.
Oct 2022: Endurance Life North Yorkshire Moors Half Marathon (15 miles) - Never Give Up!
Yet I remain hopeful… 2024 will be my marathon comeback year! (2024 update - it was 😊)
And summing up…
I think I can proudly say that I have managed to regain both my health and my fitness. I might not be able to run a marathon (yet) but I’m healthy and strong and I’m able to take part in all the activities that I love, at a level not too far from where I was 10 years ago (well except for running..). That is a huge achievement given how far I fell!
Now let me help you.
If you or a loved one have been affected by cancer (or other chronic illness) and would like support in rebuilding your health then I would love to help. Take a look at my 90 day programme for more information as to how I can support you, alternatively if you have any questions then you can contact me directly here. I know from personal experience just how difficult this time can be, and I would greatly like to support you, helping you to avoid some of the pitfalls that I encountered, whilst empowering you to take a more active role in your health, your recovery, and your return to health and fitness.
If you would like to read more about my personal experience with breast cancer and my journey back to great health then please click on the following links for more in depth information.
You can also join my Facebook group - Thriving after Cancer and follow me on Facebook or Instagram.
Notes
*Always check with your doctor before starting any new training regime. If you are currently in the midst of cancer treatment then extra care must be taken when considering the appropriate level of exercise for you. Please seek advice from an appropriately qualified health professional experienced in exercising through cancer treatment.
References
(1) Turner, KA (2020). Radical Hope - 10 Key Healing Factors from Exceptional Survivors of Cancer & Other Diseases. UK. Hay House UK Ltd.