During her treatments for breast cancer, Colleen tried to stay as active as possible by going to yoga and exercise classes specifically geared to people living with cancer. Some days it was difficult getting out of bed, but she always felt better after some exercise.
“I just don’t have the time or energy to exercise…” This phrase is familiar to most health care providers who discuss exercise with their patients. This is not a bad excuse, particularly in the oncology setting where an estimated 20-50% of patients experience post-treatment cancer-related fatigue (1). Why is exercise so important, and how can we overcome time and energy obstacles to include physical activity in our life?
Exercise and energy
The irony of not having the energy to exercise is that exercise is possibly the best thing you can do for energy levels! The evidence for exercise on energy is consistent and impressive. Aerobic exercise decreases cancer-related fatigue during and after treatment (2), improves quality of life in people with cancer and improves physical functioning (3). In fact, these large studies recommend that exercise should be an adjunct treatment in cancer care.
Exercise improves energy in many different ways. Exercise increases the number of mitochondria in our cells (4). Mitochondria are what produce energy for our body in the form of ATP. In this way, exercise actually enhances the ability for our body to produce energy! Exercise improves sleep, particularly in people with cancer (5), which in turn improves energy. Exercise releases endorphins which gives us an immediate hit of feel-good energy. Lastly, exercise decreases inflammation in the body which is one of main causes of fatigue, particularly in people with cancer (6).
Given all the important reasons to exercise, why is exercise such a tough pill to swallow? Probably because it is not a pill - it requires effort and planning.
Making the time
Time for some more irony: no one has time to exercise, and yet exercise makes you more efficient and productive! Exercise will give you the energy to get more accomplished during the day, and enhances cognitive function to allow you to finish your work faster. Aerobic exercise improves executive functioning in healthy adults, including task switching, selective attention and working memory (7). Therefore, by incorporating exercise into your daily life you will be more efficient at work and at home, giving you more time for the things that bring you enjoyment in life.
There are 1080 minutes in a week; we are asking you to find 150 minutes to devote to your physical, mental and emotional wellbeing.
There are only 24 hours in a day, which for most of us doesn’t seem like enough. We all make choices every day as to what we make time for, and what we don’t. Try changing your language from “I don’t have the time”, to “this is not a priority for me” and see if that changes your perspective. We all have the same amount of time in a day, it is how we choose to use that time that differs. We make time in our lives for the things that are important to us, and whether consciously or not we make choices every day about how to spend our precious 24 hours. Most Canadians find time for TV, Facebook, surfing the web and hitting the snooze button. It’s not really about time, it’s about priorities.
- Get to bed! The average Canadian does not sleep enough, and while this is multifactorial, the TV, iPADs and internet are not helping the problem. If you have difficulty sleeping check out this blog on improving your sleep.
- Start small. How do you break the cycle of being too tired to exercise, while knowing it will help? Start small. Maybe for you that’s a 5 minute walk every day, and next week it is a 10 minute walk. If you are new to exercise, and are experiencing fatigue maybe don’t try a Body Attack class as your foray into physical fitness!
- Some is good, more is better. Don’t fall in to the cognitive trap of convincing yourself that 15 or 30 minutes isn’t worth it. 15 minutes IS worth it! If your meeting runs late and now you only have 20 minutes, use that 20 minutes! It all adds up and makes a big difference for your health.
- Schedule your workouts. Plan your exercise for the week including what time of day you will exercise, what type of exercise, where, who will be watching the kids etc. This ensures you have the time set aside for exercise, and keeps you accountable.
- Prepare for workouts ahead of time by laying out your workout clothes or packing your gym bag the night before. When you wake up and see it there, it is harder to ignore.
- Fit exercise in to things you already do – for example, you can try run, walk or bike commuting to work, running on a treadmill during your favorite TV show, running or doing strength training at the playground with your kids or while your kids are at sport or music lessons. Where can you find “extra time” in your week, or where can you multitask your workout?
- Include the family. No need to sacrifice family-time to exercise. Children of active parents are more likely to be active adults. Unfortunately, only 13% of Canadian children over 5 meet their daily recommendation of 60 minutes per day of activity (8). Make family time active time! Playgrounds make great gyms, and the woods are better than any treadmill.
- Take advantage of morning motivation. Motivation is highest in the morning, and most experts in time management and efficiency agree that you should tackle your biggest task first thing in the morning. If exercise is a struggle for you, you might try this tactic of tackling it first thing! Not a morning person? Get your workout in before heading home from work. For many people, once you get home at night it is hard to leave again.
- Partner up. Find a workout buddy to keep you accountable. Knowing someone is expecting you can provide the external motivation if internal motivation is lacking. Exercising with a friend can also make it fun and social.
- Join group fitness classes. The OICC has a weekly yoga class on Fridays at 12:30 pm. Sign up by calling the OICC, and come join us for exercise!
- Set goals. SMART goals are specific, measurable/meaningful, attainable, result-focused and timely. If you don’t have a goal, it’s hard to achieve it.
- What is important to you, what are your goals and priorities? Compare these to how you spend your day - do they align? Are you prioritizing your day to achieve your goals and achieve what is important to you? If health is important to you, exercise needs to be a part of your daily life!
If fatigue is a major problem for you, one of our naturopathic doctors can help provide support to get you back on track.
Dr. Ellen McDonell, ND, began running as a way to stay fit after she stopped competitive swimming in her late teens. What started as a way to exercise, soon became a great source of enjoyment and fulfillment. Ellen also enjoys swimming and cycling, which provides great variation in her workouts. Ellen has competed in races ranging from 5k-half marathon, and has completed several triathlons both as an individual and as a relay team. Exercise and running in particular have become a way to get away from everyday stressors, spend time in nature, and have time in solitude, or with friends.
Dr. Julie Ennis, PhD, has been running since she can remember- but the real passion started when running became a way of managing the stressful years of her PhD degree. She found that lacing up her runners and getting outside was a great way to clear her head so she could tackle the work in the lab. Over the past few years, Julie has participated in many running events of different distances. Her favourite running moment has been completing the Boston Marathon in 2015 with her father, Bruce Mason.
This article was originally published by the Ottawa Integrative Cancer Centre, April 2016.
1 Corbett et al. 2015. Protocol for systematic review of psychological interventions for cancer-related fatigue in post-treatment cancer survivors. Systematic Review. 4:174.
2 Tian, Lu, Lin, Hu. 2015. Effects of aerobic exercise on cancer-related fatigue: a meta-analysis of randomized controlled trials. Supportive Care in Cancer.
3 Gerritsen & Vincent. 2015. Exercise improves quality of life in patients with cancer: a systematic review and meta-analysis of randomized controlled trials. British Journal of Sports Medicine.
4 Ding et al. 2013. Role of mitochondrial quality control in exercise-induced health adaptation. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 29(6):543-53
5 Chiu et al. 2015. Walking improves sleep in individuals with cancer: a meta-analysis of randomized controlled trials. Oncology Nursing Forum. 42(2), 54-62.
6 Hammonds et al. 2016. Effects of exercise on c-reactive protein in healthy patients and in patients with heart disease: A meta-analysis. Heart and Lung.
7 Guiney & Machado. 2013. Benefits of regular aerobic exercise for executive functioning in healthy populations. Psychonomic Bulletin and Review.20(1), 73-86.
8 Borkhoff et al. 2015. Objectively measured physical activity of young Canadian children using accelerometry. Applied Physiology Nutrition and Metabolism. 40(12):1302-8.