Chemotherapy and exercise. My story.
How did I carry on exercising through chemo? And why.
When my oncologist told me he wanted me to carry on doing sport through chemo, I nearly fell off my chair.
Luckily - serendipitously - my cancer doctor is also passionate about mountain sports so he understood what makes me tick and how important it is to me. My life, my home, my mental health, my identity, my social life are all inter-twined with sport. We immediately followed each other on Strava and spent most of our consultations talking about our favourite running routes.
I was fully expecting to be confined to my bed with my head in a sick bucket for months on end. And I was - but only for a few days at a time. So it came as a total surprise to hear that I would still be able to do the things I love. And that not only that, it would be one of the best things I could do for myself. Why?
As Dr Prue Cormie, cancer exercise researcher, says “If we could turn the benefits of exercise into a pill, it would be demanded by patients, prescribed by every cancer specialist and subsidised by government. It would be seen as a major breakthrough in cancer treatment. The level of evidence is really indesputable and withholding exercise from cancer patients is probably harmful.”
Exercise - movement in general - helps chemo work better. It helps reduce fatigue (I know I know, this is counter intuitive). It helps maintain muscle mass, which most cancer patients lose during treatment. It helps maintain a healthy bodyweight. It helps with confidence, self esteem and low mood, which is essential at a time when it’s hard to recognise who you see in the mirror and life is scary and uncertain. It also reduces chemo side effects and recovery time.
By day 5 or 6 after FEC chemo, I felt well enough to spin on the turbo trainer
So, what did exercise during chemo look like for me? Bear in mind I started at a high fitness level, so this is not intended as a comparison or prescription. The most important thing is to do something you enjoy. And don’t expect to make progress during treatment; it’s probable that your fitness will go backwards. And that’s normal!
First off, I promised myself that I would move every day. The cancer community is incredible and an ultra runner friend of a friend took time out to talk me through what to expect. Her goal had been to run / walk / crawl 5km every day. Mine was just to move in some way and get outside every day.
So I did. I designed a chemo loop around my house, which was about 1km. On day 1 after chemo, I would walk 1 loop. On day 2, I would walk 2 loops. On day 3, 3 loops (not always in one go). I was slow, I sometimes felt dizzy and sick, I was often in my pyjamas. It was hard. I needed breaks and always took a friend with me, just in case I felt weird. But it gave me purpose and made me feel like I was doing something positive and normal.
By day 4 after each round of FEC, I could do a little more. A steady walk. A little stretch or pilates. I never pushed it in the first few days. I couldn’t. But by day 7, I would feel ‘nearly normal’ and could manage a little indoor bike ride or a short session at the climbing wall.
My lovely friends slowed down their pace to ride with me.
On one occasion, however, I pushed it too hard, thinking I was fine, and went for a slightly too fast jog on day 8. I spent that whole night awake and panicky, with a racing heart, feeling like I’d run 100km. It scared me - it didn’t feel good and I was scared I done myself some damage as many chemotherapy drugs have cardio-toxic effects. So after consulting with my cardiologist and oncologist, we agreed a modest maximum heart rate. I bought a new smart watch stuck to it like glue.
The third week after hard core chemo feels like a gift. I would be more or less like myself - albeit bald and tired. I could do slightly longer runs - trots! - and would try and focus on strength work in this week. It’s not the case for everyone, but I lost a little weight each round so this was the week I would focus on muscle building and eating lots.
I also got really into climbing. I loved the meditative side of moving my body slowly, with complete concentration, but without stressing my muscles or heart. I actually climbed better during chemo than I do now. It felt great to be seeing progress in something when my fitness levels in other sports had fallen off a cliff.
Some days I was too tired, so I learned to listen - and actually pay attention - to my body. I would just go for a little walk. Or potter outside and do some gardening. After my second round, I caught a cold, which lasted 6 weeks and turned into pneumonia. But I still managed to move a little every day. Maybe that was ill advised but I needed the normality.
Climbing through chemo kept me sane
I honestly think exercise saved me during chemo. It gave me focus, purpose and something that made me feel like myself. I am 100% convinced it’s the reason I ‘got away’ with minimal side effects. And the reason I bounced back as quickly as I did.
My second chemo protocol was delivered weekly. It’s called taxol. And honestly, it was like a holiday compared to FEC. I would have 24 hours of feeling rubbish and ‘drugged’ - I think mainly due to the antihistamines that go with the chemo. But then I would feel pretty good. My hair even started to grow back. Funny little, white stubble.
I was able to up my game a bit during this treatment. Once I’d been cleared by the cardiologist, I felt confident to run a little longer and a little faster. Nothing crazy, but I managed to get out on the bike for longer rides too, where previously I’d been too anxious to be far from safety in case I felt funny. It felt soooooo good to head up into the mountains for hikes, and tackle a few hills on the bike with my friends.
The feel-good on Taxol lasted until week 10 (out of 12). Then my white blood cell count plummeted and I ran out of energy. I was back to tiny, little walks and lots of rest. It was all I could do to look after the kids and keep my head above water. I’m sad I didn’t quite manage to hit my move every day goal. I had about two weeks when I just couldn’t do it.
I’m still really proud of myself. I look back on my 6 months of chemo and I don’t know how I got through it. But I can honestly say, moving was the thing that helped me the most.
I also believe that doing so much exercise during Taxol helped prevent me getting peripheral neuropathy - a very common, and often irreversible - side effect.
When I was diagnosed with cancer, I set myself two challenges. The first was to ride 100km within 6 months of my mastectomy. The second was to climb 7a. I made this challenge right at the beginning and didn’t know at that point that I would need chemo.
My lovely oncologist joined my “Boobless 100” to celebrate the end of chemo
But I still wanted to give it a try. So just 3 weeks after finishing my treatment, I organised a group ride called ‘The boobless 100’. It was 100km, taking in 3 of the French Alps most famous cycling cols. Even my oncologist came along ! It was a day I’ll never forget.
I have no idea how my body let me do it.
Still working on the 7a though … :)