Exercise Oncology with Dr. Scott Adams

Here’s the deal, 75% of Adolescents and Adolescents & Young Adults (AYAs) will experience a chronic disease by the time they are 40 years old and about 50% of all long term survivors will experience moderate to severely diminished health. So, while it’s never too late to start exercising, the sooner the better.

As AYAs, we often report challenges with fatigue, poor body image and poor mental health. All of which can be improved with exercise, while reducing your chances of further chronic illness and complications. We know that exercise is becoming a common recommendation for those going through treatment and post treatment but the big mystery questions for me have always been, ‘how much and what type?’

The metrics to determine how much of a workout will make a difference is defined by what’s called Metabolic Equivalent of Task or METs. One MET represents how much energy it takes to just live. METs used for any given activity will be different based on the person doing the activity. As an example, going for a 3km walk might use 2 METs for someone who is used to walking that much, but might use 4 METs for someone who is NOT used to walking that much.

Dr. Scott also talked about what type of exercise people should be doing. The three types of exercise he spoke of were Aerobic, Resistance and Stretching/Yoga. Aerobic exercise is considered ‘living long’ exercise, while resistance and stretching/yoga are considered ‘living well’ exercises. I personally had a lightbulb moment when he mentioned this. I’ve always been partial to aerobic exercise. The elliptical, rollerblading, spinning, eons ago – step classes. But only over the last 5 years have I picked up weights and started purposefully stretching. While my stamina may have been great before I got sick, my muscles and joints were never able to keep up with the level of activity I wanted to be able to do…until I started stretching.

So, what is the recommended dosage of METs to make a difference?

• Low dose 1-2 MET/week
• Minimal dose 3-9 MET/week
• Optimal dose 10-27 MET/week

Here’s the kicker, the greatest positive impact in terms of going from a cancer friendly environment and an anti-cancer environment happens in the low to moderate aerobic category. Meaning, any activity is better than no activity. However, the improvement is not as dramatic overall as going from a cancer friendly environment to an anti-cancer environment in the high aerobic activity category. According to Dr. Scott’s research, the greatest impact is achieved doing vigorous activity in the 15-18 hrs of MET per week range, representing a 40% risk reduction.

I realize as a cancer survivor 15-18 hours per week of vigorous activity might seem intimidating but the idea is not to go from NO physical activity to 18 hours per week on week one. The idea IS to set small manageable goals and work your way to improved stamina. Also, while MET usage is better expended doing things you enjoy, there is a Compendium of Physical Activity which outlines any activity from cleaning your house to hiking to playing tennis. METs could literally consist of getting off the bus a couple stops early and walking the rest of the way to work. Also, to expend 1 MET doesn’t have to take long. Continuous moderate training (depending what you’re doing) can be equivalent to interval training (depending on what you’re doing). At the end of the day, the doctors recommendation was this – Make it fun, make it purposeful and set specific, achievable and measurable goals. All important recommendations in their own right one of the keys to remaining motivated with be in setting achievable goals. Try going for a walk and tracking how far you can walk, how long it takes you and figure out a baseline. This makes it a measurable activity. Then decide whether there is an opportunity to do the same distance faster, or to walk further for a longer period of time. Maybe by half kilometer or five minute intervals.

As a final note, if motivation is your challenge, as mine has been in the past, there are options out there to help get you started. Apart from the resources outlined in, You Want Me To Do WHAT During Treatment?, is another resource called Active Match which is an online service for women diagnosed with cancer, who can register and find themselves an exercise partner in their area. Click here for the website.

My sincere hope for you is that you can find it within yourself to just start. If all else fails, try not to think much about it, just do it.

Until next time, be well and you’ve got this.