NEW YORKSipping smoothies, exercising, and keeping a journal are
among the things cancer patients can do to combat fatigue and build energy,
according to Eileen Donovan, PT, MEd, manager of rehabilitation services at The
University of Texas M. D.
Anderson Cancer Center, and Marilyn Joyce, RD, a Los Angeles-based nutritionist
and author. Both women spoke at a Cancer Care teleconference about the role of
exercise and nutrition in coping with fatigue.
Even relatively short periods of bed rest can cause changes in a person’s
physical conditioning and a decline in energy, they noted. Whether starting a
formal exercise program or just increasing activity, a patient should always
seek a physician’s advice, she said. If there is bone disease, certain
activities should be avoided, or if someone is unable to perform the basic
activities of daily living, a referral to a physical or occupational therapist
may be necessary.
Appropriate Exercise Goals
What kind of exercise is needed and how much? "What is appropriate for
someone who is still working, even though they may feel quite fatigued, is very
different from what is appropriate for someone who gets tired just walking to
the bathroom," Ms. Donovan said.
The question turns on whether the exercise is meant to increase strength,
endurance, and stamina or to increase the strength of a specific muscle group.
Ms. Donovan said that many patients who complain about feeling weak often
have normal muscle power, and their problem seems to be endurance. Others may
have a specific muscle weakness. A physical therapist, occupational therapist,
or physical medicine physician can help sort out the reasons and recommend
exercises, equipment, or other strategies.
Many patients first realize they are losing strength when they have trouble
getting up from a low chair or from the toilet, Ms. Donovan said. If the
problem is related to the leg muscles, one strategy, she suggests, is to find a
chair the patient can get up from without much difficulty and have him or her
practice getting up from it several times a day. "After a week, I may ask
them to find a chair that is just an inch or so lower and to practice getting
up from that chair several times a day," she said.