Undergoing Chemo? Get Moving to Protect Your Heart

Experts say you should try to squeeze exercise into your chemotherapy schedule. Here’s why, plus how to make the heart-healthy practice easy and fun.

by Stephanie Stephens Health Writer

Every year, approximately 650,000 cancer patients undergo chemotherapy in an outpatient oncology clinic in the United States. Dealing with cancer itself and going through that process puts a lot on their plates—scheduling, transportation, appointments, and more. But there's one very important "to-do" element that's critical (and potentially, more fun) to add to the list: exercise.

A new study from Italy reports that exercise seems to be a promising and effective intervention, both during and after chemotherapy. It protects against ischemia or restricted blood flow, it appears to counteract negative effects caused by drugs on the cardiovascular system, also known as cardiotoxicity, and it limits tumor growth, the study says.

The research, published in the European Journal of Preventive Cardiology, says that, perhaps not surprisingly, cancer patients tend to be less active than people without cancer. Also, between 53% and 70% of survivors don't follow recommended guidelines for physical activity.

Those facts might not be surprising when we consider the exercise habits of "all of us." A recent report from the Centers for Disease Control and Prevention said that less than one-fourth of Americans ages 18 to 64 meet the recommended guidelines for both aerobic and muscle-strengthening activities.

We All Could Exercise More

Real quick, let's review why we should all love exercise as much as it loves us. It helps control weight, helps manage blood sugar and insulin levels, improves mental health and mood, helps cognition as we age, strengthens bones and muscles, reduces the risk of some cancers like colon, breast and endometrial, and—here's a connection—it reduces the risk of heart disease.

The lead author of the new study, Flavio D'Ascenzi, M.D., Ph.D., of the University of Siena, Italy, made it clear that for cancer patients undergoing any kind of treatment, exercise is, well, essential. It should also be started as soon as possible and seems to help patients even before they start chemotherapy.

He said the top goals for physical activity in cancer patients are to:

  • Maintain good physical and social function

  • Optimize the ability to provide an individually-adapted treatment—most appropriate for that patient

  • Reduce undesirable symptoms, especially nausea and fatigue

  • Attain an optimal weight and prevent unwanted gain or loss

Variety Is the Spice of Exercise

We've heard before that we should all mix up the types of exercise we do in general. That means using a combo of endurance, resistance, flexibility, and balance. In this case, the authors say endurance is important to improve cardiovascular performance and reduce inflammation, but resistance training may be just the ticket for frail cancer patients just starting to exercise.

Consider other exercise, including inspiratory muscle training or breathing exercises, for patients with thoracic cancer, they say. Be sure to think about the right specific exercise in light of each person's characteristics.

Exercise regimens must be tailored to those individual characteristics, to drugs administered, personal history, response to exercise, and by considering each patient's choice—if patients don't like it, they probably won't do it.

How to Get Started

If you're a cancer patient undergoing chemo, and you want to start or continue an exercise program, that is great! But please don't try this alone—at least not right now. The study authors suggest your multidisciplinary team weigh in so you can develop your optimum regimen together, since each member knows relevant information about you and your condition.

That means working with your oncologists, cardiologists, physical therapists, nurses, nutritionists, and psychologists. You'll need a cardiac evaluation first to assess just how you respond to exercise, a necessary starting point. And just like a medication you take, all this information can help determine the "dose" of your exercise: intensity or how much effort you expend, the right type of training, and the amount you do each week. The idea is to prevent soreness, fatigue and interrupted sleep, they say.

An invaluable extra benefit: This is one part of your journey that you can manage and be in control of, and those rewards can go a long way to motivate and inspire you every day.

  • Chemotherapy statistics: Centers for Disease Control and Prevention. (2019). "Preventing Infections in Cancer Patients." www.cdc.gov/cancer/preventinfections/providers.htm

  • Stat about recommended exercise: National Health Statistic Reports. (2018). "State Variation in Meeting the 2008 Federal Guidelines for Both Aerobic and Muscle-strengthening Activities Through Leisure-time Physical Activity Among Adults Aged 18–64: United States, 2010–2015." cdc.gov/nchs/data/nhsr/nhsr112.pdf

  • Benefits of exercise in cancer patients study: European Journal of Preventive Cardiology. (2019). "The benefits of exercise in cancer patients and the criteria for exercise prescription in cardio-oncology."

  • Heart disease benefit of exercise: MedlinePlus. (2019.) "Benefits of Exercise." medlineplus.gov/benefitsofexercise.html

  • News release from the European Society of Cardiology.

Stephanie Stephens
Meet Our Writer
Stephanie Stephens

Stephanie Stephens is a very experienced digital journalist, audio/video producer and host who covers health, healthcare and health policy, along with celebrities and their health, for a variety of publications, websites, networks, content agencies and other distinctive clients. Stephanie was accepted to THREAD AT YALE for summer 2018 to author and produce an investigative series. She is also active in the animal welfare community.