WHAT DO WE MEAN BY ‘EXERCISE’?

Exercise is anything that gets your body moving in a way that gets your heart rate up and/or challenges your muscles. Activities like running, biking, swimming or going to the gym are examples that often come to mind, but don’t forget about things you may consider as hobbies or just for fun (e.g. dancing, skateboarding, hiking, horseback riding). Yoga, pilates and even quick walking are also great forms of exercise.

Keep in mind that regardless of symptoms, circumstances or fitness level, many activities can be modified in a way that will work for you (or steps can be taken to get you there), so think more about what you enjoy and less about what you think you can do.

A balanced exercise routine includes:

• aerobic training e.g. quick walking, running, biking, interval training (HIIT), team sports, tennis, dancing, hiking, skiing(heart and lungs);
• strength/resistance traininge.g. lifting weights or bodyweight exercises like push-ups, squats and crunches, but also activities like rowing, cross-country skiing, biking, pilates, yoga and many others (muscles and bones); and
• flexibility traininge.g. stretching after workouts but also activities like dancing, martial arts, yoga and gymnastics (muscles and joints).

Each element is equally important as they work togetherFor example, aerobic exercise makes your heart and lungs better at getting oxygen to all parts of your body including your muscles, which, as they become stronger through strength/resistance training, provide better support for your joints to help improve mobility and prevent injuries. to deliver the range of benefits regular exercise can provide. Many activities incorporate two or all three of these elements, so it’s easy to include them all in a routine.

HOW MUCH IS ENOUGH?

Post-treatment health guidelines recommend that people exercise 5 times per week for 30 minutes each time.

If this feels out of reach right now, don’t be discouraged as you are not alone- only around half of young people who have been through cancer are getting enough exercise post-treatment. However, research also shows that in addition to all the benefits mentioned above, young people who exercise regularly after treatment report less fatigue and better quality of life, so it’s a goal worth working towards.

Start slowly and gradually increase the amount and intensity over time. You could also try breaking that 30 minutes of exercise up into 5, 10 or 15 minute blocks across the day instead of doing it all at once. Aim for moderate intensity, which is when your heart rate and breathing have increased to the point where you can still talk comfortably, but not sing (the ‘talk test’).

GETTING STARTED

• Identify your ‘why’. What are your goals or motivation for exercise? It could be about reducing treatment effects, getting back to particular activities, improving certain aspects of your physical or mental health or your fitness overall. Set small, achievable goals that build on one another to help keep you focused and motivated.
• Identify your ‘how’. Think about what activities you enjoy, your current fitness level and what you have access to. Remember that this doesn’t have to mean expensive gym memberships or equipment! Consider whether you prefer activities you can do alone or in a group. If you aren’t sure, try out a few different activities or classes, check out videos online, and see what inspires you. Finding something you enjoy is critical to keeping it up.
• Seek professional help. See your GPCheck out the 'Your GP' topic for more information. in the first instance- their role in supporting whole-person health and wellbeing makes them an excellent resource when it comes to fitness and exercise. They can also check with your treating (hospital) team about any concerns either of you may have, and help identify local supports and services. You may also find it helpful to see a specialised physiotherapistIn addition to treating injuries, physiotherapists specialise in reducing pain and/or increasing mobility or function through physical methods such as exercise, massage, manipulation and other treatments. or exercise physiologistExercise physiologists specialise in exercise programs that focus on managing health conditions and treatment impacts and enhancing overall health and wellbeing (often ongoing or longer term). who can design a plan specific to your needs.

A FEW TIPS FOR SETTING GOALS

• Focus on how achieving your goal will make your life better. What outcome do you want and why? (e.g. not ‘improve strength’ but ‘improve strength so I can...’)
• Make the goal specific by attaching a number and deadline (e.g. ‘improve strength by doing X for the next Y months so I can...’). Make sure these details are appropriate and realistic by talking to your GP or an exercise physiologist first.
• Set some smaller goals on the way that will contribute to your ability to achieve your main goal (or help you adjust it if needed) and boost confidence as you go. Again, it’s worth talking to a professional to help work out what’s safe and appropriate for where you are at and what you want to achieve. If you’re just starting out, begin with something you feel is easy and uncomplicated to chalk up those early wins (e.g. drink an extra glass of water each day or go for a 10 minute walk twice a week for the next two weeks).

Finally, remember that goals change and life happens, and that’s ok. It’s not about perfection, but taking steps in a positive direction.

STRATEGIES FOR SUCCESS

It’s easy to find excuses for avoiding exercise, and the effects of cancer and its treatment can make it even harder to get moving and stay motivated. Below are some tips and tricks for getting (and staying) on track:

• Talk to your GP or an exercise physiologist to help you plan and get off to a great start.
• Set small, achievable goals and celebrate your successes.
• Start slow and gradually increase the time and intensity of activity as fitness improves.
• Consistency is key. Short periods of activity on most days of the week are far more beneficial than the occasional gruelling workout.
• Schedule time for exercise like you would any other appointment, and plan it around your higher energy times to help combat fatigue.
• Experiment with ways of keeping yourself focused and motivated to find what works best for you- it could be keeping a training diary or recording progress via a phone app, exercising with a friend, or signing up for a class or group program.
• Remember that exercise actually helps many of the issues that can make getting active a challenge after treatment.

WHAT TO WATCH OUT FOR

Causing moderate stress to the body is necessary to benefit from exercise, but if you experience any of the following, stop and seek medical advice:

• Chest pain
• Excessive shortness of breath
• Light-headedness or dizziness
• Persistent joint or muscle pain
• Persistent fatigue

USEFUL LINKS AND RESOURCES

There is a wealth of information online about exercise and getting active, but it’s important to make sure that your sources are trustworthy and specific to your circumstances. Seek out information from cancer organisations such as Macmillan Cancer Support (UK) and the Cancer Council (Aus) in the first instance to make sure it’s relevant to people with a cancer experience.

Information, advice and programs found on general health and fitness websites, in magazines, etc may also be relevant, but it’s important to discuss this with your GP or other health care provider first to ensure it is safe and appropriate for you.

• Exercise after a cancer diagnosis (Cancer Council NSW) – information, videos and a booklet on exercise during and after treatment for cancer
• Video: how quickly can you get back to exercise after treatment? (CanTeen)
• Your local youth cancer service – each Australian state has a team of health care professionals specialising in the cancer treatment and care of young people aged 15-25 that you can contact for help and advice (some have an exercise physiologist on staff)
• Find an exercise professional near you (ESSA) – search for exercise physiologists close to you and with expertise in cancer. Some EPs bulkbill (no cost) with a referral from your GP while others may offer private health care rebates (reduced or no cost depending on your plan)
• Find a physiotherapist near you (APA) – search for physiotherapists close to you and with expertise in cancer (use the ‘refine your search’ option). You can get a referral from your GP (which may mean some sessions can be bulkbilled i.e. no cost), but it is not required. If you have private health insurance it may cover some or all costs of physiotherapy as well- check your plan.

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