Exercise After Cancer Treatment

June 2017

Cancer survivors often experience various long-lasting effects from their disease and treatments, such as chemotherapy or surgery. Studies show that for many different types of cancer survivors, a combined resistance training and aerobic exercise program can provide several benefits specific to the symptoms that occur after cancer treatments.[1] A combined program can help reduce fatigue levels and improve muscle strength, endurance, and perceived quality of life.

Patients who undergo breast cancer surgery often experience severe arm and shoulder dysfunction, including pain, numbness, and a limited range of motion.[2] A recent study looked at women who had undergone breast cancer surgery and were put into a post-op standard care (SC) group or a standard care plus yoga group. Standard care consisted of materials such as exercise instructions for arm and shoulder mobilization. The yoga group also received a yoga DVD. Over 6 months, the SC group reported following the exercises more often than the yoga group. For the SC group, 69% improved their Quality of life and arm movement at 10 weeks and 6 months. Within the yoga group, 62% improved at 10 weeks and 82% improved at 6 months. The yoga group also had lower reports of affected arm numbness. Yoga may not be a traditional method of care, but it could be as effective or even more so compared to the normal standard of care.

During recovery from lung cancer surgery, severe cancer-related fatigue is common, and it can affect other symptoms as well. Subjects in a study started an exercise program almost immediately after being discharged from the hospital after surgery.[3] They began with balance exercises and light walking, and increased duration of walking as tolerated. Even though the exercises were very low in intensity, the participants improved their fatigue scores, physical functioning, mental functioning, and quality of life from post-surgery to the end of the 6-week program.

Cancer treatments can have a variety of side effects that last long after treatment is over. Even small increases in physical activity may help improve the lives of cancer survivors, but a thorough and well-designed exercise protocol could greatly improve their recovery and accelerate a return to everyday activities


Beets

Beets are nutritional powerhouses, with three main edible varieties: red, golden, and candy striped. Both the colored roots and green tops are edible, but the roots have a high sugar content, giving them a sweet flavor, whereas the greens are bitter in taste.[4] Beets can be eaten raw or cooked using several different methods, such as roasting, boiling, steaming, or grilling.

One cup of beets contains about 75 calories. They are an excellent source of folate and a very good source of manganese, potassium, and copper. They are also a good source of dietary fiber and rich in nitrates that may help lower blood pressure and protect against cardiovascular disease. A study in sixteen healthy individuals assessed the postprandial glucose and insulin response from beet juice compared to a glucose beverage, and a beverage matched in macronutrient content.[5] They found a significant lowering of postprandial insulin from 0-60 minutes and a significantly lower glucose response from 0-30 minutes compared to the control group.

Beets get their deep red-purple color from betalains, which are phytonutrients that have beneficial anti-inflammatory and detoxification properties. Betalains are water soluble so they are lost with increased cooking time. To get the beneficial effects of betalians, beets should be cooked for 15 minutes or less. Leaving the skins on during the cooking process increases nutrient retention.


Balsamic Roasted Beet Salad

Ingredients:
8 medium red beets, tops removed and scrubbed
½ cup balsamic vinegar
½ cup olive oil
2 tsp dijon mustard
Kosher salt and ground black pepper
4 oz baby arugula
⅓ cup roasted, salted Marcona almonds, toasted
4 oz soft goat cheese, crumbled
Preheat the oven to 400 degrees

Directions:

Wrap beets individually in aluminum foil and place them on a sheet pan. Roast for 50 minutes to 1 hour, depending on size, until tender. Unwrap each beet and set aside for 10 minutes, until cool enough to handle. Peel the beets with a small, sharp knife over a piece of parchment paper to prevent staining your cutting board.

Whisk together vinegar, olive oil, mustard, 2 teaspoons salt, and 1 teaspoon pepper and set aside. While beets are still warm, cut each one in half and then each half into 4 to 6 wedges and place them in a large mixing bowl. As you’re cutting the beets, toss them with half of the vinaigrette (warm beets absorb more vinaigrette), 1 teaspoon salt, and 1/4 teaspoon pepper.

In a separate bowl, toss arugula with enough vinaigrette to moisten. Put the arugula on a serving platter and then arrange the beets, almonds, and goat cheese on top. Drizzle with additional vinaigrette, if desired, sprinkle with salt and pepper, and serve warm or at room temperature.

Recipe courtesy of Ina Garten

Recipe from http://www.foodnetwork.com/recipes/ina-garten/balsamic-roasted-beet-salad-recipe-2006690


Spotting a concussion

Sports are a great way for children and young adults to develop motor skills, practice team-building, and exercise in a fun environment. However, more and more research is revealing that head injuries and concussions are an all too common occurrence for many young athletes. Sport-related concussions affect about 300,000 young adults in America each year.[6] The contact sport with the highest incidence rate for concussion is football, but soccer, ice hockey, lacrosse, and basketball are also high on the list.

If an athlete experiences an impact to the head, there are several signs that may indicate a concussion. These include the inability to recall events prior to, or after, the hit, a dazed appearance, clumsy movements, changes in mood or behavior, and/or loss of consciousness.[7] The athlete may complain of a headache, vomit, experience balance problems, or act confused. If precautions are not taken, they could be at risk for second impact syndrome.[8] Even if the athlete only has a mild concussion, a second hit within a short time, or even several weeks later, can result in cerebral hemorrhaging and even death. Repeated concussions over the span of a lifetime can result in permanent neurological disability.[9]

For these reasons, it’s extremely important for parents, teachers, and coaches to recognize the signs of a concussion so they can help protect young athletes from serious injury.


Health Matters is written by Lindsey Guthrie, MS, RD, LD/N and Tyler Guthrie, MS, CSCS.

References:

  1. O’Neill M. Effects of combined aerobic and resistance exercise on quality of life and fitness of individuals who are post cancer treatment: A pilot study. Dissertation 2013.1.
  2. Harder H, Langridge C, Solis-Trapala I, et al. Post-operative exercises after breast cancer surgery: Results of a RCT evaluating standard care versus standard care plus additional yoga exercise. European Journal of Integrative Medicine. 2015; 7(3): 202.
  3. Hoffman AJ, Brintnall RA, von Eye A, et al. Home-based exercise: promising rehabilitation for symptom relief, improved functional status and quality of life for post-surgical lung cancer patients. Journal of Thoracic Disease. 2014; 6(6): 632.
  4. Beets. The George Mateljan Foundation. http://www.whfoods.com/genpage.php?tname=foodspice&dbid=49
  5. Wootton-Beard, Peter, Brandt K, Fell D, Warner S, Ryan L. Effects of a beetroot juice with high neobetanin content on the early-phase insulin response in healthy volunteers. Journal of Nutrition Science. 2014; 3: 9.
  6. Noble JM, Hesdorffer DC. Sport-Related Concussions: A Review of Epidemiology, Challenges in Diagnosis, and Potential Risk Factors. Neuropsychology Review. 2013; 23(4): 273.
  7. CDC. Head Up. Concussions Signs and Symptoms. http://www.cdc.gov/headsup/basics/concussion_symptoms.html
  8. Dessy AM, Rasouli J, Choudhri TF. Second impact syndrome: a rare, devastating consequence of repetitive head injuries. Journal of Neurosurgery. 2014; Q 10.
  9. Headcase Company. Sports Concussion Statistics. http://www.headcasecompany.com/concussion_info/stats_on_concussions_sports

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