Some common questions we have in the clinic are:
Can I exercise if I have cancer in my bones?
Is exercise safe if I have bone metastasis or lesions?
Will exercise make my bone lesions worse?
What exercise can I do if I have cancer in my bones or bone lesions?
Well if you have also wondered any of these questions you have come to the right place and the good news is you CAN exercise with bone lesions you just have to be a little careful about what you do!
Exercise at all stages of the cancer continuum is extremely important for many reasons, including:
↑ muscle mass
↑ tolerance to treatment,
↑ quality of life
↑ immune function
↓ side effects of treatment e.g., cancer-related fatigue
↓ risk of progression
Whilst, living with metastatic cancer can provide a unique set of challenges, exercise remains a critical component of maintaining overall health and quality of life and emerging evidence suggesting that it can even reduce bone pain.
If the idea of physical activity/exercise seems a little daunting to you this is completely normal! Due to the fragile nature of bone lesions, associated pain, and changes in mobility there has been underlying concern of the safety of exercise.
The good news is that exercise with metastatic lesions is safe, however, it is recommended you consult a qualified Exercise Physiologist that specialises in oncology prior to commencing.
Research in metastatic prostate cancer demonstrated that exercise interventions are safe and beneficial for improvements in physical functioning and muscle mass (Cormie et al., 2013). Likewise, research has demonstrated that strength training can reduce pain in people undergoing radiation for bone metastasis (Rief et al. 2014).
More recently, in 2022, Hart and colleagues released clinical exercise recommendations for metastatic lesions, created by the Bone Metastases Exercise Working Group. These recommendations state that bone metastases may require extra consideration when exercising. However, regular physical activity can improve health-related quality of life and overall physical functioning in people with metastatic lesions (Hart et al., 2022). So, the moral of the story, is that exercise is safe and beneficial for people with bone lesions!
Of course, everyone experiences symptoms associated with bone lesions and treatment-related side effects differently, which is why engaging an exercise professional with expertise in cancer will ensure you receive the best treatment plan possible that is specific to you and your overall wellbeing and safety.
Here are our top tips for exercising with bone metastasis or bone lesions:
1. Consult an Exercise Physiologist for individualised advice.
2. Listen to your body. Whilst pain is unfortunately a common disease-related side effect. Exercise should NOT worsen bone pain.
3. Start low and go slow. Start with movements based on activities of daily living an progress from there.
4. Minimise impact exercises that involve rotational force around lesions e.g., golf for spinal lesions.
5. Include strength building exercises. Start with what we call isometric exercises around lesion sites (e.g., wall sit or bird dog) and slowly progress to loading through movement range. For the rest of the body exercise as normal
6. Include balance work. Depending on lesion site you may be at an increased risk of fracture if you were to have a fall. Improving your balance will reduce your risk of falling.
7. Low impact aerobic exercise. Include cardiorespiratory exercises that are low impact like walking, stationary cycling, rowing, or swimming.
If you would like an example of some of the exercises mentioned in these studies email us at valere@valerehealth.com.au.
Client Spotlight:
Tony has a diagnosis of advanced metastatic prostate cancer. He initially came to see us to improve his fitness levels and quality of life and was unsure how to best approach exercising given his diagnosis. 6 months down the line, he is now leg pressing over 60kg and walking 5km a day!!
“Coming to see Morgan and Dani at Valere Health is one of the most sensible things I have done since my diagnosis, the fitter I am the better I withstand my treatments. Coming to Valere has been a tremendous benefit to me and I look forward to my sessions each week”
Tony – Metastatic Prostate Cancer
At Valere Health, we have first-hand experience with exercise prescription and treatment for all diagnoses of all stages, so if you’re looking for a sign to safely begin exercising, get in touch with us today!
References:
Cormie, P., Newton, R., Spry, N. et al. Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 16, 328–335 (2013). https://doi.org/10.1038/pcan.2013.22
Hart, N.H., Poprawski, D.M., Ashbury, F., Fitch, M.I., Chan, R.J., Newton, R.U. & Campbell, K.L. 2022, "Exercise for people with bone metastases: MASCC endorsed clinical recommendations developed by the International Bone Metastases Exercise Working Group", Supportive Care in Cancer, vol. 30, no. 9, pp. 7061-7065.
Rief H, Welzel T, Omlor G, Akbar M, Bruckner T, Rieken S, Haefner MF, Schlampp I, Gioules A, Debus J. Pain response of resistance training of the paravertebral musculature under radiotherapy in patients with spinal bone metastases--a randomized trial. BMC Cancer. 2014. PMID: 24996223;