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Muscle Gain During Treatment

by Jenna Koroly, MS, RD, CSOWM, CDN

Increased muscle mass is associated with a multitude of benefits, including better weight control, increased bone mineral density and strength, decreased risk of injury, and improved quality of life.  The importance of maintaining proper muscle mass, or even gaining a little bit, should be taken very seriously during the cancer journey.  In cancer patients, muscle wasting is common.  Muscle wasting, often as a result of the disease or treatment, is associated with poor clinical outcomes which include decreased tolerance to treatment [i].


The Formula

Gaining muscle mass is a simple formula.  Building or maintaining muscle mass is the sum of the total calories consumed plus the amount of quality time spent practicing resistance training.  This gain is exponential when you recover properly. Let’s explore the main variables of muscle gain, starting with “proper calories.”


(Proper Calories + Quality Resistance Training) Smart Recovery = Muscle Gain


Proper Calories

Calories are the fuel for our bodies, and you mustn’t deprive yourself.  Without enough “fuel,” including proteins, carbohydrate and fats found in foods like salmon, brown rice and olive oil, quality exercise would not be possible.  And with treatment, it becomes even more important to focus on a good calorie intake for recovery purposes as well.  During treatment, the body is constantly working to recover itself.  But additional challenges abound.  Undergoing cancer treatment can affect calorie intake because of fatigue, trouble swallowing, dry mouth, poor appetite, constipation, nausea or diarrhea, as well as taste changes.  For guidance on how to increase your intake of calories, check out Body Composition for Cancer Patients: Part II on healthy weight gain, which goes a bit more in depth on ways to bulk up the meals with calories and protein, and provides a quick and easy recipe for a calorie rich smoothie.


Quality Resistance Training

There are a few components to consider when planning to continue or begin a resistance training program (which may include body weight exercises, free weights or machine weights).  First, talk to your physician about your plan of action as it pertains to exercise before, during and after treatment so that they can recommend any prior fitness testing that may beneeded.  Next, consider working with an exercise physiologist or physical therapist who understands your diagnosis.  The exercise physiologist can begin by testing your fitness levels which will enable for precise exercise prescriptions that will be tailored to your physiological fitness from the start. The physical therapist can help to guide you through the best exercises during treatment, while working within your fitness zones.  Regardless of who you work with, they will break the workouts into different components, such as:  type of exercise, amount of weight, number of repetitions, number of sets, length of the workout, and frequency per week.  Once you understand how to incorporate these variables, you will be able to create your own workouts at home.  If exercise is familiar to you, then this can be determined more independently.  To get a snapshot of what this may look like, check out the resistance training section of Strength and Cardio – The Dynamic Duo.


Smart Recovery

Recovering after exercise is dependent on proper repletion from food.  Recovery requires replenishing your body with quality calories and nutrients to allow for growth and maintenance of lean muscle mass.  Don’t wait for it.  Get a complete meal in within an hour after working out.  Again, including proteins, carbohydrate and fats is important,.  Since certain cancer-related side effects can make this more challenging, incorporate strategies that manage the side effects properly while still replenishing with the necessary proteins and calories.  This will help to promote  vital muscle mass that is important for improving treatment outcomes.


Make Adjustments

Don’t be afraid to be flexible with your exercise routine.  If you don’t have prior experience with resistance training, make sure to start off with body weight, or lighter weight exercises and progress from there, making simple adjustments every 2-4 weeks depending on how you feel. Stay attuned to your body.  You may find that on some days resistance training increases your energy levels.  However, other days may be different.  Serious fatigue may set in, preventing you from doing any kind of exercise, and that is okay and very normal.  Resistance training is important, but ensure your body is up to it and keep your healthcare team informed of your exercise plan, as you want to make sure that you are exercising safely.



Studies suggest that those patients who have had breast, colorectal, prostate, and ovarian cancer and who have entered survivorship have a significantly lower risk of cancer recurrence with consistent physical activity [ii].  The  important role resistance training plays in your regular physical activity routine is clear, and it’s up to you.


[i] Aversa Z, Costelli P, Muscaritoli M. Cancer-induced muscle wasting: latest findings in prevention and treatment. Therapeutic Advances in Medical Oncology. 2017;9(5):369-382.doi:10.1177/1758834017698643
[ii] Physical activity and the cancer patient. American Cancer Society. 2014. Retrieved from http://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/physical-activity-and-the-cancer-patient.html


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