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Physical activity is important in chronic disease prevention, and is associated with better outcomes for cancer patients. Being active is considered safe and beneficial for people undergoing cancer treatment.

Regular physical activity can help manage common side effects of cancer treatment, such as fatigue, pain, and nausea. For many, the feeling of tiredness does not get better with rest, and the severity of fatigue can limit activity. Too much inactivity can lead to muscle wasting and loss of function. Finding a regular, aerobic exercise regimen that works for your specific needs can help break the cycle of inactivity and reduce fatigue.

Light, regular exercise can also improve appetite, aid digestion, and prevent constipation. Even short bursts of movement throughout the day can promote stress relief, boost mood, and enhance quality and amount of sleep [i].

 

Current Recommendations

The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity physical activity each week, preferably spread throughout the week. Cancer survivors should aim for at least 150 minutes of exercise per week, which translates to about 30 minutes of physical activity, five days per week.

It is important to note that exercise guidelines for each person vary depending on your medical condition and past fitness level. It is important to get approval from your health care provider before starting a new physical activity regimen [ii].

 

The Role of Physical Activity in Cancer Prevention

Studies looking at the role of physical activity in cancer prevention have shown that physical inactivity can lead to obesity, and obesity leads to increased risk for cancer of the colon, pancreas, gallbladder, endometrium, breast (among postmenopausal women), kidney, and other types of cancer. For colon cancer in particular, the risk seems to be highest for people with accumulated body fat in the abdomen.

Other studies looking at the role of physical activity on cancer recurrence and long-term survival suggest that physically active cancer survivors have a lower risk of cancer recurrence and improved survival, compared with those who are inactive 

A good strategy for people undergoing cancer treatment or recovering after treatment is to be as active as your physical abilities allow. Try to do a little something every day—even for just 10 minutes—early in your cancer treatment so that you can maintain optimal strength throughout [iii].

 

Simple strategies to start incorporating exercise into the day:

  • Go for a walk around the block with your family and friends, or seek out a new area in town and explore by foot. Walking is one of the simplest ways to start and continue an exercise regimen. Walking has the lowest dropout rate of any type of exercise, and it costs nothing but a good pair of shoes to get started!
  • Park the car farther away or get off the bus or subway one stop earlier than your destination. Every extra step counts!
  • Pedal a stationary bike while watching television. Or, exercise in bed! Lie on your back, hold in your stomach muscles, and pedal your feet in the air as if you were riding a bicycle.
  • Take the stairs rather than the elevator or escalator. The average flight of stairs has about 12 steps. Going up three flights of stairs, three times per day can burn about 45 calories for a 150-pound person. Take more flights of stairs to burn extra calories and tone your calves and rear end! [iv].
  • If you sit for most of the day, take a break at least once an hour to stand up and stretch.
  • Get online. Tons of free exercise videos are available online from yoga and Pilates to cardio and toning routines. Set up a mat in the comfort of your own home and take a few minutes to move.

 

Starting an exercise routine

When beginning a regular exercise routine, it is important to start with small changes. A little movement a few days of the week is better than overexertion one day and inactivity on the remaining days of the week. Slowly, start incorporating physical activity into your daily life, working up to a moderate level of exercise as you are able. For many, adopting a regular exercise regimen helps reestablish a sense of autonomy that is sometimes lost during cancer treatment.

 

Usual activities versus exercise: the difference

Usual activities involve activities of daily living, such as walking to and from the car or subway, climbing a few flights of stairs at home or at work, and dressing and bathing. Usual activities are typically brief and of low intensity.

Intentional activities include those that are done in addition to usual activities. These activities are often planned and done at leisure as regularly scheduled exercise sessions, such as biking, running, or taking a group fitness class. Other intentional activities may involve adding more purposeful physical activity into the day and making lifestyle choices to add to or replace other routine activities, such as walking to use public transportation or taking the stairs instead of the escalator.

 

Exercise Intensity

Usual and intentional activities can both be beneficial. The most important factor to consider is the intensity of the exercise. Exercise intensity is a measure of how hard the body works during physical activity, and is often characterized as light, moderate, or vigorous activity. Aim to include a variety of exercise intensities in your routine, while keeping in mind your medical condition and your doctor’s recommendations [v].

  • Light intensity activities include housework, shopping, or gardening. At this intensity, you should be able to talk normally without any strain or heavy breathing.
  • Moderate intensity activities include those that require effort equal to a brisk walk. At this intensity, you should be able to hold a conversation easily.
  • Vigorous intensity activities generally use large muscle groups and result in a faster heart rate, deeper and faster breathing, and sweating. At this intensity, you may become winded or easily out of breath, making it difficult to talk.

The chart listed below provides some examples of moderate and vigorous intensity level exercises for a variety of common activities that can help you to find fun ways that suit your interests and lifestyle:

  Moderate Intensity Vigorous Intensity
Exercise and Leisure Walking, dancing, leisurely bicycling, ice and roller skating, canoeing, yoga, using a manual wheelchair Jogging or running, fast dancing, fast bicycling, circuit weight training, aerobic dance, martial arts, jumping rope, swimming, hiking uphill
Sports Volleyball, golfing, softball, baseball, badminton, doubles tennis, downhill skiing Soccer, field or ice hockey, lacrosse, singles tennis, racquetball, basketball, cross-country skiing
Home Activities Mowing the lawn, general yard and gardening maintenance, mopping and sweeping the floors, vacuuming Digging, carrying and hauling, carpentry
Work Activities Walking and lifting as part of a job (custodial work, farming, auto or machine repair, restaurant work [dishwashers, servers, cooks]) Heavy manual labor (construction, fire fighting)

A well-rounded activity plan includes aerobic exercises, strength training with weights, and flexibility exercises. This type of varied plan offers a balanced range of exercise intensities. Remember, exercise can be accomplished in 10-minute increments throughout the day, so let’s get moving!

 

Get FITT

As you get stronger and feel more confident about your exercise routine, try slowly adding more physical activity to your schedule. Think about getting F.I.T.T., a term that stands for frequency, intensity, time, and type, four key components of a physical activity program [vi].

 

Personalizing the exercise during treatment

  • Because of fatigue, some people in chemotherapy may feel like waiting and finishing their chemotherapy before starting an exercise program. It is generally better to try to include some level of activity throughout therapy. Even 10 minutes of stretching each day may help. Establishing a habit of activity early on will make it easier to continue even if fatigue sets in.
  • Older people and those with conditions like arthritis should pay careful attention to balance exercises that can help prevent falls. A caregiver or exercise professional may be able to help those who need assistance.
  • If you have severe anemia, wait to exercise until you have recovered from treatment.
  • If you have compromised immune function, avoid public gyms and other public places until your WBC counts are back to normal.
  • If you have significant peripheral neuropathies, you may not be able to exercise your affected limbs. You may feel off balance and may prefer pedaling a reclining bicycle, for example, rather than walking on a treadmill.
  • If you are in bed because of your cancer or treatment, talk to your health care team about physical therapy in bed to keep up your strength and maintain range of motion. Physical activity can help lessen fatigue and depression often experienced by some people confined to bed.

 

Even with limited activity, make sure to drink plenty of liquids to keep you feeling strong and hydrated.

Set small, manageable goals for your exercise routines within the framework of F.I.T.T. At the start of each week or month, think about how many times a week you can squeeze in physical activity. Think about whether you want to exercise at low or moderate intensity or add in a set of vigorous intensity exercise once or twice a week.

Start with a goal of 10 to 15 minute bouts of physical activity, and work up to 30 or 45 minutes as able. Jot down some of your favorite ways to be active, and keep that list hanging on the refrigerator or at your desk to motivate you to make exercise fun. Starting small can lead to big changes!

 

Be sure to speak with your physician and health care team before starting any new exercise regimen or making changes to your current routine.

 

References
[i] Physical Activity and the Cancer Patient. American Cancer Society website. http://www.cancer.org/treatment/survivorshipduringandaftertreatment/stayingactive/-physical-activity-and-the-cancer-patient Last Medical Review: March 24, 2014. Last Revised: March 24, 2014. Accessed: October 21, 2014.
[ii] ACS Guidelines for Nutrition and Physical Activity. American Cancer Society website. http://www.cancer.org/healthy/eathealthygetactive/acsguidelinesonnutritionphysical-activityforcancerprevention/acs-guidelines-on-nutrition-and-physical-activity-for-cancer-prevention-guidelines Last Medical Review: January 11, 2012. Last Revised January 11, 2012. Accessed October 21, 2014.
[iii] Grant B, Bloch A, Hamilton K, Thomson C. Complete Guide to Nutrition for Cancer Survivors. 2nd ed. Atlanta, GA: American Cancer Society/Health Promotions; 2010.
[iv] Calories burned walking a flight of stairs. NH DHHS-DPHS-Health Promotion in Motion website. http://www.dhhs.nh.gov/dphs/nhp/worksite/documents/calories.pdf Accessed October 17, 2014.
[v] Reduce Your Cancer Risk: Physical Activity. American Institute for Cancer Research website. http://www.aicr.org/reduce-your-cancer-risk/physical-activity/reduce_physical_add.html Published August 15, 2011. Accessed October 21, 2014.
[vi] HEAL Well Guide. American Institute for Cancer Research, pages 17-20. http://www.aicr.org/assets/docs/pdf/education/heal-well-guide.pdf Accessed October 17, 2014.

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Susan started Savor Health after losing a close friend to a brain tumor and, through that experience, becoming aware of the significant unmet nutritional needs of people with cancer.  Struck by the fact that her friend was told “nutrition doesn’t matter” and “eat whatever you want,” Susan read the evidence-based literature on the subject, interviewed oncologists, oncology nurses and oncology dietitians, as well as patients and caregivers, and found that, in fact, nutrition does matter in oncology. Armed with solid scientific evidence supporting the clinical and quality of life benefits of proper nutrition, Susan left Wall Street and created Savor Health, an AI-based provider of personalized and clinically appropriate nutrition solutions for cancer patients, their caregivers and health enterprises. Susan brings to Savor Health over 25 years of industry experience in healthcare and business as well as expertise in strategy, finance and management.

Susan is an outspoken and tireless advocate for cancer patients receiving proper nutrition and nutrition support before, during and after treatment. She strongly believes that the U. S. healthcare system requires new innovation to transform it into a more holistic and integrated system of care whereby multiple disciplines coordinate care together for the benefit of the whole patient. As part of this, her goal is for nutrition to be an integral component of such an integrated cancer care delivery system.  Susan’s commitment to the field of oncology extends beyond Savor Health to volunteer work at Memorial Sloan Kettering Cancer Center in pediatrics and as a runner for Fred’s Team to raise money for research at Memorial Sloan Kettering. Susan participated in the Cancer Moonshot in June of 2016 where she was a breakout session group “igniter” tasked with starting and leading discussion. Susan’s first book, the Meals to Heal Cancer Cookbook, was published in March 2016.

In addition to her role as CEO of Savor Health, Susan speaks nationally about the importance of ensuring proper nutrition in the cancer patient and on topics including leadership and startups. She has been a speaker at the Harvard Medical School’s Career Advancement and Leadership Skills for Women in Healthcare, ESMO World Congress on GI Cancer, BioPharm America, AARP Live @50+, Lake Nona Impact Forum, and IIR ePharma Summit.

Prior to starting Savor Health, Susan had a successful career on Wall Street as a healthcare services investment banker working at prestigious firms including Donaldson, Lufkin & Jenrette, Wasserstein Perella and Robertson Stephens. Susan earned a B.A. from Duke University and M.B.A. from the University of Virginia’s Darden Graduate School of Business.

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Marissa Buchan is a registered dietitian, with advanced practice certifications in Oncology Nutrition (CSO) and Clinical Research (CCRP). She received her Bachelor’s degree in Psychology from Duke University, and Master’s of Science degree in Clinical Nutrition from New York University. Marissa worked for 10 years at Memorial Sloan Kettering Cancer Center in both the clinical research and nutrition departments.  In addition to counseling patients before, during, and after cancer therapy, she spearheaded nutrition-research efforts for the bone marrow transplant service. She has co-authored over 20 articles and has a particular interest in the role of nutrition on the intestinal microbiota and its impact on patient outcomes. When Marissa’s not wearing her lab coat, she’s in her apron whipping up healthy and delicious recipes that you can find on her blog, Get Off Your Tush and Cook.

Marissa is Chief Operating Officer of Savor Health where she leads operations working with the technology, clinical, and business development teams and management. Prior to assuming the role of COO in March 2020, Marissa was Vice President, Clinical Research and Operations at Savor Health where she worked closely with Savor Health’s Chief Medical Advisor, Scientific Advisory Board, and Clinical Operations Team to evaluate, design and conduct clinical research.  She also counsels patients on oncology nutrition issues and contributes to the Company website’s clinical content.

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Dr. DeFrance has a unique background including clinical interventional cardiologist, chief medical officer, educator, outcomes researcher and entrepreneur. He has expertise in Lifestyle medicine in which he was board certified in 2020 and is highly interested in the prevention and reversal of chronic disease. Dr. DeFrance also has expertise in appropriate utilization of technology in medicine, healthcare economics, value-based metrics, and educational design and delivery. He worked as Chief Medical Officer for HealthHelp, one of the largest specialty benefit managers in the US, and led large teams of healthcare professionals in writing evidence based appropriate care guidelines and rule sets which improve the quality and safety of medicine for over 20 million people in the US while also creating sustained savings in healthcare. He has also designed clinical decision support systems that are currently in use helping to improve patient care.

In 2018 Dr. DeFrance founded MedMentor Education, a company that provides state of the art CME content using the latest in eLearning science and online delivery platforms. Dr. DeFrance is also the founder and President of Digimedica, a consulting and educational design and delivery company for healthcare professionals, hospitals, and universities. He is passionate about creating systems to optimize knowledge transfer and has won numerous awards for teaching excellence during his career. He is an expert in cardiovascular CT imaging and has taught more than 3,000 physicians how to perform and interpret cardiac CT nationally and internationally and has lectured extensively on this subject.

Dr. DeFrance has a stellar reputation in the medical field and continues work to improve the quality and safety of patient care in the US.

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Alyson is a registered nurse and is certified in oncology nursing (OCN) through the Oncology Nursing Society (ONS). She also has her certification as an ONS Biotherapy and Chemotherapy Provider. Alyson studied nursing at Thomas Jefferson University where she obtained her Bachelor’s of Science in Nursing (BSN). Since starting her nursing career in 2004, Alyson has had a strong dedication and commitment to oncology patients. She has worked inpatient specializing in Bone Marrow and Peripheral Blood Stem Cell Transplantation. Alyson currently works in outpatient oncology at the North Shore-LIJ Monter Cancer Center. Alyson is part of the clinical team at Savor Health where she counsels patients on oncology and oncology nutrition issues and contributes to website and other Savor Health content.

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Chelsey is a Registered Dietitian and Board Certified Specialist in Oncology nutrition (CSO). She completed her Dietetic Internship at Northwell Health, received her BS in Dietetics at the University of Wisconsin-Madison, and her MS in Nutrition at Stony Brook University’s School of Medicine. Chelsey works as an outpatient dietitian at Mount Sinai covering all of the downtown cancer services at Mount Sinai Beth Israel and Philips Ambulatory Care Center. Chelsey works with patients and families before, during and after treatment to optimize their nutrition through dietary counseling and support. Chelsey has experience counseling clients with a variety of diagnoses including breast cancer, lung cancer, prostate cancer, head & neck cancer, and more. Chelsey also enjoys sharing nutrition knowledge with her peers by running a monthly Employee Wellness program that showcases healthy topics, recipes and food demos.

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Michelle is a Registered Dietitian specializing in oncology. She works as a clinical dietitian at an ambulatory cancer center in New York City and is a consultant for Savor Health. She is passionate about educating oncology patients on the importance of nutrition during their fight against cancer and helping them to optimize their nutrition through all phases of treatment. Michelle received her Bachelor of Science degree in dietetics from the University of Wisconsin-Madison and her Master of Science degree in Clinical Nutrition from New York University.

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Denise Sievering is a Registered Dietitian who is board certified in Oncology Nutrition as well as Nutrition Support. A fluent Spanish speaker, Denise joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Denise holds a Bachelor of Science degree from Rutgers University, and completed her internship at New York Presbyterian Hospital (NYP). Denise started her career as a registered dietitian at NYP-Columbia University Medical Center, primarily covering inpatient Oncology units. Denise also holds a Master of Arts degree in Mental Health Counseling from New York University, and incorporates her advanced training in motivational interviewing and empathic listening in her patient encounters, particularly those whose lives have been forever changed by a cancer diagnosis. A New Jersey native, Denise now resides in sunny San Diego, CA where she works as a part-time outpatient Oncology dietitian at Scripps Health-MD Anderson Cancer Center, and also works as an inpatient dietitian at Kaiser Permanente. In her spare time, Denise can be found at a mom-and-pop taco shop, one of the many local craft breweries, and exploring her new city of San Diego with her husband and her rescue pup, Ripley.

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Karen is a Registered Dietitian, Board Certified Specialist in Oncology Nutrition and registered in New York as a Certified Dietitian Nutritionist. Fluent in Spanish, Karen joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Karen received her Bachelor of Science degree from Ithaca College and her Master of Science degree from Hunter College. She works as an outpatient oncology dietitian in New York. Karen often works with local community centers to host nutrition programs for cancer survivors and their families, leading classes on how to live healthier lifestyles throughout their continuum of care. The American Institute of Cancer Research selected to showcase one of her many programs at their conference in 2019. Karen has written for and lent commentary to various publications and truly enjoys teaching people how to eat better. She loves to cook and strongly feels that healthy food doesn’t have to taste bad.

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Allie is a Registered Dietitian and a Certified Specialist in Oncology (CSO). She joins Savor in 2023, bringing years of experience from the John Theurer Cancer Center in New Jersey, where she worked with patients with a variety of cancers. Her goal is to help people feel their best, both mentally and physically, when physical health challenges arise. She believes in the power of nutrition ever since the impact it made on her athletic career as a volleyball player during college. Allie graduated with her Bachelor of Science degree from University of Maryland-Baltimore County and has her Master’s degree in Human Nutrition from the University of Wisconsin Stout. She enjoys travelling, enjoying different cuisines, cooking, and hiking and other outdoor activities with her family and dog.

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Julia Penberg is a seasoned healthcare professional with more than 30 years of experience focusing on maximizing operational excellence, leading clinical program development and building strong cross-functional teams. Her previous roles include overseeing the performance of clinical managers and nurse practitioners across multiple markets within United Healthcare-Optum’s Medicare Advantage and dual-eligible special needs populations, payer outreach and program development at Mayo Clinic, ground level specialty hospital development and direct patient care as a family and dermatology nurse practitioner. Julia volunteered as an operating room nurse and nurse practitioner on several mission trips to Romania and was a support group leader for the Kansas City chapter of the International Myeloma Foundation. Her motivation throughout her career has been with wellness promotion, disease risk modification and ensuring the best patient experience across the health continuum. Ms. Penberg received an MBA from the University of Dallas; a MS in Nursing from the University of Kansas and a BS in Nursing from the University of Texas-Austin. She is board certified as a Family Nurse Practitioner.

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Rachel is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition (“CSO”). She joined NYP-Columbia as the outpatient oncology dietitian in 2020 after working at Jamaica Hospital Medical Center for two years. Rachel completed her dietetic internship through Keene State College in 2017. She is pursuing an MS in Integrative Nutrition at Stony Brook University and has a BS in Human Nutrition, Foods and Exercise from Virginia Tech. Rachel provides nutrition counseling to all types of oncology patients and helps them understand the mental and physical benefits of nutrition as an ally in their fight against cancer. In her free time she enjoys slow meals with family and friends, Pilates, and tending to her fire escape garden.

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Allie Werner is a Registered Dietitian at Fresenius Kidney Care where she provides medical nutrition therapy diet counseling to patients on Dialysis. She received her Bachelor’s Degree in nutrition from Indiana University and completed her Master’s Degree and dietetic internship at Loyola University Chicago. In her free time she enjoys spending time with friends and family, checking out the amazing food scene in downtown Chicago, and exercising on her Peloton bike.

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Immersed in the tech world for a decade, I've coded, led teams, and honed my skills in architecture and design. As a tech enthusiast, I've seamlessly woven through full-stack projects, fusing my love for code with the art of leadership.

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Mohit is a full-stack developer with expertise in Python and JavaScript, known for his efficient coding and ability to deliver scalable software solutions. His technical contributions are highlighted on GitHub and Stack Overflow, demonstrating his commitment to the tech community and problem-solving skills. With a solid educational foundation and a diverse project portfolio, Mohit excels at navigating complex challenges and is well-equipped to contribute to dynamic software projects.

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Rayna McCann is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition. She is a Registered Yoga Teacher and yoga4cancer certified. She received her BS in Nutrition at Penn State University and her MS from Stony Brook University. For work, Rayna wears many hats in the world of nutrition and worked for years in clinical settings focusing on oncology nutrition. She is also an Adjunct Professor and passionate about inspiring the future of dietitians. Throughout her career, she has received awards recognizing her dedication to patient safety and her contributions to improving malnutrition awareness. In 2022, Rayna was proud to accept the ‘Dietitian of the Year’ award through the Long Island Academy of Nutrition and Dietetics. Rayna has co-authored abstracts for poster presentations within the American Institute for Cancer Research conference, as well as, the Nutrition and Dietetics Food and Nutrition Conference Expo and subsequent publication. She has enjoyed authoring articles, including an article for The Cure magazine regarding Multiple Myeloma and nutrition. When Rayna is not participating in nutrition related activities, she is dedicated to dog rescue.

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