28 Oct The do’s and don’ts of exercising with colorectal cancer
Colorectal cancer (commonly referred to as bowel cancer) is the third most commonly diagnosed type of cancer in Australia. It occurs when abnormal cells in the colon or rectum grow and multiply out of control. Lifestyle choices can influence risk of colorectal cancer. For example, there is convincing evidence that being physically active reduces the risk of colon (but not rectal) cancer; in one large study people who did more exercise had a lower risk of colon cancer than those doing less. But it’s not just about prevention… Exercise can be beneficial for those undergoing treatment as well. Here’s what you need to know about exercising with colorectal cancer.
TREATMENT AND SIDE EFFECTS
Treatment for colorectal cancer depends on whether the disease has spread or is likely to spread and may include surgery, radiation therapy and/or chemotherapy. Common side effects are bowel symptoms, fatigue, pain and bloating, tingling/numbness/pain in hands and feet and psychological distress. Some people also report worsened sexual functioning and urination. In some cases (less than 10%), surgery to remove the tumour means that the bowel cannot be joined back together, and a temporary or permanent opening is created (i.e., a stoma) for the collection of body waste in a colostomy bag.
BENEFITS OF EXERCISE
Exercise during and after treatment improves quality of life and the ability to do daily activities, as well as reduces the frequency and severity of treatment-related side effects. Exercising after a diagnosis of colorectal cancer has also been associated with reduced risk of the cancer recurring and improved overall survival. Emerging evidence also suggests that exercise may improve recovery from surgery and increase ability to complete planned chemotherapy.
TYPES OF EXERCISE RECOMMENDED
Moderate-to-high-intensity aerobic and resistance exercise is safe and beneficial during and after treatment for colorectal cancer. If one is not currently exercising then it’s recommended to start gradually and progress slowly. If exercising for extended blocks of time (e.g., 20 minutes or more) is too hard or increases fatigue, then exercise can be done in shorter bouts of 5 minutes and completed multiple times in a day.
EXERCISING WITH A STOMA BAG
Exercising with a colostomy bag can have its challenges, but it is not a reason to avoid exercise. Sometimes there are weaknesses in the abdominal wall due to the surgeries related to treatment and stoma, and care is needed to protect this area during exercise.
Exercises to avoid
Avoid increasing abdominal pressure (e.g., holding breath during exercises/Valsalva) and protect the stoma bag during swimming or exercise in which the bag may be bumped (e.g., contact sport) or pierced (e.g., rock climbing). Compression garments, high-waisted underwear or exercise clothing, waterproof dressings and stoma-specific belts, guards or swimwear may help remove some of the barriers to exercising with a stoma bag and protect both the bag and the abdomen.
Asking for help
A stoma nurse and experienced dietitian are invaluable resources to support problem solving issues such as stoma bags becoming dislodged during exercise or risk of dehydration. An exercise physiologist can help to modify exercises and activities to reduce intra-abdominal pressure or movements that are awkward or painful because of the stoma bag.
Expert Contributor: Dr Rosa Spence, Accredited Exercise Physiologist, Queensland University of Technology