Cancer-Related Deconditioning: A Serious Issue to Consider

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In my last blog, “Cancer Rehab Assessments Minimize Complications After Cancer Treatments”, I presented an overview of the possible complications of cancer and its treatments. As promised, we will now break it down by each complication and discuss how exercise and cancer rehabilitation may be able to help.

Of all cancer treatment complications, one of the most prevalent is cancer-related deconditioning. As defined by Wikipedia:

Deconditioning is the adaptation of an organism to a less demanding environment, or, alternatively, the decrease of physiological adaptation to normal conditions. Deconditioning may result from decreased physical activity, prescribed bed restorthopedic castingparalysisaging, etc. [1][2]  Deconditioning due to decreased physical effort results in muscle loss, including heart muscles.

Deconditioning related to the inactivity that may result from cancer and cancer treatments is a serious problem. It is the basis for why physical activity recommendations for cancer patients are beginning to change. More and more cancer patients are winning the fight against cancer- and in some instances many forms of cancer are becoming more of a chronic disease. It is because of this that the long-term effects on the body and on a persons general health are even more important to consider. In more recent years, large population studies have also identified a strong association between lower levels of physical activity and higher cancer mortality.

 Maintaining 30 minutes of activity per day has been associated with a 34% lower rate of cancer death and a 33% improved cancer survival

 All body systems are affected by cancer, its treatments and inactivity that can result. This blog will cover the musculoskeletal, respiratory and cardiovascular systems. First, the musculoskeletal system. Weakening of the muscles from not using them is more commonly known. However, not only do the muscles weaken from inactivity, but muscles shorten as well. This combination of weakening and shortening will cause dynamic muscle imbalances which can affect overall health of the joints, affects posture and can lead to a myriad of health problems in a persons lifetime to include pain, arthritis formation, tendonitis, osteoporosis in addition to activity intolerance which can affect every aspect of a survivors life.

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Cancer rehab can include: strength and endurance training education, cardiorespiratory fitness testing and exercise program prescription that will be safe for you.

 It is noted that even in healthy individuals on complete bedrest, strength declines at a rate of 1-1.5% per day or approximately 10% per week.

 The respiratory system is affected by cancer-related deconditioning and can become a serious complication if not managed. Patients who are not mobile and are recumbent (ie. Laying in bed) may suffer from life-threatening pneumonia, respiratory infections due to fluid building up causing shortness of breath and eventually can cause infection. In addition, the lack of use of the respiratory muscles (diaphragm and muscles in between ribs) also weaken, just as inactivity causes weakness in the extremities. Additionally, the rib cage muscles can become tight and decrease breathing ability even further (or increase the work needed to breathe).

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Cancer rehab can provide: education on deep breathing exercises, resisted breathing exercises, stretching and strengthening of the trunk and abdominal muscles, address rib cage tightness, identify and treat postural issues, prescribe strength and/or aerobic exercise programs which will help to improve respiratory function.

Another very important system that can be affected by inactivity is the cardiovascular system. While the potential complications are many (and will be addressed in its own upcoming blog post), an urgent life-threatening risk of a cardiovascular system deficit is a DVT or deep vein thrombosis. Bed rest, in association with other risk factors, may result in a blood clot in the venous system and the risk increases with the length of bed rest. In addition to changes in the “thickness” of the blood, prolonged compression of the veins may contribute to blood flow impedence. Cancer patients are even more predisposed to this sequelae. DVT’s, while dangerous on their own, can travel to other parts of the bodies and can be deadly.

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Cancer rehab can address: education on specific mobility recommendations, exercises that can be done in or out of bed to improve blood flow and maintain even a low level of activity.

It cannot be stressed enough how important physical activity is to cancer patients. It needs to be understood that while surviving cancer itself is a difficult journey, suffering from additional complications related to inactivity can make recovery more difficult, can affect cancer survival itself and can lead to serious lifelong complications.

 Cancer rehabilitation specialists are educated in the complications of cancer treatments and can work with you to effectively manage the late effects of deconditioning…and help to prevent it in the first place.

 

If you haven’t been referred to cancer rehabilitation, talk with your doctor to see if cancer rehab help.