Following on from the presentation with Professor Robert Thomas and Lizzy Davis discussing the benefits of physical exercise, we ran out of time to answer all of the questions so Professor Thomas and Lizzy have documented their responses below:
 

How much exercise is needed in order to hit the 30-40% reduction in risk of recurrence?

Hi, much of the evidence has focused largely on breast, prostate and colorectal.  Ideally meeting the recommended guidelines, but several studies have found that doing more than this can increase these figures, especially in breast and colorectal.  There are obviously additional factors to address as well, such as body weight, diet, stress, other health related problems.  Here are a few research links but as always more research needed to explore other cancers;



I have had cancer in the past and am well but want to stay well and prevent recurrence.  I am aware that as we get older our muscle mass reduces how can we stop this and build our muscle?

Regular strength training, ideally 2-3 sessions each week.  This will help to strengthen bones and muscle mass.  Try to seek the support from a certified exercise professional if this is something you haven’t done before.  


What is your thought about rebound as a form of exercise to reduce the chance of a cancer to reoccur?

I don’t know of any evidence to support this.  I do know that rebounding is great for the lymphatic system, so it’s a boost to your immune system for sure. 


How can we find a professional who familiar with different types of cancer and stages of cancer, so that we can get the most helpful programme?

CanRehab is the major provider of Level 4 Certified Cancer Rehab Trainers/Specialists.  Try contacting them to see if they have a database of professionals. Alternatively, you can visit The Register of Exercise Professionals (REPS) and search for someone there.


This may be more of a dietician question. Calories get burnt while exercising, what should one be eating after after so as not to feed cancer but make sure one does not loose weight?

I’m not a Nutritionist so always tend to steer people in that direction. That said, this is my list of favourite foods to try and include.  Here’s link to a website I recently came across and her suggestions when training. https://anitabean.co.uk/recovery-nutrition-what-to-eat-after-a-workout/ 

My go-to foods to help aid muscle recovery are (dependent on people’s diet naturally) those rich in protein, complex carbohydrates, minerals and vitamins - plus plenty of hydration. 

•    Cottage cheese (casein protein is a slow acting protein)
•    Sweet potato (high in complex carbs; vit A and potassium)
•    Watermelon (largely water; high in vit C, vit A and potassium)
•    Salmon (high omega 3’s; ideally wild salmon not farmed; protein; vit B; potassium and selenium)
•    Eggs (rich in protein; this aids amino acid repair)
•    Spinach (packed full of pretty much everything; I always recommend the dense, earthy spinach, less so the baby kind; rich in minerals and key electrolytes) 
•    Bananas (carbs; potassium; vit B6; vit C; magnesium and fibre; can help to reduce cramps and muscle soreness)
•    Turmeric (root kind; or good supplement like PUKKA; pro anti-inflammatory)
•    Nuts and seeds (walnuts; brazils; chia seeds; flax seeds; hazelnuts
•    Green tea (packed with catechins; boosts metabolic rate)


Your tips are excellent. For people who are NED but who can't afford financially to seek one to one expert help, are there any resources you can recommend to help them get started with an exercise programme safely?

I’m always happy to help get you going so please do free to contact me at lizzy@canexercise.co.uk
 
I’ve always thought Carol Michaels’ book is a good starting place.  Her focus is strength training and stretching and she addresses side effects in the book and her recommendations: https://www.amazon.co.uk/Exercises-Cancer-Survivors-Carol-Michaels-ebook/dp/B00HTAEVR2/ref=sr_1_1?dchild=1&keywords=carol+michaels+cancer+exercise&qid=1601396501&sr=8-1


More info re the cancer-related medical advantages of exercise please!

There’s so much research and evidence now Leslie, I could email you for hours. The team at Edith Cowan University in Perth, Australia are leading the way in exercise and cancer. This short video sums it up: https://www.abc.net.au/catalyst/exercise-and-cancer/11016526 Check out Professor Robert Newton and Prue Cormie on YouTube. Lots of talks/presentations with medical evidence. 


What's the best way to do aerobic exercise to get out of breath, if you have limited mobility?

Using a recumbent bike if you can access one.  People often find water-based activities better as the body is supported by water.  I appreciate due to COVID these might not be possible. Walking with poles for stability; seated aerobics workouts (lots on YouTube); shadow boxing seated or standing will definitely raise your heart-rate. Compound movements (moving more than one muscle group at a time) will also raise your heart-rate.  Arm and leg mini resistance bikes are also great!


What would you suggest for patients who are on Aromatase Inhibitors and suffering from side effects of it like joint pains, stiffness, joint pain?

Movement is medicine.  My experience is that the less movement there is, the more discomfort there is.  Begin with low impact aerobic exercise (brisk 
walking/swimming/cycling).  Joint mobilisation daily to ensure range of motion is maintained at the joints.  Build up to 2-3 strength training sessions per week as building muscle will help to support the bones and joints. 

Keep a healthy body weight and regular stretching too will help with flexibility. 

Sometimes warm pads/cold packs can help too.  Apply warmth prior to exercise to encourage blood flow.  Cool pack can help reduce inflammation.  
Always build up your exercise slowly and progress with care.  Acupuncture can also help. 


I absolutely hate exercise... Are there any tricks to change my mindset?

Try to find something you like Tara and ask a friend to join you for support.  Try not to think of your movement as fitness training, instead think of it as health training.  Start with one small thing and try to stick to it, then build on that day by day.  

Think of ways to simply be more active each day.  Don’t sit – stand.  Use the stairs, not the lift.  Walk to the shops, carry your shopping home.  Get off bus/train one stop earlier and walk home. 

Maybe invest in a fit-bit to track your steps.  This can be very motivating. 

We have out-reached so much of our movement in the last 3 decades because of technology.  Reclaim that back – you don’t need to wear latex and join a gym or class.  Good luck..


When is the best time to exercise, after food or before food? Also I read about a study in Australian to exercise directly after chemo, would you advise that?

This trail in Australia is still on-going Louise so there’s no evidence yet to fully support that until the trail is complete. All of that is also taking place in very controlled environments to support patients. 

Fasting before exercise will help to burn calories, using fat for fuel.  If this is something suited to you.  If not, then a healthy meal a few hours prior to exercise is ideal.  Protein and complex carbs to fuel your efforts.