"Feel alive again!"

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People with cancer often feel weak and in need of rest. But doctors advise exactly the opposite of idleness: exercise! In the interview, Prof. Martin Halle * explains what regular exercise brings for cancer patients

Prof. Halle, in the past, doctors recommended that cancer patients take it easy, today they should definitely not stay on the couch. Why?

A person with cancer needs a strong immune system to fight the tumor cells. And this can be boosted with sport. The fitter you go into an operation, radiation or chemotherapy, the better you can survive it. Cancer patients tell us that they tolerate the therapies better and that they feel better - that's crucial. What we don't know is whether the side effects are actually decreasing or whether the patient's perception is simply changing. Doctors also report another effect: those who are physically active are more likely to go through with the therapies and not stop them because the side effects are so bad.

What does exercise mean for the soul of a cancer patient?

After the diagnosis, a cancer patient often falls into absolute passivity - doctors have sovereignty over the therapies and shower him with it, he himself feels completely foreign-controlled. It is extremely important for his emotional well-being that he can be active himself. During exercise, patients gain a new sense of their body and notice: I can put pressure on myself, increase my performance and achieve things that I could no longer do. Usually there is rapid progress, and sport is also fun.

Even during chemotherapy, you recommend a bike ride on the ergometer rather than lying in an armchair.

Exactly. I believe that a certain amount of stress during and after chemotherapy would make more sense than lying down quietly. However, it is important that you do not exceed your stress level. However, many patients believe that they need to lie down and gather strength. Doctors, too, used to think that exercise put a strain on the immune system, sending sick people down to the basement with strength and ensuring that a cancerous tumor becomes all the more active. We know better today. Exercise has a positive effect.

How does exercise work during an anticancer drug infusion?

This is not yet entirely clear, but exercise probably improves the transport of drugs into the cells. In addition, the blood circulation gets going and the body can better remove pollutants and dead cells. Dialysis is known to be 30 to 60 minutes faster if the patient is active during the blood cleansing.

There are cancer patients who trained for a triathlon during their chemotherapy. Isn't that a bit much?

Probably nothing speaks against it as long as the infusion does not damage the heart, i.e. is cardiotoxic. But nobody really knows whether this might not have negative effects. That is why I would advise against such extreme loads.

Which measure is the right one then?

Cancer patients should be able to talk to each other without any problems during their activity, i.e. not exercise too intensively. Duration is more important than intensity. However, the first priority is to test the patient's resilience and to create an individual training program. For example, it would be possible to ride a bicycle for ten minutes three times a day or take a quick walk.

I would only start strength training after completing the acute treatment and with a little training experience, if the patient wants to add a little more. Another decisive factor in tumor patients is that they need longer periods of rest than healthy people to regenerate. A day's break is the right amount, because after two days the training effect will wear off again.

Are there cancer patients for whom exercise is absolutely not helpful?

Definitely, for example patients in whom chemotherapy can impair the pumping function of the heart. I would be careful here, that would probably be too risky. Patients with an infection are also not allowed to exercise under any circumstances - the heart can also be damaged.

Sport is also supposed to improve the prognosis for cancer. And how?

The muscles not only move bones and joints, but can also influence other body systems - and thus also the development and spread of tumors. Studies on cancer patients suggest that the muscles release inflammatory messengers, the cytokines, during exercise. And these can suppress the degeneration of cells.

In addition, physical activity can lower the risk of cancer by regulating blood sugar levels. An increased blood sugar level promotes cell division and contributes to the development of cancer. Fat loss through exercise also plays a role - obesity is linked to various types of cancer such as breast or colon cancer. And with these types of tumors, we also see the greatest effects of training.

What numbers are we talking about exactly?

For breast cancer, walking briskly four hours a week reduces mortality by 40 percent after ten years. Colon cancer patients who are physically active after diagnosis reduce their risk of death by 50 percent. Even if fewer patients benefited, that would be worth a lot. That would be better than some new drugs. So there is enormous potential in sports therapy.

Some experts call for exercise to be prescribed like a drug.

A prescription is binding because it is an official letterheaded document. The patient does what it says on it. Hopefully. And it serves the exchange of information between doctor and patient. When I write a movement recipe, it says exactly when the patient should do how much and what. For example, the recipe could be: Nordic walking, 2 times 20 minutes a day, pulse 125 - such a specific instruction helps the patient. For the future, I imagine that you will go to a center with a movement recipe and be treated there in a goal-oriented manner.

Many people are not sportive who cannot outsmart their inner weaker self.

You're right, but it is different with tumor patients than with overweight people, for example. I don't have to persuade them, the cancer patients themselves are very motivated. Your bastard is pretty quiet.

Finally, a personal question: What is your driving force?

When a cancer patient stands in front of me and says: 'I have felt alive again since your therapy', then I know that I am doing the right thing.

Prof. Halle, thank you for talking to us.

* Prof. Martin Halle is the Medical Director of Preventive and Rehabilitative Sports Medicine in Munich. He is currently preparing a study on the influence of lifestyle in the genetic burden of breast cancer. He is also working on a training program for colorectal cancer patients.

Tags:  eyes womenshealth gpp