By Julie K. Silver, MD

After cancer treatment, people are often elated that the worst is over and then quickly sobered by the fact they don’t feel well. Cancer is a disease that takes a tremendous physical and emotional toll. Reclaiming our lives has to do with working to heal our bodies and our minds. They go hand in hand and are so intimately linked that as one mends, so does the other. 

Most people know that if you exercise, your mood will likely improve. Working your body helps your mind and vice versa. Of course after a cancer diagnosis, there is a lot of work to be done to heal and that can seem overwhelming and terribly discouraging at times. But it is helpful to remember something Confucius said: “A journey of a thousand leagues begins with a single step.” In this article, I will offer advice about how to literally take the first step toward healing.

When it comes to physical healing after cancer treatment, your body will do a remarkable job on its own. However, those of us who specialize in rehabilitation medicine—the health specialty concerned with physical recovery after serious illness or injury—know there are some specific things people can do to help themselves heal faster and better. One of the ways to promote the healing process is to start moving your body. That’s right, exercise. But not just any exercise—therapeutic exercise, or what rehabilitation specialists call “ther ex.”

Therapeutic exercise is designed to specifically combat the effects of serious illness or injury that leave people weak and tired. For anyone who has been through cancer treatment, a major part of healing involves recovering from the “deconditioning” that occurs because of immobility and sometimes bed rest. One of the most striking effects of bed rest happens at the muscular level.  Research has shown that people on bed rest lose up to 1.5 percent of their strength each day for the first two weeks. Marked losses in muscular strength occur even in those who are not on bed rest but who become sedentary because of a medical condition such as cancer. Ironically, losing strength in muscles occurs with no effort and happens extremely quickly, while gaining strength back takes considerable effort and occurs much more slowly.   

Strengthening your body and working to build up your stamina will help reduce pain and fatigue and will almost certainly improve your mood. Although I always recommend that people check with their doctors before beginning to exercise, almost anyone (notable exceptions include those with serious heart or lung problems) can safely begin this first step before they consult their doctor.  However, as you progress, be sure to check in with your physician.

The first “step” is to literally count your steps. I recommend buying a pedometer (these are inexpensive and can be found at most sporting goods stores and there are many online dealers). Obtain one that specifically counts the number of steps you take daily, and record your steps for a week. Your six-week goal should be 5,000 steps per day. That means wherever you start, increase gradually by a few hundred steps per day in order to reach the 5,000 mark. Once you reach 5,000 steps per day, your next goal is 10,000 steps per day. You can usually accomplish this over a period of six to 12 weeks. Between 5,000 to 10,000 steps per day is a good range for most people.

Using a pedometer is one way to increase your activity level and improve your overall conditioning and endurance. You’ll start feeling much better as you are able to increase the number of daily steps you take. However, there is more you can do to help yourself heal. Ideally, you should do a little strength training, too.

People who do some strength training, whether they use weights, resistance in the water (pool), medicine balls or bands, work their muscles in a different manner than what can be accomplished by other means, such as walking. Strength training is easy to do but if you are new to it, you should get some professional advice. Talk to your doctor about getting a referral to see a physical therapist or a knowledgeable personal trainer who can suggest specific strengthening exercises and explain how to advance them once they become too easy.

If you are reading this article and my advice seems like something that might help you, then consider ordering a pedometer before you leave your computer. That way, you can get started on your healing journey right away.

Julie K. Silver, MD, a breast cancer survivor and the author of After Cancer Treatment: Heal Faster, Better, Stronger (Johns Hopkins Press, 2006), is an assistant professor at Harvard Medical School in the department of physical medicine and rehabilitation. Dr. Silver is the founder and director of RESTORE (www.cancer-rehab.org), a multidisciplinary program that focuses on physical recovery after cancer treatment. She is a recipient of the 2006 Lane Adams Quality of Life Award given to caregivers by the American Cancer Society.