How Do You Get a Person with Cancer to Exercise?

Andrea Branas, PT, MSE, MPT, CLT

September 28, 2015

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Question

How do you get a person with fatigue from cancer to exercise?

Answer

I have seen a lot of patients with cancer fatigue who have done well with exercise.  Patients are often reticent to do exercise.  They just tell me that I am crazy.  How can they exercise?  They are so tired.  If I can get them to start and get them to start moving, get them to take some deeper breaths, get them to get exercising, and teach them that putting one foot in front of the other, they will slowly progress to doing activity and they feel better.  Sometimes it is just getting over the hurdle of recognizing the exercise is safe.  They are very concerned that they are supposed to rest.  They need to know that exercise is safe and that doing it will make them feel better.  Once you get that one patient in, you can use that patient as a mental example to talk to your other patients about how they can be successful.  As I was thinking about this presentation and discussion, I have a patient in my mind that I saw over the course of last year.  He had had an allogeneic bone marrow transplant.  He is a patient who said he wanted to rest until he felt better.  He did that for so long and he was so deconditioned, that he literally could not walk down the hallway.  He came to therapy and we convinced him that slowly we could get back his energy and his strength.  I saw him only once a week, but over the course of probably 6 weeks, he participated in a home exercise program as recommended.  He did a lot of breathing exercises.  He did some stretching.  He started strengthening and his goal was to be able to get back outside and do gardening.  He was also a painter.  He did it all.  He came back and thanked me.  He said he never thought that he would get to be able to move again.  He did not think he would ever have that strength.  Because he was able to keep up with his exercises and really rebuild his strength and endurance, he was able to do that activity again. 


andrea branas

Andrea Branas, PT, MSE, MPT, CLT

Andrea Branas is a lead physical therapist at Good Shepherd Penn Partners in Philadelphia, PA.  Andrea works in the Abramson Cancer Center at the University of Pennsylvania Health System providing patient care, education, leadership and training in the area of cancer rehabilitation.  Andrea’s areas of clinical expertise include lymphedema, pelvic floor rehabilitation, breast cancer rehabilitation and exercise for cancer related fatigue. In her current role, Andrea uses her expertise to help cancer survivors reach their physical potential by promoting rehabilitation starting at the time of cancer diagnosis.  She is currently a collaborator on an NIH Funded Dissemination grant to look at strength training for survivors of breast cancer.   Andrea has served as a guest lecturer for women’s health and cancer content at Arcadia and Widener Universities and the University of Medicine and Dentistry in New Jersey DPT programs. Andrea received her Masters degree in Physical Therapy from the University of the Sciences in Philadelphia in 1998 and her Master’s of Science in Engineering degree from the University of Pennsylvania in 1991.  She is currently working towards her transition DPT at Arcadia University. 


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