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Reduced Mobility = Increased Mortality

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Reduced mobility might seem like it is not a big deal for cancer survivors. After all, we’re talking about cancer, right? I mean, we are fighting for our lives.  Fatigue, nausea, constipation/diarrhea, etc. make the patient want to stay on the couch.

That was my thinking during my active therapy including:

  • local radiation to both my neck (C5) and lower back (sacrum)
  • induction chemotherapy (vincristine, adriamycin and dexamethasone)-
  • high dose cytoxan aka cyclophosphamide-
  • autologous stem cell transplant (busulphan, melphalan)-

The problem is that surgery, chemo and radiation lead to side effects such as pain, nerve, organ and bone damage. Over time, once active therapy has long since concluded, these side effects can limit the cancer survivors mobility.

Since the conclusion of my active therapy my long-term and late stage side effects are brain, eye, nerve, joint and bladder damage.

Please understand that my experience is typical. If you undergo surgery, chemo and radiation during your active therapy, the odds are that you will if you live long enough you will experience similar long-term and late stage side effects as I have.

As the research linked and excerpted below cites, reduced mobility is linked to increased mortality in cancer survivors.

The solution? Less conventional treatment (toxicity)  and more exercise  before, during and after treatment. If you are reading this post before you have begun therapy, consider beginning pre-habilitation now.

Regarding the second highlighted paragraph below. I sustained years of radiation fibrosis (radiation scarring) since my radiation treatments in ’95,’96. My leg strength is minimal. But I can get to the gym every morning to exercise at least, a little bit.

Simply exercising more each day will keep you alive longer according to the research below-

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

The Link Between Ambulatory Dysfunction and Mortality in Cancer Survivors

“Individuals with cancer often experience reduced mobility that persists long after the completion of treatment. In a study of patients undergoing outpatient cancer treatment, the most common functional problem was difficulty walking,..

“The causes of ambulatory dysfunction are often multi-factorial and can result from

  • loss of muscle mass,
  • neurotoxicities including chemotherapy-induced peripheral neuropathy and
  • vestibular impairments, fatigue, pain, and vision changes…”

Along with a significant negative effect on well-being, quality of life, and independence, research has demonstrated a link between ambulatory dysfunction/reduced mobility and increased mortality among cancer survivors.2,3…

Lower ambulatory function (reduced mobility) was observed across 9 cancer types

  • breast,
  • colon,
  • oral,
  • prostate,
  • rectal,
  • respiratory,
  • soft tissue,
  • stomach,
  • and urinary cancers,

with the strongest associations observed in patients with respiratory and oral cancers.3…

“As for treatment, the more treatments someone has, the higher the potential risk of dysfunction is because symptoms and side effects can be widespread and cumulative,” she stated. “I would say that chemotherapy tends to be the biggest culprit in terms of dysfunction because the side effects and symptoms are widespread.” 

According to Dr Winters-Stone, it is also “possible that ambulatory dysfunction (reduced mobility) is a proxy for more aggressive cancer or multimodal therapies and thus is linked to mortality by association.”

However, she noted that ambulatory dysfunction (limited mobility) can increase the risk of falls, which can be life-threatening, as well as the risk of frailty.

In addition, a decline in physical activity due to disability can increase the risk of chronic illnesses and cancer recurrence, and “if dysfunction progresses, a person may be more likely to be placed in a care facility and have poor survival.”

Dr Salerno explained that, to her knowledge, this was the first study to explore the relationship between cancer history, ambulatory function, and mortality in 15 different cancer types..

As is the case within the general population, exercise in various forms — including

  • strengthening,
  • stretching, and
  • endurance exercises —

may be helpful in preserving function in cancer survivors. Dr Winters-Stone and colleagues have conducted multiple studies to explore the effectiveness of resistance training in preserving function in older cancer survivors. “For example, one of our studies found that resistance training reverses self-reported disability in [patients with] prostate cancer on androgen deprivation therapy — a type of treatment we have also shown increases the risk of frailty and falls,” she said.4,5…

Additionally, Dr Salerno mentioned a roundtable report6 from the American College of Sports Medicine (co-authored by Dr Winters-Stone) that “highlights strong evidence for the benefits of physical activity for reducing anxiety, depressive symptoms, fatigue, and lymphedema, as well as improving health-related quality of life and physical function, in cancer survivors.”

For patients who are unable or unwilling to engage in more formal types of exercise, efforts to reduce sedentary time and incorporate short bouts of movement into their day can be helpful, Dr Winters-Stone advised…

Aiming to increase “patients’ mobility during their hospital stay represents a key opportunity to prevent functional decline in both the short term and long term,” the authors wrote.2

Dr Winters-Stone noted that referral to physical therapy can be an excellent resource to improve physical activity in cancer survivors, and “given the role of muscle mass and weight in mobility, referral to a nutritionist might also help to ensure that patients have adequate dietary intake to preserve muscle and health.”…













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