Testicular cancer resource center

The Healing Power of Movement

by Lisa Hoffman, M.A. with Alison Freeland

Perseus Publishing, 11 Cambridge Center, Cambridge, Massachusetts 02142 USA; www.perseuspublishing.com

Softbound; ISBN 0-7382-0540-0; c. 2002; 92 pp; $15.00 (US)/$22.95 (CAN)

The Healing Power of Movement by exercise physiologist Lisa Hoffman, MA and journalist Alison Freeland encourages moderate exercise to aid people who are undergoing cancer treatment. Until recently oncologists had encouraged only gentle stretching or relaxation techniques for their patients in the belief that active exercise would use energy needed by the body to fight cancer. Then, bicyclist Lance Armstrong, who had recently undergone surgery and chemotherapy for testicular cancer, won the Tour de France in 1999. His widely publicized experiences as well as recent studies have encouraged the incorporation of exercise during cancer treatment. Drawing on research, the advice of doctors with whom she has worked, and her own professional experience, Lisa Hoffman has created a step-by-step guide for patients who seek to retain or regain strength and energy.

Moderate exercise has both physical and psychological benefits. Although extreme exercise has been shown to depress natural killer cell activity (natural killer cells protect the body against viral infections and cancer), moderate exercise actually boosts the immune system. It also strengthens muscles, increases energy, and prevents stiffness whereas inactivity leads to muscle and bone loss, fatigue, and depression. In addition, moderate exercise relieves stress and anxiety held in the body as well as depression.

Lisa Hoffman is keenly aware of the physical challenges experienced by people who undergo chemotherapy, radiation therapy, stem cell or bone marrow transplants, hormone therapy, and surgery. The goals of the exercises in her book are modest. The first is to create a feeling of control during a very vulnerable period by providing a simple routine that a patient can follow, regardless of his/her physical capability. The second is to prepare the physical body for resuming daily activity -- such as walking to the bathroom, carrying groceries, and getting dishes from a cupboard shelf.

The Healing Power of Movement illustrates specific exercises for each level of physical ability -- from those who are confined to a bed and too weak to stand, to those who are able to walk, bike, or swim and perform regular daily activity. Because no "explicit" exercise standards for people in cancer treatment exist, Lisa Hoffman advises patients to consult their doctors about limitations and to use common sense. She says: "Contrary to the mantra of 'no pain, no gain,' cancer patients should not repeat movements if they have significant pain. Additionally, you may have to adapt exercises to accommodate a part of your body that has undergone surgery." She gives the example of a breast cancer patient who uses an eight-pound weight in one hand and a two-pound weight in the other, which is the same side as her surgery. Ms. Hoffman also emphasizes the importance of listening to the body and honoring the times when a simple arm press is as much exercise as one can manage. She suggests following the American Colleg e of Sports Medicine's guidelines of exercising three to five days a week, for twenty to thirty minutes, which can be stretched out with rest breaks throughout the day if necessary.

The exercise program that Lisa Hoffman recommends is a combination of weight training to strengthen muscles, stretching for flexibility, and aerobic exercise in the form of walking or cycling for cardiovascular and overall fitness. "From my years of experience working with different kinds of patients and survivors, I've seen walking alone simply doesn't cut it," she states. The exercise program for the bedridden includes deep breathing, pelvic tilts, arm presses toward the ceiling with the help of a partner, alternating knee lifts, leg lifts, ankle circles, and towel push-outs as well as some stretches. Ms. Hoffman says that people who feel really sick and exhausted do not feel like moving. She says: "It's likely the motivation will come from someone else, and that's why it helps to have a caregiver or a friend or family member who will stand by your bed and encourage you to give it a try. The movement won't hurt you. Continuing to lie motionless will." Succeeding chapters give chair exercises for those who need to restore and increase lower and upper body strength in preparation for standing and walking and standing exercises designed to increase balance and endurance. An extensive physical activity chart lists considerations and physical activity recommendations for each cancer therapy.

Even though The Healing Power of Movement is designed for persons recovering from cancer treatment, this program can benefit anyone who is bedridden or feels debilitated. By following these simple exercises with their clear illustrations, patients can make a valuable contribution to their own recovery. The Healing Power of Movement is a wonderful resource for patients and doctors alike.