Appropriate exercise not only strengthens the body, but also helps fight cancer
A study by the American Cancer Center that included more than 1.44 million people found that exercise significantly reduced the incidence of 14 types of cancer, and stomach cancer was one of them. Being overweight and obese is a high risk factor for stomach cancer, and regular exercise can reduce the incidence of stomach cancer by 23%. Exercise not only reduces the incidence of gastric cancer, but also improves the condition of gastric cancer patients through several mechanisms. Exercise increases the number of immune cells, accelerates white blood cell growth, and improves cellular antioxidants, which in turn slows the progression of gastric cancer and reduces treatment-related adverse effects.
Exercise options for different periods
The specific intensity and duration of exercise for patients with gastric cancer needs to be chosen based on the current treatment and physical condition.
Experts suggest that 1-2 years after gastric cancer surgery (especially after total gastrectomy) should be a period of adaptation and recovery of patients’ digestive function, and many patients have to undergo postoperative adjuvant radiotherapy and chemotherapy, etc. It is often difficult for patients to maintain normal weight due to insufficient nutritional intake or poor digestion and absorption, or due to the adverse effects of adjuvant therapy; at this time, if patients are blindly encouraged to do active physical exercise, such as brisk walking, climbing, or other physical activities, they may not be able to maintain normal weight. At this time, if patients are blindly encouraged to do positive physical exercise, such as brisk walking, mountain climbing, long-distance running, etc., it will further deplete the physical energy of patients, cause malnutrition and immunity decline, and seriously affect the prognosis of patients. Therefore, how to carry out scientific and appropriate physical exercise after tumor surgery is a very important scientific issue, and it is best to ask the opinion of the attending physician, not to judge by oneself.
48 hours after surgery
I believe that many people believe that they should try to stay in bed after surgery to avoid any effect on wound healing, which would be detrimental to the patient’s early recovery. In fact, this notion is wrong, and patients can instead promote recovery by getting out of bed early after surgery.
Within 48 hours of surgery, patients walking more than 500 steps is most effective for recovery of gastrointestinal function.
Patients who walked more than 500 steps within 48 hours after surgery had a significantly earlier time to first defecation, bowel movement, and food intake than patients with less than 500 steps of activity, and a significantly lower incidence of gastric weakness (defined as delayed gastric emptying, which can manifest as nausea, vomiting, bloating, and early satiety) than the latter.
So patients are advised to get out of bed as soon as possible within 48 hours after surgery, when they can be supported by their family members to walk around the ward. Early movement out of bed helps to reduce the incidence of blood clots and promotes faster recovery of the gastrointestinal tract and all body functions.
Stabilization and recovery
If patients with gastric cancer are recovering well, they can gradually increase the amount of exercise and choose exercises such as brisk walking, jogging, tai chi, and gymnastics according to their physical strength and habits. The center rate of the exercise process to 60%-75% of the maximum heart rate is more appropriate, where the maximum heart rate is (220 – actual age) times/min. Take a 60-year-old patient with stomach cancer as an example, the maximum heart rate is 160 beats/min, and it is more appropriate for the exercise process to reach the center rate of 96~120 beats/min. The intensity of exercise can also be described in terms of subjective sensation. Moderate intensity means that you feel “a little bit out of breath, but you can still talk”; if you are not out of breath at all, then the intensity is too low for you; if you are so out of breath that you cannot talk, then the intensity is too high.
Exercise is more effective when kept at the right heart rate, plus exercise should be gradual and measured.
Cautions during exercise
Because patients with gastric cancer (especially those who have undergone gastrectomy) are more prone to anemia and malnutrition, care should be taken to assess blood work before exercise. Patients with moderate or greater anemia (hemoglobin <80 g/L) should delay exercise and correct the anemia before exercising, but can perform normal daily activities. For patients with severe fatigue due to anemia and malnutrition, 10 minutes of light exercise (e.g., wiping tables, sweeping floors) can be performed daily.
Some patients have indwelling catheters during chemotherapy, and these patients should reduce or avoid factors that may cause infection, such as public pools, and in particular, patients with leukopenia due to chemotherapy should hold off on swimming.
In addition, these patients with severe pain, peripheral neuropathy due to chemotherapy (often manifested as numbness or tingling in the hands and feet, decreased balance, etc.), and bone metastases need to consult with their physicians before exercising.