Exercise Precautions During Blood Cancer Treatment

The benefits of exercise during cancer treatment are well documented. Regular physical activity can help you beat the treatment blues and control certain side effects such as fatigue and pain. But, patients with blood and bone marrow cancers like leukemia, lymphoma, and myeloma may have unique concerns when it comes to safe and healthy exercise. Here are a few things for you to think about before getting started or keeping up your exercise program.

Consider Your Blood Cell Counts When Planning Exercise

Blood and marrow cancers, as well as their treatments, can cause a decrease in the number of healthy red blood cells, white blood cells, and platelets that you have in your circulation. These lowered cell counts can make your exercise regimen risky or even unsafe.

• Low white blood cells (neutropenia): When your white blood cell counts are low, you have a decreased ability to fight off infections. At this time, you should avoid crowds and keep your exercise routine closer to home. Gyms, swimming pools, and locker rooms increase your risk of being exposed to a virus or bacteria that can make you sick. If you have a fever, don’t push yourself to exercise. Take some time off to help your body heal and recuperate.
• Low red blood cells (anemia): Red blood cells carry oxygen to your organs and tissues. When they are low, they may not be able to keep up with the increased demand put on your body during exercise. You may notice that you get tired much more easily and might have difficulty catching your breath when you exert yourself. During times when you have low red blood cell counts, you should back off on the intensity of your workouts, or avoid them altogether depending on the advice of your physician.
• Low platelet counts (thrombocytopenia): Platelets are responsible for forming clots in your body. When their numbers are decreased, you are more at risk of bleeding and bruising. For this reason, you should avoid activities in which you may be at high risk of falls or injury. You may choose to use resistance bands instead of heavyweights that you could drop. You should also stay away from contact sports during this time.

Safety First With Exercise During Cancer Treatment

In addition to cell counts, blood and marrow cancer patients have a few safety points to keep in mind:

• If you have a central venous catheter (CVC), you will need to make sure it is well secured before exercise activities. Tunneled CVC can be tucked into a sports bra, or taped or fastened to your body. Peripheral CVC (PICC lines) should be taped or wrapped securely to prevent them from becoming dislodged. Ask your health care team about activity limitations for your PICC arm.
• Patients with CVC and those who have received radiation therapy should also avoid swimming and hot tubs to prevent infection.
• Myeloma patients are at increased risk of bone fractures and damage. You should avoid high-risk activities and those with body contact.
• Exercise with a buddy, both to motivate you and keep you safe.
• Always check with your healthcare professional before starting any exercise program.

Exercise Emergencies to Be Aware of

Keep your healthcare team in the loop about your exercise activities and be monitored regularly (keep your appointments) to ensure that you aren’t putting yourself at risk with your program. There are times, however, when it can't wait for the next appointment, and you need to seek more urgent medical attention.

Get immediate help if you develop:

• Chest pain or palpitations
• Changes to your vision
• Dizziness
• Confusion
• Leg pain
• Sudden shortness of breath
• Unusual pain in your bones or joints
• Sudden nausea and vomiting
• Fainting spells
• Unusual bruising