Exercising with CMLIf you’re having a bad day with your CML, exercise may be the furthest thing from your mind. While the day-to-day experience of CML is different for every person, many people struggle with treatment-related side effects such as nausea and persistent fatigue. It is totally understandable that you might not feel too inclined to lace up your trainers on those days when it’s a struggle to get out of bed.
However, staying active doesn’t have to mean running marathons or climbing mountains – and it’s simply untrue to say that exercising with CML is unsafe. Staying active, in a way that’s appropriate to your circumstances, can have incredible benefits for your mental and physical health.
The benefits
There is a wealth of research showing how exercise can help people who are living with cancer. Exercise has been shown to reduce chronic pain and tiredness. It boosts the immune system, meaning you have an easier time fighting off infections (although we don’t have enough evidence to say whether it has an impact on the CML itself).[i]
Through improving your heart health, staying active can even help stave off the cardiovascular side effects of some CML treatments,[ii] as well as reducing your risk of developing other diseases.
Just as importantly, exercise can help reduce anxiety, depression and chronic stress. Living with CML means dealing with a lot of uncertainty, which over time can take its toll. Through taking action to improve your mental health, you will be better placed to tackle these challenges.
How to add physical activity to your day-to-day routine
Activity guidelines recommend that adults get 150 minutes of moderate intensity exercise (or 75 minutes of vigorous exercise) every week, along with at least two sessions of strengthening activities. Moderate exercise means anything that raises your heart rate – think brisk walking, dancing or gardening – while strengthening activities can include yoga, tai chi or even carrying heavy shopping bags.[iii]
Of course, when deciding what kind of exercise to do, a lot will depend on how fit you are, as well as how much energy you have that day. If you haven’t exercised much before, it’s important to start very gradually – think about walking to the corner shop, or getting up every so often to do some light stretching. You don’t need to do a designated exercise session. Any activity is better than none, and there are many creative ways to incorporate movement into your daily routine.
It’s also important to think about what you enjoy the most, to stop exercise feeling like a chore. Some people enjoy exercise classes (including online classes, which can be done from the comfort of your own home) while others prefer walking with their friends in nature, dancing along to their favourite songs on the radio or even challenging themselves to try a new sport.
Consider setting some achievable goals and keeping a record of your progress. Exercising with friends or family members can also be a big help when motivation is flagging.
Precautions to take and where to get help
If you are dealing with pain and discomfort, it may be wise to try a lower impact activity such as yoga or Pilates. And if you have low immune function due to treatment, it is best to avoid places where you may be at risk of picking up an infection like gyms and swimming pools.
There is a whole world of online exercise programmes out there, tailored towards every ability. However, if you’re looking for something more specific, look out for cancer charities that run classes for patients undergoing treatment. You may also find it helpful to join a forum for people living with blood cancer, to discuss ways of keeping fit.
Above all, listen to your body – if you’re feeling exhausted, pushing yourself too hard will be counterproductive. Talk to your medical team if you’re dealing with extreme fatigue, or other debilitating treatment side effects that make exercise seem impossible. Over time, you will find a level and type of activity that feels right for you.
Useful Links:
Exercise guidelines:
https://www.cancerresearchuk.org/aboutcancer/coping/physically/exercise-guidelines
Building exercise into your life:
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/physical-activity-and-cancer/how-can-i-be-more-active
https://www.leukaemiacare.org.uk/support-and-information/information-about-blood-cancer/living-well-with-leukaemia/exercise/getting-more-active/
https://bloodcancer.org.uk/support-for-you/living-well/keeping-active/
The importance of exercise in CML:
https://media.leukaemiacare.org.uk/wp-content/uploads/Living-Well-with-Chronic-Myeloid-Leukaemia-CML-Web-Version.pdf
https://www.macmillan.org.uk/cancer-information-and-support/treatment/preparing-for-treatment/eating-well-and-keeping-active
[i] Sitlinger A, Brander DM, Bartlett DB. Impact of exercise on the immune system and outcomes in hematologic malignancies. Blood Adv. 2020;4(8):1801-1811. doi:10.1182/bloodadvances.2019001317
[ii] Ross DM, Arthur C, Burbury K, Ko BS, Mills AK, Shortt J, Kostner K. Chronic myeloid leukaemia and tyrosine kinase inhibitor therapy: assessment and management of cardiovascular risk factors. Intern Med J. 2018 Feb;48 Suppl 2:5-13. doi: 10.1111/imj.13716. PMID: 29388307.