Interesting article that may not make the OCF newsfeed since it does not mention oral cancer at all, but rather deals with
[quote]Fatigue is the most common distressing symptom within the cancer experience.[1�4] Associated with all cancer treatment modalities, cancer-related fatigue (CRF) is differentiated by its predominance, its interference with normal daily functioning, and its unresponsiveness to usual attempts to reduce the subjective sense of tiredness. Its enduring nature across the cancer trajectory distinguishes it as a deterrent to a good quality of life, both during and after cancer therapy.[/quote]
One possible remedy for CRF noted is
[quote]Physical activity has the strongest supportive evidence as a nonpharmacologic intervention for management of CRF.[11] Yet there is a paucity of information about the older adult�s experience with exercise during the cancer trajectory. [/quote]
Here is the link to the full article.
The Debility of Fatigue in Older Cancer Patients
I was disappointed that this article overlooked a primary cause of CRF: Thryoid damage. Taking those pills and hitting the gym helped eliminate my CRF. Although I am still tired of having my feeding tube
Charm

Another article, not specfically oral cancer, but documents how EXERCISE is especially good for us cancer survivors.
Physical Activity in Cancer Survivors Associated With Better Health Outcomes
T[quote]he study, led by Rachel Ballard-Barbash, MD, Applied Research Program at the Division of Cancer Control and Population Sciences at the NCI, analyzed published observational and randomized controlled studies on the link between mortality, cancer biomarkers, and physical activity among cancer survivors.
Overall, all evidence points to the benefit of exercise in terms of quality of life as well as actual mortality outcomes.(emphasis supplied by me) [/quote]
So drop and give me 20 pushups - just kidding. Relax and do a nice downward dog.
Charm

And to jump start that so important excercise after treatment the Livestrong at the Y program gives you six weeks with specialized trainers that help you work out and then a modified stretching session at the end. You go about 2 times per week plus your entire family has a free YMCA pass while in the program. It is a great program and free for cancer survivors.

Ed

Charm and Ed - You have NO idea how much I appreciated your posts!! It's almost uncanny how they came at just the right time! I've been concerned recently about my son, Paul who, although doing so well in every way, has gained weight a little past what he should have and he does get tired more easily than before OC. On Thursday when I picked up his daughter (almost 12yr old) at school and brought her to his house, I patted his tummy and mentioned his weight gain. He said he was adding bulk so in case he gets cancer again he'll be ahead of the weight loss game. I just made a copy of all the posts and emailed it to Paul. I've learned from past experience with him that when info comes from other experienced and knowledgeable people, he notices it more than when it comes from just me. So - thank you, thank you, thank you!!

Anne Marie

Thank you for the kind words. Actually Eric S is visiting me this weekend and his story is a perfect example of the major rehabilitative effects of exercise for cancer recovery.
Let Paul know that adding "bulk" in the form of fat is not going to see him thru any recurrence (God forbid such a thing happens)
Adding lean muscle mass is another matter. Also, since Paul is a guy, I'm adding that all the studies show that exercise such as weightlifting adds lean muscle mass which INCREASES TESTOSTERONE which is otherwise adversely affected by radiation. Or as they say on the streets: pump up to man up.
Charm

I have so much to say on this topic its not even funny. I'll expand my thoughts when I get back home and don't have to type on my phone...stay tuned!

Thanks so much! You guys light up my life! Another great post, Charm - I'm making a copy for Paul. And Eric - I'm looking forward to your further thoughts on exercise or anything else that impacts, influences or enhances recovery and fun after OC.

I couldn't wait to get back on my bike but I was very weak for a good 4 months post Tx nad then of course they found my badly damaged thyroid which played a role but mentally I was there as if I had a chip on my shoulder. Back on the bike was scary at first but after about a month to 2 months I was riding better than I had in years.

I lost so much weight I was on a 4,000 cal/day diet for many months without any weight gain,walking, riding the bike, working outbut nothing seemed to work. Then one day I recal my Otolaryngologist asking me if I remembered the day he told me to eat everything in sight and get that weight going back up. When I said emphatically YES. His next remark was that I could feel free to go back to my normal diet as soon as possible. That was a great feeling and the yard loved me again.

Ed

Because there is so much to say on this topic, I'm not quite sure where to begin really, so I guess I�ll just pick a point and dive in...so, here we go (smile)!

First, Cancer Related Fatigue (CRF), one of my favorite topics actually, and if you read my earliest posts on OCF it was a major issue for me, and still is in some aspects. Understand that CRF isn't very well understood by our medical community and there is more to it than just thyroid issues and TSH levels, although that is one contributing factor.

Depression, anxiety, medications, poor diet, massive muscle loss, lack of physical activity, dehydration, sleep disorders, anemia, and chemical/hormonal imbalances are all culprits of fatigue, not just thyroid issues. When we consider the massive assault our bodies suffer through treatment, it's a wonder most of us get out of bed in the morning at all. We sure don�t want to.

Our bodies really are a delicate system and everything we experience from daily life, work, family, diet, exercise, mental outlook etc affect the way we feel due to hormone response.

Understand that controlling hormone response is the key to the way we feel and the way our bodies respond to stimulus. To get it to do what we want, we have to understand those responses and control them the best we can. Arguably, the two most important hormones when it comes to mood control, well being, and muscle development, recovery etc are cortisol and testosterone.

Cortisol is an important hormone in the body, secreted by the adrenal glands and involved in the following functions and more:

Proper glucose metabolism
Regulation of blood pressure
Insulin release for blood sugar maintenance Immune function Inflammatory response

Normally, it�s present in the body at higher levels in the morning and lower levels at night. Although stress isn�t the only reason that cortisol is secreted into the bloodstream, it has been termed �the stress hormone� because it�s also secreted in higher levels during the body�s �fight or flight� response to stress, and is responsible for several stress-related changes in the body. Small increases of cortisol have some positive effects:

A quick burst of energy for survival reasons, heightened memory functions, a burst of increased immunity, lower sensitivity to pain, helps maintain homeostasis in the body.

While cortisol is an important and helpful part of the body�s response to stress, it�s important that the body�s relaxation response be activated so the body�s functions can return to normal following a stressful event. Unfortunately, in our current high-stress culture, the body�s stress response is activated so often that the body doesn�t always have a chance to return to normal, resulting in a state of chronic stress.

Higher and more prolonged levels of cortisol in the bloodstream (like those associated with chronic stress) have been shown to have negative effects, such as:
Fatigue
Impaired cognitive performance
Suppressed thyroid function
Blood sugar imbalances such as hyperglycemia, decreased bone density, decrease in muscle tissue, higher blood pressure, lower immunity and inflammatory responses in the body, slower wound healing, and other health consequences.

Increased abdominal fat is associated with a greater amount of health problems than fat deposited in other areas of the body. Some of the health problems associated with increased stomach fat are heart attacks, strokes, the development of metabolic syndrome, higher levels of �bad� cholesterol (LDL) and lower levels of �good� cholesterol (HDL), which can lead to other health problems.

To keep cortisol levels healthy and under control, the body�s relaxation response should be activated after the fight or flight response occurs. You can learn to relax your body with various stress management techniques, and you can make lifestyle changes in order to keep your body from reacting to stress in the first place. The following have been found by many to be very helpful in relaxing the body and mind, aiding the body in maintaining healthy cortisol levels:

Guided Imagery
Journaling
Self-Hypnosis
Exercise
Yoga
Listening to Music
Breathing Exercises
Meditation
Sex (Favorite!)
& Other Techniques or medications

Cortisol secretion varies among individuals. People are biologically �wired� to react differently to stress. One person may secrete higher levels of cortisol than another in the same situation. Studies have also shown that people who secrete higher levels of cortisol in response to stress also tend to eat more food, and food that is higher in carbohydrates than people who secrete less cortisol. If you�re more sensitive to stress, it�s especially important for you to learn stress management techniques and maintain a low-stress lifestyle.

Testosterone is the other key hormone in our bodies and in men, really "the" most important hormone. Testosterone is a steroid hormone from the androgen group, and is primarily secreted in the testicles of men and the ovaries of females, although small amounts are also secreted by the adrenal glands. It is the principal male sex hormone and an anabolic steroid.

In men, testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate, as well as promoting secondary sexual characteristics such as increased muscle, bone mass, and the growth of body hair. Testosterone is also essential for health and well-being as well as the prevention of osteoporosis.
On average, men produce about 8 times more testosterone than women.

Stress, medications like anti-depressants and narcotic pain killers actually constrain testosterone production in the body, affecting almost literally everything from our moods, recovery/healing etc... At the same time stress and depression are spiking our cortisol levels, severely affecting our digestion/absorption and insulin levels. This coupled with the bodies hormone response that accelerates our immune response to fight cancer also inhibits digestion/absorption and at the same time, increases the need for amino acids and proteins. All of this leads to a condition called Cachexia, or cancer-related wasting syndrome.

When our bodies lose weight during treatment, it's not generally adipose tissue (fat, stored "energy") instead its lean muscle mass.
The body kicks into a hyper-metabolic state during treatment, as we well know, and is burning calories at an incredible rate trying to heal itself from the treatments, maintain "normal" body functions, as well as trying to fight off the cancer. Due to the poor digestion/absorption environment caused by hormones, the body has no choice but to start cannibalizing itself, with lean muscle tissue being the fastest/best burning fuel. This is one of the reasons that cancer patients look so "flappy," with lose skin, no muscle tone, and high body fat percentage.

This loss of lean muscle mass is also a huge cause of weakness and fatigue after cancer. With the bodies constrained testosterone and high cortisol levels post treatment, recovery is generally slow which is why we feel so "blah," along with most certainly thyroid issues and lingering effects of pain medications. The key to getting back up to speed? Nutrition and Exercise, Baby!

When I said before that nutrition is half the battle to fitness and health, I sincerely believe that. We have to understand that "what" we eat is as important as how much we eat and when we eat. A calorie isn't just a calorie, top level athletes and trainers have known this for "years". Everything we eat matters if we want to run at the "best" our bodies can. It's crucial to know the proper breakdown of macro-nutrients in our diets to promote the best hormone response as carbs affect cortisol levels in the body, fats help testosterone levels and cell repair, proteins provide the building blocks to all of our lean muscle mass. It's a balancing act using food to control the most important hormones in your body.

Knowing when to eat and what to eat and how much to keep your metabolism functioning, boost immune function, control hormone response, build or maintain lean muscle mass is paramount. You "are" what you eat! Nutrition isn't just "energy," it's what we're made of and who we are, and is the key to healing and rebuilding.

Exercise is phenomenal for almost anything that ails you. Due to hormone response from physical activity, exercise is as effective as anti-depressants at treating depression. Exercise is the only way to rebuild lost muscle mass due to hormone response, namely testosterone which is the key to protein synthesis. Exercise helps every part of our being and when used in conjunction with solid nutrition it can be the key to amazing recovery. I think I'm an example of that, really!

Anyone who's met me in person or followed me on Facebook or these forums can see what a testament I am to good nutrition and exercise...and hard work. It's also allowed me to go from a paltry, sickly 140 lbs (at 5'8") to 175 lbs of solid muscle. Hate to brag, but, I look impressive, and despite the issues I face from treatment, I lead a really active schedule. I've been able to do some amazing things I'm very proud of and I attribute a large part of that success to nutrition and exercise. As there is a direct link between muscle mass percentage and cancer survival rates, I'm going to keep lifting and eat right to give myself the absolute best chance at surviving.

Sorry for the book...I have no idea if any of this makes sense at this point, but hope it helps. These are my thoughts for what they�re worth (Smile!)


Eric