Fitness freak here as well...

My first mistake was trying to " bulk up" by increasing my healthy diet. Two chicken breasts instead of one won't cut it. Got behind the eight-ball right off the bat. You need calorie dense (read "crap") stuff like gravy, ice cream, sweets.

Second, early on I did my usual 6 mile training run. That was actually the day after my first chemo and 3rd day of rads. Thing is, if they've given you a calorie target it is NET not gross. If you burn 600 you have to replace that plus your target or once again you're behind the 8-ball. I did really really well IMO because I was in shape so I guess it's a matter of finding the right balance.

I did my deal with no PEG and had to cheat on my weigh-ins to finish. Busted my red line weight the week after my last rads. I'm glad I did it that way but its hard. Being an athlete will help you a lot.

Welcome Rich,

1. In addition to the TSH baseline David mentioned, a baseline eye exam, testosterone, creatinine, and hemoglobin levels, with the last two are common with your blood test monitoring.

I underestimated chemo, so went in thinking I was stronger lol, not even knowing what chemo I was getting, just that it was Induction chemo. I was exercising during my week in the hospital, walking around, doing push-ups, using the room chair as weights, but things went down real fasttje 5th day.

As far as exercise, moderation. Excessive exercise can lower your immune system. I was a gym rat most my life since 15, was 245 before treatment, and lost 110 pounds in a matter of weeks. Maybe it was my exercise reigning that pulled me though from near death, which lasted 8 months, but some things may not be prevented, and just happen.

The other is going onto public places can expose one to infections with a compromised immune system, so precautions should be taken, limited, and with any yard work, even hospitals.

Definitely get the fluoride trays, prescription fluoride, and other oral care suggested. I didn't, long story, I knew about them, and did not want to even go near a hospital after my experience, so I went to a local one instead of an oncology one, and none were recommended. And went along with that. Again, I thought I was somewhat stronger lol, and now I'm going to need all my teeth removed due to deminerlization, cavities thuus breaking off, cracking, falling out.

Get copies of every blood test, scans, the cd's, reports, surgical and pathology reports. It's good for knowing, and for reference in the future, and would need for any consultations.

Many more like preparing yourself if things worsen, like seeing about finances, employment, benefits, not being able to work, insurance continuation. The social worker at the hospital pre-treatment even suggested filing for SSDI. I was like you're kidding me in my mind. Turns out I needed it, but didn't get a chance to file until 8 months later when I was released from the hospital, critical care nursing home, but had to learn about, apply, given contradictory information while in my hospital bed as fast as short term disability, long term disability, and employment benefits with

2. There are many studies with radiation alone in HNC vs with Chemoradiation, which has better outcome, but no difference in overall survival, I believe, which I can't figure out when Chemoradiation has fewer recurrences, more local-regional control, less distant metastases off the top of my head, but radiation alone does have less toxicities.

Good luck.

[quote=Bart]Hi Rich, welcome from another fitness freak. My recommendation to you is to keep to your workout schedule to the maximum extent possible while you go through your treatments.

I know it's counter-intuitive, I firmly believe (from my onw experience) that by keeping your metabolism elevated, it helps the body avoid the worst of the physical symptoms (mainly nausea) and allows the body to quickly metabolize and excrete the excess.

I had 8 weeks of rads, concurrent with three applications of Cisplatin. Unfortunately, I had a mediport implanted before beginning the chemo, and then I had to wait 6 weeks after the Treatments for a PET, meaning I couldn't even schedule the removal of the port until after the results showed no sign of active cancer. That kept me from working out for a total of 6 months.

I wasn't bothered by the radiation, but the chemo made me so nauseated I couldn't keep more than a single bottle of Ensure in my stomach, and lost 38 lbs (from a very solid 192, down to an emaciated 154.)

However, as soon as possible after the removal of the port, I got back into the gym and started working hard to rebuild my body. When a distant metastasis was discovered in my liver 18 months later, it was treated with Carboplatin and Taxol/Taxetere in 4 week cycles (3 weeks of one infusion/week, with the last week free.) During this treatment, I never skipped a day in the gym, and I never felt any nausea. Do the math. Keep working out, you'll thank me. [/quote]

Bart,

Thank you for this. This is an amazing thing for me to read and take hope from. I had planned to work out as much as possible and you have confirmed what I thought that it can help you heal so much faster or at least just make you feel better emotionally.

Interesting that you say that you weren't bothered by the radiation. That's all I'm having for now (they may do chemo at the end, but all doctors think it unlikely). Did you do anything special from that standpoint that you think helped?

Stay strong brother and keep inspiring people.

Thanks Rich.

I'm afraid that I don't have anything to contribute about the radiation. I have to assume that my reaction is a genetic accident, because I was caregiver to an ex-wife who had much less radiation and much more severe reaction to it.

I'm frankly completely mystified. I have a ring of scar-tissue inside my throat from the experience, yet I did not ever feel anything beyond the mildest possible discomfort at any point; and even that did not feel like it was connected to the radiation (i.e., no burning sensation ever.)

Hi Rich,

Welcome... you've received a lot of really good info. Just keep in mind the mantra "Everyone is Different".

The key is hydration, nutrition and pain control. Do the best you can but don't be surprised if you get hit upside the head.

Positive thoughts and prayers

"T"

The amount of Grays (Gy), fractions, field, location of radiated area are different in the type, location of cancer that can matter, like oral vs oropharyngeal, nodal or non nodal, and other involvement, where it's directed mainly, can be a reason for different effects, and so each person is different too with treatment. Good luck.

PaulB,

I read your comments about not working out too hard with considerable interest.

I've spent the last day pondering this, and after careful consideration, I have to say that I disagree with you conclusion about that, even though I agree with everything else you recommend.

My first Tx regimen was when I was 70, I'm 74 today and I'm taking Xeloda (my cycles are 14 days of 2500mg/day; followed by 7 days w/o chemo.)

I'm in my off-week of my third cycle and will have a PET on 10/1 (I start my 4th cycle on Monday) to assess progress on knocking down the latest set of tumors in my liver. This is my third recurrence, but won't be my last because I'm Stage IVc. (100% mortality in 5 years.)

Fatigue is probably the most common side effect of nearly any chemo, and I'm really feeling it in the gym right now. This week, I'm using to build back, but yesterday, when the concentration (of chemo in my system) was at its peak, I could only complete three of my rounds (a round is 20 pushups, 10 pullups and 10 dips). Tomorrow I hope to complete four; and by friday, five.

When I had my first recurrence, it was treated with IV infusions of Carboplatin and Taxol (later switched to Taxetere to reduce hearing loss.) Cycles were one infusion/week for 3 weeks plus a week off. I had a total of 7 or 8 cycles, and at least twice, was refused (did not get any chemo) because my immune system had crashed, or my red cells had.

Those were the only two times I missed a day in the gym (and a hard work out) in that 7 or 8 month period. My gym days are always M-W-F, and every other week, I was working out hard on the Friday after my infusion on Thursday.

Oddly enough, the Xeloda gives me more fatigue than the Carb/Tax mixture, but I still make a fairly quick recovery. I'll report tomorrow if I fail to get 4 rounds.

That's ok to disgree. Whatever works for you or anyone else, and don't disagree for the most part about working out. I have some do's and dont's for myself. Everyone is different, have different treatments, reactions, underlying health issues, and mentioning infections because they can be serious, turn for the worse quickly, with a compromised immune system like cancer, and chemo can lower them further, and reason they stop treaments sometimes due to a low WBC, so it was worthy to mention about excessive exercise, to my knowledge, and being in public places in case anyone is interested. I think I mentioned gardening too, which has baceria in the soil, cats like to frequent, and their feces can spread illnesses to humans. At least wear gloves, wash hands afterwards, some will say wear a mask, and definitely take precautions in a public pool or gym.

As far as exercising heavy can lower your immune system I still believe so, have read about it many times, and happened to me, friends of mine, who were heavy runners. Maybe our ideas of a heavy workouts are different? I'm talking 6, 7 days of heavy exercising, running, biking, or swimming, and serious weight lifting. 3 Days does not sound excessive, except if doing for several hours each time.

Good luck tomorrow.

Hi Paul,

I definitely agree when you kick it up to 6 or 7 days a week, and also agree that our ideas of "heavy workout" are different. Although I've done that, it's been a long time and not something I want to repeat. I salute you, you are a beast, and I mean that in the friendliest and most positive manner possible! Respect!

I've got too many body parts that no longer work to be able to pursue that path, even if I still wanted to, and I'm happy to keep memories of the past safely ensconced in the past. Today, "Hard workouts" mean giving it everything I've got and leaving when the tank is completely empty.

To me, that point is where my body tells me that if I do another rep, it's going to cost me the contents of my stomach.

Thanks for the friendly feedback and reality-check!

Bart your accomplishments speak for themselves. We are all different and respond differently to treatments. I am dying to get back to pre treatment workouts a nd will when my body says go.