Everyone knows that exercising is healthy. Not everyone does it. But in the case of lymphoma or leukemia patients, it is vital.

What do I mean by exercise, though?

Exercise during chemotherapy is extremely difficult. I will not lie. I was lucky enough to have a team of highly-knowledgeable doctors deal with my case, and I will be forever grateful that they skipped past the traditional first-line treatment straight to the highest-course option my body could tolerate. I am 100% convinced that DA-EPOCH-R was the right decision for my stubborn and aggressive NHL. But my body really took a beating.

I had a central venous port catheter put in the very first week after my diagnosis. My veins are small; the nurses recommended it. However, there are specific adaptations one must make: you cannot lift anything too heavy lest the catheter shift, and you  must do daily exercises to maintain mobility and port function.

But exercise during chemotherapy does not refer to that. It’s even simpler:Walk around the hospital floor when you’re hooked up. I was an in-patient for 6-7 days every treatment cycle, and I made sure I walked every single day. It was hard. Many times I just wanted to skip it. But every day my husband (then fiance), my sister, and I made a round of the floor. Some days I could do 2-3 rounds of the floor; others I only made it to one. Half the time I clutched at my IV stand just for mobility support. However, the movement was important. So I damn well did it.

Exercise (or in this case, walking) actively helps your blood and lymph circulate. During chemotherapy, it helps distribute the drugs to where it’s needed most. It also combats fatigue (counter-intuitively, I know), decreases somatic stress, and improves psychological parameters of anxiety [Dimeo 1999]. And, quite importantly, walking encourages the bowels to move–an especially helpful point to remember. The prevailing advice is for patients undergoing intensive high-dose chemotherapy to rest and avoid intensive exercise. As a former patient, I can say this: there was no way in hell I could have done any intensive exercise. I offer a resounding applause for survivors who managed to run, bike, and work full-time while undergoing cancer treatment. But I could not. I did feel vaguely guilty that I wasn’t a superhuman. I still do. However, there is one exercise I could manage, and I heartily advocate it: Walk.

That’s it. Walk, walk, and walk some more.

After I went home, I would feel awful. I didn’t want to eat. I’d be nauseous and dizzy. And it got worse with each progressive cycle.

I still walked. Usually I rested at home the first 1-3 days after being discharged. But afterwards, I made sure to walk every day. I started walking around the block. Then I walked to the park, doing breathing exercises around the trees and plants as the sun rose. When I heard the birds sing the dawn chorus, I said my thanks for being there and greeting one more day alive.

Current studies do support the incorporation of physical exercise as parallel and immediate-post therapies. Aerobic exercise has been found to mediate better performance post-discharge, shorten duration of neutropenia (an extremely common and enduring side effect of blood cancer therapies), and contribute to better recovery from thrombopenia [Elter 2009]. For patients with acute leukemia or aggressive lymphoma, walking may be the only exercise possible.

Luckily, walking is all you need.

Recovery therapies and exercise are different, of course. But while under treatment, you would be well-advised to make sure you walk every day. Pace doesn’t matter. Try to shoot for 20 minutes every day, if you can, shortening duration as necessary. Even 20 minutes broken up into 5 minute segments is acceptable. The important part is to try.