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You have been hearing for your whole life that a proper diet and regular physical exercise are good for you. Some people make physical fitness a big part of their identity; if you doubt this, look at the multibillion-dollar industry dedicated to nutritional supplements, exercise equipment, and gym memberships. Meanwhile, if you need to improve your fitness level, it can be hard to get started. Perhaps you are afraid of the judgmental stares that will follow you as you walk into the gym, a dad bod among hunks. Perhaps you have come to think of fitness as something that you do or don’t have, and you might see it as incompatible with your fondness for cigarettes and for binge-watching reality TV. The decision to get into better physical shape often starts with a big moment, such as a New Year’s resolution or getting invited to your high school reunion and anticipating seeing your high school crush for the first time in decades. A mesothelioma diagnosis does not rank highly among sources of inspiration to start exercising again, but exercise is important when you are living with mesothelioma treatment. It can help you live longer and improve your quality of life before, during, and after treatment.
Exercise Is Good for Your Physical and Mental Health at Any Age
It is ideal for adults of any age to get at least 30 minutes of moderate physical exercise at least three days per week. Cardiovascular exercise and strength training are both beneficial to your health, but it doesn’t have to be anything special. You don’t have to exercise like you are training for the Olympics, running a marathon, or entering the Iron Man competition; just going for a walk can go a long way toward helping you stay healthy. No matter what kind of exercise you do, it will pay dividends for your physical and mental health.
Exercise, even if it is just a 30-minute walk, helps you control your insulin resistance and blood pressure. Older adults who exercise regularly are less likely to suffer from cardiovascular disease, which is a leading cause of death in elderly people. Exercise is also excellent for your mental health. Most people who have experienced a major depressive episode have reported that regular physical exercise reduced their feelings of depression and anxiety, whether or not they were also taking antidepressants or other psychiatric medication. Exercise can help you get through stressful situations, such as the menopausal transition, the COVID-19 pandemic, or even a mesothelioma diagnosis.
Older adults who exercise regularly are also less likely to suffer from cognitive decline. Exercising is one of the best things you can do for your body and mind. You can choose whichever form of exercise you most enjoy, whether it is riding your bike around your neighborhood, going for a walk with a friend, or participating in a Zumba class at your local gym or community center. Whether you choose swimming laps, riding a stationary bicycle, or anything else, there is no wrong way to exercise.
How Does Mesothelioma Make It More Difficult for You to Exercise?
Mesothelioma is a type of cancer that affects the lining of the body’s cavities. Most cases of mesothelioma are pleural mesothelioma. This means that they begin on the pleural, the layers of tissue on the inside of the chest wall, and the outer surface of the lungs. It is not lung cancer, but many of its symptoms involve the respiratory system. The complaints that usually bring people to the doctor for the series of tests that ultimately leads to a diagnosis of malignant mesothelioma tend to relate to the lungs, too. Most patients first experience mesothelioma symptoms in the form of a persistent cough or shortness of breath. In fact, your first indication that something is wrong could be that, when you exercise, you get tired more quickly than you used to. The proximate cause of this shortness of breath could be the cancerous tumor itself, or it could be a buildup of fluid in the chest cavity, thereby decreasing the capacity of your lungs to expand.
Draining fluid from your chest cavity can bring you almost immediate relief; this procedure requires a brief recovery time, but once your doctor gives you the approval to start exercising, you should do it. Having the best possible level of cardiovascular fitness as you begin cancer treatments will help you tolerate the treatments better and could even increase their effectiveness.
Unfortunately, the treatments for malignant mesothelioma do not make it much easier to engage in cardiovascular exercise, at least not in the short term. For cases of pleural mesothelioma where surgery is an option, there are two types of surgeries from which your doctor may choose. The goal of these surgeries is to remove the entire tumor, thereby removing all macroscopic signs of cancer (all cancerous lesions visible without a microscope). Techniques for making surgeries less invasive are always evolving, but most of the time, surgery to remove pleural mesothelioma requires an open-chest procedure. This is unsurprising, considering that the tissue biopsy required to diagnose pleural mesothelioma accurately often involves the removal of part of a rib.
If the tumor is relatively small, your doctors may perform a pleurectomy decortication (PD). This surgery involves the removal of the tumor and the affected area of the pleurae, as well as part of the lung to which the affected pleura is attached. If the tumor has spread to the lung or covers too big an area of the pleurae to save the lung, then the best option is a surgery called extrapleural pneumonectomy (EPP). This surgery involves the removal of an entire lung, as well as part of the pericardium, which is the membrane that surrounds the heart. In either case, the best-case scenario after mesothelioma surgery is that you will have less lung capacity than you did before the surgery. You will need to learn to breathe with only one lung or without part of one of your lungs. For this reason, pulmonary physical therapy is often part of the recovery from mesothelioma surgery; the physical therapist will help you learn to take deep breaths comfortably.
Only some cases of mesothelioma are good candidates for surgery; your doctors will decide on a case-by-case basis whether the benefits of surgically removing the mesothelioma tumor outweigh the risks. Whether or not you have surgery, chemotherapy will almost certainly be part of your chemotherapy treatment. In a small minority of cases, where doctors are almost certain that the tumor has not spread beyond the pleurae, your doctors might simply administer the chemotherapy drugs directly to the inside of your chest cavity during the PD or EPP surgery, while you are still under anesthesia; this will reduce the risk of systemic side effects. Most mesothelioma patients will have to take chemotherapy drugs orally or intravenously, though. The newer chemotherapy drugs have less severe side effects than the older ones, and oncologists are always finding new ways to help patients reduce their chemotherapy side effects, but most patients who undergo chemotherapy experience fatigue. Chemotherapy-induced fatigue tends to go away on its own, usually subsiding a few weeks after your last chemotherapy session. If possible, you should try to exercise at least a little bit during your course of chemotherapy, although it will probably be substantially less than what you can do after your chemotherapy is finished.
A Little Bit of Physical Exercise Goes a Long Way
No one expects a 60-year-old mesothelioma patient who only has one lung after EPP surgery to complete a triathlon, but any amount of physical exercise that you can do will have great benefits to your physical and mental health. Even if it is as simple as walking your fingers up the wall next to you, it will help you maintain your muscle strength and coordination. If you are not healthy enough to go on a walk, you might be able to participate in a chair aerobics class.
Remember that, when you are actively undergoing mesothelioma treatment, you should not focus on fitness goals but rather on keeping up your strength to get to the other side of treatment. Whether you are currently undergoing treatment for cancer or are already in remission, it is important to take care of your overall health. Exercise will help you maintain the best possible breathing capacity, even if you only have one lung. If you exercise several times per week, or every day if you are able, you will find that you have more energy overall. In addition to fatigue, loss of appetite is a common side effect of chemotherapy, and it can continue for some time even after your chemotherapy sessions have finished. Exercise will help stimulate your appetite. If eating feels like a chore, then exercising with a friend or family member and then sharing a meal with your exercise buddy will make the whole experience more pleasant, even if you are only able to eat a few bites.