Fitness Testing for Cancer Survivors

Exercise testing provides valuable information for survivorship:

• Assess Treatment Impact: Many cancer treatments (chemotherapy, radiation, hormone therapy) reduce cardiovascular fitness. Baseline testing quantifies current capacity
• Detect Cardiotoxicity:Some chemotherapies (anthracyclines like doxorubicin, trastuzumab) and chest radiation can damage heart. Unexpectedly low VO₂ max may indicate cardiac effects requiring further evaluation
• Safe Exercise Prescription: Individualized heart rate zones ensure you exercise at appropriate intensity for your current fitness level
• Manage Specific Side Effects: Exercise helps with peripheral neuropathy, lymphedema management, fatigue, and deconditioning
• Track Recovery:Retest every 2 to 3 months to document fitness improvements as you recover from treatment
• Return to Work/Activities: Objective fitness data supports decisions about returning to physically demanding jobs or recreational activities
• Long-Term Surveillance: Annual testing monitors for late cardiovascular effects of cancer treatment

Discuss testing with your oncologist if you have:

• Treatment-Related Cardiac Effects: Anthracycline chemotherapy, trastuzumab (Herceptin), chest radiation all increase cardiac risk. May need echocardiogram or stress test before exercise testing
• Anemia:Hemoglobin below 10 g/dL may limit exercise capacity and require medical management first
• Thrombocytopenia (Low Platelets): Platelets below 50,000 increase bleeding risk with vigorous exercise
• Neutropenia (Low White Blood Cells): Increased infection risk may require delaying testing until counts recover
• Bone Metastases: Weight-bearing exercise may be contraindicated. Discuss safety with oncologist
• Peripheral Neuropathy: Balance issues from chemotherapy-induced neuropathy may affect equipment choice
• Lymphedema: Arm or leg swelling requires special precautions but exercise is not contraindicated
• Pulmonary Effects: Bleomycin and chest radiation can affect lungs. May need pulmonary function tests first

When Testing Should Be Deferred: Active cancer treatment causing severe side effects, recent surgery (wait for surgical clearance), unstable cardiac conditions, severe anemia or thrombocytopenia, uncontrolled symptoms (nausea, pain, fatigue preventing activity).

Timing considerations:

• During Active Treatment: Can test if blood counts adequate, no severe treatment side effects, and oncologist approves. Helps maintain fitness through treatment. May need more frequent retesting as treatment progresses
• Immediately Post-Treatment:Wait 2 to 4 weeks after final chemotherapy or radiation to allow acute side effects to resolve
• Early Survivorship:First 6 months post-treatment is crucial for rebuilding fitness
• Long-Term Survivorship: Annual testing for ongoing cardiovascular surveillance, especially if received cardiotoxic treatments

Different cancers and treatments have unique considerations:

• Breast Cancer:
  • • Exercise reduces recurrence risk by approximately 25 to 30%
  • • If lymphedema present, resistance training is safe and beneficial
  • • Hormone therapy (aromatase inhibitors) causes joint pain and bone loss-exercise helps both
  • • If post-mastectomy, may have reduced shoulder ROM affecting equipment choice
• Colon Cancer:
  • • Exercise reduces recurrence risk by approximately 40 to 50%
  • • If ostomy present, secure appliance and consider protective covering
  • • Neuropathy from oxaliplatin common-affects balance
• Prostate Cancer:
  • • Androgen deprivation therapy causes muscle loss and bone loss-resistance training crucial
  • • Exercise may slow PSA progression
  • • If post-prostatectomy, ensure continence adequate for testing
• Lymphoma/Leukemia:
  • • High-dose anthracyclines common-cardiac monitoring important
  • • Fatigue often severe-start very gradually
  • • Check blood counts before testing
• Lung Cancer:
  • • If lobectomy or pneumonectomy, reduced pulmonary capacity expected
  • • May need pulmonary function tests before exercise testing
  • • Exercise improves shortness of breath and quality of life

Based on American College of Sports Medicine guidelines for cancer survivors:

• Aerobic Exercise:
  • • Target: 150 minutes per week moderate intensity (Zone 2)
  • • Or 75 minutes per week vigorous intensity
  • • Start with 10 minute bouts if needed, gradually increase
  • • Walking is most accessible and safe for most survivors
• Resistance Training:
  • • 2 to 3 days per week
  • • All major muscle groups
  • • 2 to 3 sets of 8 to 12 repetitions
  • • Critical for preventing muscle loss and bone loss
  • • Safe even with lymphedema-progresses gradually
• Flexibility: Daily stretching, especially areas affected by surgery or radiation
• Balance Training: Important if neuropathy present

VO₂ max testing provides YOUR specific heart rate zones to meet these guidelines safely.

Common side effects and exercise modifications:

• Fatigue:Most common side effect. Exercise actually reduces cancer-related fatigue. Start with 10 minutes, build gradually
• Peripheral Neuropathy: Numbness, tingling in hands/feet. Choose bike or rowing machine for better stability than treadmill. Include balance exercises
• Lymphedema: Wear compression garment during exercise. Resistance training is safe and may reduce lymphedema
• Bone Loss: From hormone therapy or steroids. Weight-bearing and resistance exercise crucial. Avoid high-impact if severe osteoporosis
• Joint Pain: Common with aromatase inhibitors. Exercise helps. Consider aquatic exercise if severe
• Hot Flashes: Exercise in cool environment, have water available, dress in layers
• Cognitive Changes: "Chemo brain" affects memory and concentration. Written exercise plan and heart rate zones provide external structure

Resting Metabolic Rate testing addresses nutrition concerns:

• Weight Management: Many treatments cause weight gain (hormone therapy, steroids, reduced activity). RMR provides exact calorie needs for weight management
• Prevent Cachexia: Some cancers cause unintended weight loss. RMR helps ensure adequate calorie intake
• Support Treatment: Adequate nutrition supports better treatment tolerance and outcomes
• Muscle Preservation: Combined with adequate protein, proper calories prevent muscle wasting

VO₂ Max plus RMR Testing (save $25)

Comprehensive approach to survivorship:

• Exercise Prescription: Heart rate zones from VO₂ max testing
• Nutrition Optimization: Calorie and protein targets from RMR testing
• Complete Recovery Support: Address both activity and nutrition for optimal survivorship

Monitor multiple markers with your oncology team:

• VO₂ Max: Test every 2 to 3 months during active recovery, then annually
• Strength and Function: Track improvements in daily activities
• Fatigue Levels: Use validated scales (FACIT-F)
• Quality of Life: Cancer-specific quality of life questionnaires
• Body Composition: Maintain muscle mass, manage body fat
• Blood Work: Regular monitoring per oncologist (tumor markers if applicable)
• Cardiac Function: Echocardiograms if received cardiotoxic therapy

If you received potentially cardiotoxic treatments:

• Anthracyclines: Cardiac effects can emerge years later. Annual echocardiogram and VO₂ max testing recommended
• Trastuzumab: Cardiac monitoring during treatment and for 2 years after
• Chest Radiation: Accelerates atherosclerosis. Increased coronary artery disease risk 10 to 15 years post-radiation
• Exercise as Prevention: Regular aerobic exercise provides cardiovascular protection against treatment-related cardiac effects

Share your testing results with:

• Medical Oncologist: Manages overall cancer care and surveillance
• Cardiologist: If cardiac effects from treatment
• Physical Therapist: Cancer rehabilitation PT uses data to design programs
• Certified Cancer Exercise Trainer: Specialized fitness professionals trained in cancer exercise programming
• Registered Dietitian: Oncology nutrition specialist uses RMR for meal planning
• Lymphedema Therapist: If lymphedema present

VO₂ Max Test: $250

RMR Test: $75

Performance Pack (Both): $300

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com

Call to discuss your cancer history, treatments, and medical clearance requirements before booking.