Personalize Your Exercise Plan

Your Exercise Rx: Create A Fitness Plan That Works For You

OCTOBER 13, 2010

We all know that exercise is important. Beyond helping you maintain or lose weight, physical activity boosts your energy, increases your focus, helps you sleep, improves your body composition and metabolism, and can help prevent heart disease, diabetes, osteoporosis, and cancer. If you could get all of that in a pill, it would be a wonder drug!

But how much exercise is enough? Which guidelines should you follow? Do you
really need a full 60 minutes per day to prevent weight gain, as recent studies suggest?¹

If you find yourself intimidated by guidelines that seem out of reach, take a step back and think outside the box. If the discomfort of making a change is too great, you won’t make the effort. Instead, create realistic goals for yourself—goals that you will be sure to meet and that you may even be tempted to exceed.

Rethink Your Goals and Create a Personalized Plan

To get started with your own customized plan, ask yourself this question: What is the least amount of exercise I could do most days joyfully and consistently? Yes, you read that right: do the least amount of exercise—so long as you do so joyfully and consistently. In fact, I recommend lowering the bar so low that the temptation to step right over it is irresistible.

The key to finding physical activity that you’ll do joyfully and consistently is to evaluate your fitness level and your time constraints within the context of your lifestyle. To get a good picture of a plan that will take each of these factors into account, try using what is known as the FITT (frequency, intensity, time, and type) formula:

Frequency. Exercise recommendations vary depending on the source, the purpose, and the type of exercise. Personally, I prefer “most days of the week.” That may be four, five, six, or even seven days, depending on the week. If three days have gone by without any exercise, I know I need to fit it in every day for the rest of that week. When my schedule is less busy and more flexible, I enjoy hiking or yoga every day of the week.

Intensity. Your intensity will be determined by your current activity and fitness level. Keep in mind that you are setting small, irresistible goals. Here are some ideas to get you started:

• Walk for five minutes on your breaks at work.
• Dance in your living room nightly.
• Take a flight or two of stairs (even if you need to take the elevator up the rest of the way).
• March in place during the commercials of one 30-minute television show.
• Walk around the soccer field during your child’s practice.
• Increase the incline on your treadmill by 3 percent.
• Add weight training to your cardio workout twice a week.

Now look over your FITT prescription. How does it make you feel? Optimistic and excited? If not, revisit the questions above and think about what will truly bring joy and consistency to your exercise plan.

Type. Another important way to overcome the discomfort of change is to discover which activities you find pleasurable. This is where the “joyful” part comes in. If you’ve struggled with exercising consistently in the past, you may have been trying to do things that just didn’t fit your personality, preferences, or values. Here are some questions to guide a brainstorming session to decide which types of activities you are likely to enjoy:

• Are you most comfortable outside, in a gym environment, or at home exercising to videos?
• Do you like to take classes with other people, participate in team sports, or walk by yourself?
• Are you competitive? Creative? Outdoorsy?
• Do you like gadgets, numbers, music, or other distractions?
• How much accountability do you need, and would you get that from walking with a friend, working out with a personal trainer, or committing to a 5K fundraising event?
• What are your values? If you want to spend more time with your partner, how could you plan time to exercise together? If you want to teach your children to make healthy choices, what activities could you do as a family?
• Do you value the spiritual connection that you might find through activities like yoga, hiking, or meditative walking?
• What activities did you enjoy doing in the past—bicycling, swimming, racquetball?
• What have you always wanted to learn—tennis, ballroom dancing, tai chi? What else appeals to you?

Time. When is your energy at its peak? When do you have the most control over your schedule? Could you add a few minutes to what you are already doing? Would you be better off breaking your exercise into multiple short bouts due to your schedule or fitness level? How much flexibility do you need to have to fit physical activity into your family obligations, work, and travel schedule? Again, set the bar low and raise it gradually as your body and schedule adjust.

Small, Manageable Changes

Remember, fitness is not a one-size-fits-all prescription; for many women the best exercise plan is the one that you create yourself to fit your lifestyle. If you’re still concerned that you’re not doing enough, keep in mind that the important thing is to set accessible goals and, when possible, step beyond them. By setting a small, specific, manageable goal, you’ll take the next step toward becoming the active, energetic person you want to be.

Michelle May, MD, is a recovered yo-yo dieter and the award-winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle(Austin, Tex.: Greenleaf Book Group Press, 2010). Download the first chapter atwww.AmIHungry.com.

reference

Lee IM, Djoussé L, Sesso HD, Wang L, Buring JE. Physical activity and weight gain prevention. Journal of the American Medical Association. 2010;303(12):1173-79

http://awomanshealth.com/your-exercise-rx-create-a-fitness-plan-that-works-for-you/

Cancer: If You Are Diagnosed With It

Cancers

Questions for the doctor:

• What kind of cancer do I have?

• Is it invasive?

• What lab tests were completed, and what did they show?

• Do I need any additional lab tests or diagnostic studies?

• What is the purpose of each test or study?

• How will this information help decide what types of further tests or treatments I should have?

• What are my treatment choices?

• What are the expected benefits of each kind of treatment?

• What are the risks of each treatment?

• What are the side effects of each treatment?

• Are there new treatments or clinical trials that I should consider?

• What are my chances of being cured?

• How will we know if this is working?

• How will each treatment affect my daily life?

• What are the chances of the tumor coming back again?

---

Licensed from

 Stay Well.

http://www.healthline.com/sw/cs-cancer-if-you-are-diagnosed-with-it

Depression drug may relieve pain from breast cancer treatment, U-M study finds

ANN ARBOR, Mich. — A drug commonly used to treat depression and anxiety disorder was effective at reducing joint and muscle pain associated with a breast cancer treatment, according to a study from the University of Michigan Comprehensive Cancer Center.

The women in the study were taking aromatase inhibitors, a type of drug designed to block the production of estrogen, which fuels some breast cancers. About half of women taking these drugs experience aches and pains in their joints and muscles that cannot be adequately relieved by over-the-counter painkillers. Up to 20 percent of these women will stop taking an aromatase inhibitor because of this pain.

"Since women typically take these drugs for five years, it is important that the side effects not interfere too much with their quality of life, or they will be less likely to continue taking the medicine, which may lead to a greater chance of their breast cancer returning," says study author N. Lynn Henry, M.D., Ph.D., assistant professor of internal medicine at the U-M Medical School.

Henry will present the initial results of the study Dec. 11 at the 33rd Annual San Antonio Breast Cancer Symposium.

The study looked at the drug duloxetine, or Cymbalta, which is used to treat depression and generalized anxiety disorder. It's also been shown to work in multiple other chronic pain conditions, such as fibromyalgia and, more recently, osteoarthritis. It is believed to decrease pain through its actions in the central nervous system.

Of 29 patients evaluated, nearly three-quarters reported that their pain had decreased by at least 30 percent. On average, after eight weeks of treatment, pain scores declined 61 percent. Only one in five patients stopped taking duloxetine because of side effects.

"Duloxetine appears to be effective at reducing the muscle and joint pain many women experience from aromatase inhibitors, with only mild additional side effects," Henry says.

The researchers are planning a randomized, controlled trial comparing duloxetine to placebo. Henry is also doing research looking at the effect of aromatase inhibitors on pain perception to better understand why women develop pain.

###

Breast cancer statistics: 209,060 Americans will be diagnosed with breast cancer this year and 40,230 will die from the disease, according to the American Cancer Society

Additional U-M authors: Mousumi Banerjee, Ph.D., Dorothy Blossom, Max Wicha, M.D., Catherine Van Poznak, M.D., Jeffrey Smerage, M.D., Ph.D., Anne Schott, M.D., Jennifer Griggs, M.D., M.P.H., and Daniel Hayes, M.D.

Funding: Supported by an Investigator Initiated Grant from Lilly Pharmaceuticals

Disclosure: None

Reference: 33rd Annual San Antonio Breast Cancer Symposium, Dec. 8-12, 2010, San Antonio, Texas

Resources:
U-M Cancer AnswerLine, 800-865-1125
U-M Comprehensive Cancer Center, www.mcancer.org
Clinical trials at U-M, www.UMClinicalStudies.org

http://www.eurekalert.org/pub_releases/2010-12/uomh-ddm121010.php

Novel Imaging Technique May Reduce Lymphedema in Breast Cancer Patients

SAN ANTONIO--(BUSINESS WIRE)--With guidance from a specialized scan, radiation oncologists at Mayo Clinic were able to reduce by 55 percent the number of lymph nodes critical for removing fluid from the arm that received damaging radiation doses.

“We can use this information to personalize the fields of radiation such that the tumor bed in the breast is therapeutically treated while the lymph nodes that drain the arm are maximally blocked from radiation and thereby spared”

VIDEO ALERT: Additional audio and video resources, including excerpts from an interview with Dr. Andrea Cheville and other researchers presenting at San Antonio Breast Cancer Symposium, are available on the Mayo Clinic News Blog. These materials also are subject to embargo, but may be accessed in advance by journalists for incorporation into stories. The password is sanantonio1.

The researchers report that integrating single photon emission computed tomography (SPECT) with the computerized tomography (CT) scans utilized for breast cancer radiotherapy planning may offer patients substantial protection against lymphedema, an incurable, chronic swelling of tissue that results from damage to lymph nodes sustained during breast cancer radiation. The SPECT-CT scan pinpoints the precise locations of the lymph nodes that are critical for removing fluid from the arm, allowing physicians to block them, as much as possible, from X-ray beams delivered to the chest.

These findings were presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium.

http://www.businesswire.com/news/home/20101211005006/en/Imaging-Technique-Reduce-Lymphedema-Breast-Cancer-Patients

Weight Training Helps Breast Cancer Survivors

http://abcnews.go.com/Health/OnCallPlusBreastCancerNews/pumping-iron-cancer-weight-training-beneficial-breast-cancer/story?id=12353670

Lifting Weights May Help Women Avoid Condition Known as Lymphedema

By LIZ NEPORENT

Dec. 9, 2010—

Just as doctors now know heart attack and back pain patients can benefit from physical activity during recovery, a study published in Wednesday's Journal of the American Medical Association (JAMA) finds breast cancer survivors may benefit from pumping iron after surgery.
The study, performed by researchers at the University of Pennsylvania, shows that breast cancer survivors who participated in a supervised, slowly progressive weight training program after undergoing surgery did not develop the painful, arm-swelling condition known as lymphedema -- and in fact, may have even reduced or prevented the complication.
The researchers placed 154 women who had been diagnosed with breast cancer in the previous five years, and who had had at least two lymph nodes removed but did not have lymphedema, into two randomly assigned groups. The first group was supervised by a personal trainer who led them through a 13-week weight lifting program, which they continued for another nine months at home. The second group didn't exercise.
By the end of the one year study, the weight lifters had cut their risk of developing the condition by 35 percent. Only 11 percent of the group developed lymphedema, compared to 17 percent of those in the non-exercising group. Among women who had the most aggressive surgery, with five or more lymph nodes removed, the impact of the weightlifting intervention was even greater -- a nearly 70 percent risk reduction. Twenty-two percent of inactive participants developed lymphedema, compared to just 7 percent in the exercising group.
"Women have been told for decades that they should not do anything with the affected limb," said the study's lead author, Dr. Kathryn Schmitz, an associate professor of epidemiology and biostatistics and a member of Penn's Abramson Cancer Center. "Our work is showing that women who have had lymph nodes removed and have not developed cancer are less likely to develop arm swelling over time if they slowly and progressively increase the capacity of their damaged limb to withstand the stresses of real life like lifting their purse, moving heavy boxes or carrying a child."

Arm, Shoulder Problems Common in Breast Cancer Survivors

Currently half of all breast cancer survivors have some sort of arm and shoulder problems, but their doctors have been cautious about recommending exercise for fear it would harm the affected areas and cause further problems. Schmitz said she hopes her work will put these fears to rest for both doctors and patients.
She said she believes her findings may be the greatest help to African American women who, studies show, are typically diagnosed with later stage cancer, have more lymph nodes removed in surgery and are more apt to return manual labor jobs after medical care.
"These women are prime candidates for developing lymphedema and all the complications that go with it. Without an evaluation and proper rehabilitation they often find themselves out of work because they can no longer lift things," she said.
This latest study builds on the team's previous work, which showed that slow and careful strength training with an assessment beforehand by a qualified therapist is not only safe for women but also decreases the likelihood that lymphedema would flare up.
"It should be a wakeup call for women to be given a prescription for rehabilitation as a standard of care. If their doctor doesn't automatically make a referral, women need to become squeaky wheels and demand it," Schmitz said.
However, Schmitz cautions that women who have been through breast cancer surgery should not rush out to buy a gym membership and start exercising on their own. Instead, they should work with a qualified professional who can guide them carefully through a customized program. She also recommends they review the exercise guidelines for cancer patients published earlier this year by the American College of Sports Medicine. Her team has a website that will release weight training protocols to licensed physical therapists but not to the survivors themselves. This is necessary, she says, to ensure proper treatment and keep patients out of harm's way.

Copyright © 2010 ABC News Internet Ventures

UK Poll Leads to National Campaign

Cancer 'is nation's biggest fear'

By Michelle RobertsHealth reporter, BBC News

Tumours can often be treated if detected early

Continue reading the main story

Related stories

• Inherited cancer fear 'unfounded'

Cancer is the nation's biggest fear but more than a third wrongly think getting the disease is down to fate and there is nothing they can do to avoid it, say experts.

The poll of more than 2,000 UK adults shows cancer is feared ahead of debt, knife crime and unemployment.

Cancer Research UK, who led the survey, said it was important for people to realise cancer is not inevitable.

Half of all cancers could be prevented by healthy lifestyle changes.

Getting cancer is not purely down to genes, fate or bad luck. Indeed, only a small number of cancers are hereditary.

Whereas whether you smoke, drink and are overweight, as well what you eat and how much exercise you get can greatly influence your risk.

Continue reading the main story

“Start Quote

Cancer is no longer the death sentence people still seem to dread”

Sara HiomCancer Research UK

And even if a person does develop a tumour, if spotted early many cases can be treated to give a better chance of long-term survival, says the charity.

Thanks to screening and better treatment, the average 10-year survival rate for cancer has doubled over the past 30 years.

Half the people diagnosed with cancer today will still be alive in five years' time. And more than 40% will still be alive in 10 years' time.

The Department of Health is launching an England-wide campaign in January to raise awareness of the early signs and symptoms of the three most common cancers - breast, lung and bowel - to encourage people to seek medical advice as soon as possible.

Sara Hiom of Cancer Research UK said: "The fear factor is a serious wake-up call for the British public.

Continue reading the main story

Cancer signs to be aware of

• An unusual lump or swelling
• A change in the size, shape or colour of a mole
• Coughing up blood or blood in urine or bowel motions
• Unexplained weight loss

Source: Cancer Research UK

"It's absolutely vital for us to get the message out that people can do something to alleviate their emphatic fear of cancer.

"Cancer is no longer the death sentence people still seem to dread.

"Long-term survival has doubled since the '70s thanks to better diagnosis, improved treatments and the development of nationwide screening programmes for breast, bowel and cervical cancers.

"Spotting early signs and symptoms of what could be cancer - but probably isn't - and getting these checked out by a doctor means that the disease can be diagnosed more quickly."

Teresa Nightingale of the World Cancer Research Fund said: "It is a concern that so many people think cancer is a matter of fate, because there is now strong scientific evidence that people can make relatively simple changes to reduce their risk."

http://www.bbc.co.uk/news/health-11937305?utm_source=twitter.com%252Fcancer_buzz&utm_medium=twitter&utm_term=cancer&utm_content=cancer

Elizabeth Edwards

December 7, 2010, 4:54 PM

Lessons From Elizabeth Edwards

By BARRON H. LERNER, M.D.

Matt Sayles/Associated PressElizabeth Edwards at the “Stand Up to Cancer” television show in Culver City, Calif., in September.

5:32 p.m. | Updated

The news that Elizabeth Edwards died on Tuesday is extremely sad. Ms. Edwards, 61, a lawyer, mother and author of two autobiographical books and the estranged wife of former Senator John Edwards, had only recently announced that she had stopped treatment for advanced breast cancer.

Ms. Edwards’s last disclosure provided another “educational moment,” both for others with cancer and for the general public. Although we are very familiar with celebrity cancer survivors, Ms. Edwards’s candor in her final days taught us what it means to be a cancer “non-survivor.”

Famous people with cancer have been in the news for decades. In the 1950s, a series of politicians, including Secretary of State John Foster Dulles and Senator Robert Taft of Ohio, disclosed that they had cancer. These individuals released very few specific details, however, and in no way were “spokesmen” for their disease.

Things began to change in the 1970s, when several well-known women, including the actress and diplomat Shirley Temple Black and two political wives, Betty Ford and Happy Rockefeller, disclosed that they had breast cancer. These women were more forthcoming, discussing the details of their treatments and things that women could do — breast self-examination and mammographic screening — to find breast cancers early.

Ms. Black, Ms. Ford and Ms. Rockefeller were especially effective advocates because they all survived their disease. “Cure” rates for certain cancers, like breast cancer, were increasing, and all three benefited. Celebrities cured of cancer not only could serve as spokespeople for decades, but also put an optimistic face on cancer control efforts. By the 1980s, people had begun to use the empowering term “cancer survivor” to describe such individuals, famous and not. Recent celebrity cancer patients, like Lance Armstrong, have underscored the connection between strength, optimism and survivorship.

But “survivor” was always an ambiguous term. Was a survivor only someone who was permanently cured of his or her disease? Or did it also make sense to call oneself a survivor even if there was a chance that the cancer might return and be fatal?

Ms. Edwards’s case demonstrates the tricky nature of labels with a disease as unpredictable as cancer. When her breast cancer was diagnosed in 2004, she was upbeat. There was no evidence that it had spread, and a family spokesman termed her prognosis “very, very good.” Ms. Edwards openly discussed her breast cancer in her 2006 book, “Saving Graces.”

But in March 2007, during her husband’s campaign for the presidency, Ms. Edwards announced at a news conference that the breast cancer had recurred, certainly in a rib and possibly her lung. What she did next was rare for celebrity patients: She announced that the cancer was terminal. Yes, Elizabeth Edwards was a breast cancer survivor, according to the lingo. But she would not survive the disease.

By being so frank, Ms. Edwards provided other important lessons. Some breast cancers, even those without evidence of spread at diagnosis, come back. Breast cancers that have spread to the bone are invariably incurable. But, Ms. Edwards emphasized, there are effective treatments that could keep her and women with similar cases alive for many years.

She remained hopeful, saying, “I expect to do next week all the things I did last week, and the week after that and next year at the same time all the same things I did last week.” This included assisting her husband’s candidacy.

Unfortunately, there was no way to sugarcoat the latest news. The treatments that Ms. Edwards mentioned probably bought her less than four years.

But once again, she used the opportunity to teach. She announced that she had reached the point, as do other Stage 4 cancer patients, where aggressive chemotherapy no longer can shrink the tumors. Her doctors said it would be “unproductive” to continue to treat the disease. Ms. Edwards chose to go home to die rather than to remain in the hospital.

There was much she didn’t tell us. How were doctors managing the symptoms — pain, nausea, shortness of breath — that her cancer probably caused? Did she sign up for palliative or hospice care, both of which specialize in the treatment of end-stage disease? Did she sign an advance directive explicitly stating her end-of-life wishes?

Even if Ms. Edwards herself did not reveal these details, these topics are now being discussed widely. As such, they are likely to help other individuals struggling with the same issues. That legacy, at least, will survive her.

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Dr. Barron H. Lerner is a professor of medicine and public health at Columbia University Medical Center and the author of “When Illness Goes Public: Celebrity Patients and How We Look at Medicine.”

http://well.blogs.nytimes.com/2010/12/07/lessons-from-elizabeth-edwards/?ref=health