Exercise is springboard to recovery for cancer patient

Courtesy of USA TODAY
Shannon Miller's competitive spirit and life-long love for exercise are helping her fight the brave fight again. This time, beating cancer is her mission.

"A friend said to me: 'This cancer diagnosis is like being on the balance beam. You fall off. You get back up.' "

The former Olympic gold-medal gymnast is "back up" after being diagnosed with a germ cell malignancy, a form of ovarian cancer, in December. She started nine weeks of chemotherapy March 9 after doctors removed a baseball-size cyst and an ovary. And she started an exercise program that she follows faithfully, even during treatment.

Experts say she is on the right track: assisting her treatment by exercising. Many of the 12 million cancer survivors in the USA also would benefit, they say.

"There is a growing body of research showing exercise not only helps with the side effects of treatment but also decreases the recurrence risk and improves overall survival," says researcher Melinda Irwin, an associate professor of epidemiology and public health at Yale.

"My prognosis is good," says Miller, 34. She says her doctors have said they're hopeful that she and her husband, John Falconetti, will be able to have more children. Their son, Rocco, is 15 months old. The family lives in Jacksonville near John's parents, who, along with friends, help with Rocco on treatment days.

Miller concedes it isn't easy. She says there are many days she just wants to lie in bed, usually during the first week of a three-week treatment cycle. That's when she has five straight days of chemotherapy for five to six hours a day. The other two weeks, she has chemo one day a week.

Nutrition can be a problem. She says she always has had a tendency to become dehydrated, and at one point, she ended up in the hospital because of dehydration after a round of chemo.

Exercise isn't always possible, but more often than not, she says, she finds time to be on her exercise mat at home.

"I find exercise is really helping me with the nausea and fatigue and helping me regain control of my life," says Miller, who won two gold and seven Olympic medals overall in 1992 and 1996.

She says her physical activity also helps her with "chemo brain," a fogginess that can cause forgetfulness and lead to depression.

A far cry from Olympic workouts

The level and kinds of exercise Miller does are endorsed by the American Cancer Society and the National Cancer Institute.

"People think. 'Oh, she's an Olympian. She's probably doing three-hour workouts.' That's not the case at all," she says.

After getting a green light from her physician, Miller began a routine in which she spends 10 to 15 minutes a day doing yoga, lifting 2- to 3-pound weights and walking or swimming. She says she gets winded and has to listen to her body, "which I got very good at doing as an athlete, learning when to rest and when to push it."

The 2006 American Cancer Society guidelines on nutrition and exercise say patients receiving chemotherapy and radiation therapy who are already on an exercise program may need to exercise at a lower intensity and progress at a slower pace temporarily, but the principal goal should be to maintain physical activity as much as possible.

Epidemiologist Larry Kushi, ACS spokesman, says the organization is in the process of updating the 2006 guide and will expand on the benefits of exercise. He adds that he's unaware of any research showing exercise has a negative impact on cancer treatments.

"She's totally doing the right thing," says Yale researcher Irwin, who is a former competitive gymnast herself, "but not nearly as good as Shannon Miller."

The research behind it

Irwin says the verdict is still out on how exercise benefits cancer survivors, but she notes studies in which breast cancer survivors who exercise have lower levels of insulin, and some studies have shown that high levels of insulin strongly increase the risk of breast cancer recurrence and death.

Her National Cancer Institute-funded trial involving 230 sedentary women diagnosed with ovarian cancer is examining the impact of exercise on quality of life, fatigue and survival.

"Our study is the largest exercise trial in cancer survivors," she says. It will provide critical information in understanding the potential mechanisms through which physical activity may affect ovarian cancer risk and prognosis, including what roles estrogens, insulin and insulin-like growth factors might play.

In a 2008 study in which she participated, Irwin says, "we not only showed an improvement in survival from breast cancer, but survival from other causes, such as cardiovascular disease and diabetes, so exercise is really associated with a multitude of benefits."

Miller says she has kept up with the research on exercise and cancer, but that hasn't been the driving factor behind her workouts.

Even before her diagnosis, she had long been an advocate for healthy living. She started her own business, Shannon Miller Lifestyles, after getting a marketing degree from the University of Houston and a law degree from Boston College. The focus is on fitness, health and nutrition, and pregnancy and motherhood.

She is an author and motivational speaker, and she has continued her radio show on SML Radio during her treatments.

Her son 'keeps me going'

Being an avid journal writer has helped Miller lately. She has kept journals for as long as she can remember, she says, but now, outlining her treatments, diet and workouts has helped her feel she has regained control of her life. She's featuring her writings on her website, documenting her journey through chemotherapy.

"I have trouble remembering what works and what doesn't," she says. "I write everything down. That way, when you're having a bad day, you can look back and see what you did that might help you have a good day again.

"Sometimes even looking back and knowing you had a good day is a big boost."

And being a mom has helped as well. By far, walking with her toddler to the park is her favorite way to get her exercise.

"People think it must be tough with a small child," she says. "But he keeps me going. He loves to walk. He holds onto my hand and walks to the park with me. We can't slow him down."

Rocco certainly plays a role in her weight-lifting routine as well, she says.

"Anyone with a toddler knows you have to be able to pick them up and carry them around," she says. "So I need to stay strong.

"Plus, this will get me back on my feet faster once the chemotherapy is over."

chemotherapy. Experts agree that many cancer patients can benefit from following her example.