Living with and beyond cancer

Exercise is important for keeping your bones and muscles strong. It helps prevent muscle loss which can happen with inactivity and some medications. It also helps boost your mood, reduce anxiety and generally feel better about yourself.

Any type of exercise or movement that uses your muscles counts, it doesn’t have to be about going to the gym. Do something you enjoy that fits your ability. Start small and build yourself up. Try some of the exercises below:

• Housework
• Gardening
• Shopping
• Walking – why not join a walking group?
• Chair exercises – to TV theme tunes or music, foot tapping and build up to marching on the spot
• Using the stairs rather than a lift
• Dancing
• Climbing the stairs
• Ask your GP for a referral to supported exercise classes.

Cancer and its treatments can affect your weight in different ways. You might lose a lot of weight in a short space of time due to lack of appetite or feeling sick. Or, you might find yourself putting on weight due to medication.

Being overweight can affect your quality of life, increase the risk of cancer coming back or getting a second cancer and also increase your risk of developing other conditions such as diabetes or heart disease. Trying to get to a healthy weight can be a struggle.

If you have weight loss, try:

• Eating little and often rather than having set meals which can be off-putting.
• Have high calorie/high energy foods to pack as many calories into the bits you can manage.
• Use full fat milk
• Adding cream to soups and puddings can boost calories without adding too much volume
• Ask for a referral to a dietician for advice and support

If you have weight gain, try:

• Choose healthy options at meal times
• Control your portion size
• Get active
• Consider a weight management programme
• Talk to your GP
• Ask for a referral to a dietician

Cancer and its treatments can change the way you eat and how your body uses foods and nutrients. Eating the right foods can help you:

• Feel better
• Stay stronger
• Boost your energy levels
• Tolerate the side effects of treatment
• Boost your immune system and reduce the risk of infection

Protein – gives your body the resources it needs to repair itself. You can find healthy protein in meat (especially chicken or turkey), fish, milk and dairy products, pulses and nuts.

Fruit and veg – give you minerals, vitamins and fibre and should make up about a third of your daily food intake. Remember your five a day. Try chewing pineapple if you have a dry mouth.

Carbohydrates (starch foods) – are the body’s energy source and should make up about a third of your daily food intake. They also provide fibre, calcium, iron and B vitamins. You can get them from bread, cereal, rice, pasta, potatoes.

Fibre – helps to prevent constipation. Find it in fruit and veg and starchy foods (especially if you have wholegrain options).

Sugar – can be useful to give you energy – but pick your sugars. Processed sugar in sweets and fizzy drinks is not so good. Go natural with fruit, nuts and wholemeal bread. The energy from these is released more slowly and will last for longer.

Remember to stay hydrated. The recommended amount is eight glasses per day (1.6L) for women and 10 glasses (2L) for men. Water is good but you can get your fluids and additional energy and nutrients from milk, smoothies and freshly squeezed fruit juice (not from concentrate).

Caffeine makes you urinate more, so whilst it’s fine to have tea or coffee, make sure you are also having other drinks.

The physical and mental side effects of cancer and treatment can disturb your sleep and increase fatigue. Being too hot or too cold, unable to switch off and needing the toilet more frequently can all affect your sleep. To help:

• Try to go to bed and get up at a regular time
• Reduce tea and coffee and try a hot milky drink
• Keep the room at a temperature which suits you
• Reduce stimulus such as iPad or mobile phones
• Try using a relaxation session on CD or download onto a mobile device

Cancer fatigue, however, is a type of tiredness that sleep can’t help with, even if you may be sleeping more.  It feels like an overwhelming tiredness doing day to day tasks. Your limbs may feel weak and heavy and you may experience a fuzzy head (like brain fog) and are unable to concentrate.

To help with fatigue, try and understand your energy levels – conserve your energy and delegate. Think of tasks as physical and mental activities which use up energy in different ways. For example:

• Low: coffee with friend (mental)
• Medium: making breakfast (physical)
• High: Washing, dressing, going up and down stairs (physical)

During our day we move between all three and this is where we need to identify how to balance and plan our activities to help with energy conservation. Think of your energy levels like your phone battery. If you run multiple apps together you’ll drain your battery more quickly. So, doing multiple tasks together will drain your energy levels more quickly. Washing, dressing and cooking breakfast at the same time will be more tiring. Don’t drain your battery completely, keep at least 25% in reserve. Plan and prioritise your tasks and activities and balance your day between these and rest.

Follow this guide to resting:

• Yawning means you need to rest for an hour
• Word finding problems means you need to rest for up to three hours
• Difficulty with concentration means half a day in bed
• Achy limbs means you need a day in bed or more
• Difficulty moving means you need several days in bed

Ideally, do not let your fatigue reach this level. Follow the strategies to help manage your fatigue. Know your warning signs and when to sleep.

• Get washed then rest
• Get dressed then rest
• Delegate breakfast duties or prepare as much as you can the night before
• Having treatment in the next few days? Rest more in the days before to build up your energy reserve

Keeping a diary can help identify your high and low energy, what tasks you were doing and if there were any side effects of treatment or pain problems.

We all know the link between smoking and cancer. Even if you have cancer, there are always good reasons to consider cutting down or giving up. Smoking makes treatments harder and blocks some from working as effectively. It can make the symptoms of cancer, the side effects of treatment and your quality of life worse.

Smoking can increase the chances of cancer coming back or a new cancer developing. You’re more likely to be successful if you get support to quit. Get help from your GP, pharmacy and hospital team.

Alcohol can have negative effects on your life. Cutting down or stopping altogether can help. Alcohol, like smoking, can make the side effects of your treatment worse and stop some medications working properly. It can interfere with your sleeping pattern, cause dehydration, lower your mood and increase anxiety. You’re more likely to be successful if you get support. Get help from your GP, pharmacy and hospital team.

You may feel many emotions when you are told you have cancer. Some of the most common are:

• Loss
• Blame and guilt
• Shock and disbelief
• Loss of control
• Sorrow and sadness
• Resentment
• Depression
• Anxiety
• Fear and uncertainty
• Anger
• Denial
• Withdrawal and isolation

Building a support network with your family and friends, peers, community, colleagues and professionals can really help. Be honest with them. Seek help when you need it. Resilience is not about being positive, but about working around things that get in your way. Give yourself a break:

• Be kind to yourself
• Reward yourself for achievements
• Have a change of scenery
• Take a break
• Resolve conflicts
• Forgive yourself and don’t punish yourself if things don’t go according to plan

Pursue your interests and hobbies, use relaxation techniques and find balance. Emotional wellbeing is tied to your physical health and each impacts on the other. Look after your physical health. Get enough sleep, do some activity and eat well.

• Macmillan Cancer Support
• Cancer Research UK
• Maggies Centres
• NHS One You
• Drinkaware
• NHS Smokefree
• NHS Stop Smoking Service
• MIND
• We Are Undefeatable
• MacMillan Support Service North Tyneside  / 0191 293 4377
• Macmillan Support Service Northumberland / 01670 855533