Sleep

Along with physical discomfort and emotional tension many patients struggle with sleep problems such as nightmares, insomnia, daytime sleepiness and fatigue. However, a fulfilling and restful sleep (7 to 8 hours) is crucial for cancer patients undergoing antitumor therapies, since it is key to a patient’s immune system function, body recovery processes, mental and emotional state and quality of life.

In order to maintain a healthy circadian rhythm, it is necessary to adhere to a regular sleep schedule with falling asleep and waking up at the same time every day, even on chemotherapy days. A comfortable and restful sleep environment can make a significant difference in sleep quality. A cool, dark and quiet room along with a quality mattress, pillows and bedding can be crucial to healthy sleep. Avoid alcohol, nicotine and caffeine consumption at least 6 hours before bedtime. Exposure to screens, such as smartphones, tablets or TV, immediately before sleep may suppress the production of the sleep hormone melatonin and make it harder to fall asleep.

Physical activity

Cancer patients have reduced levels of physical activity. Inactivity and depression, on the one hand, and cancer treatment, on the other hand, have serious adverse effects on а patient’s muscle mass. Data from many analyses provide convincing evidence that physical activity is well tolerated and safe at various stages of cancer and that patients with advanced disease are able and willing to engage in physical activity. Increased physical activity is associated with maintenance or significant improvement of a patient’s aerobic capacity, muscle strength, lean muscle mass, quality of life and self-esteem.

The following are recommended: 

• Aerobic exercises such as walking in the fresh air, cycling, etc. result in a reduced risk of muscular atrophy due to inactivity.
• In addition to aerobic exercises, individualized resistance exercises are recommended. Such exercises may be done using self-weight, such as abdominal crunches and plank position exercises, and may also include the use of bands of varying resistance, dumbbells (not very heavy) or a medicine ball, and are more effective in improving upper and lower body muscle mass and strength than aerobic exercises.
• All exercises should be tailored to the individual abilities, comorbidities, general condition, type of cancer and surgical interventions performed.
• Physical exercises should strengthen the body’s tone and improve a patient’s general condition without causing overexertion.
• One of the easiest ways to reach healthy physical activity is to walk daily and use a pedometer to track results.
• About 90 minutes of walking a day is recommended, which is equal to an average of 7 to 8,000 steps. Walking, on its part, should not be high-intensity, should not cause fatigue or shortness of breath and should not increase heart rate above 115/min.