Story by: David Steen Martin on March 16, 2022
The added benefits of exercise for survivors of acute lymphoblastic leukemia (ALL) can include psychological well-being, improved quality of life and lower risk of long-term effects — like broken bones or chronic diseases — from their treatment.
Decreased anxiety and help with social integration are also benefits of exercise for ALL survivors, in addition to the more common benefits of improving strength, conditioning, coordination and range of motion, as well as reducing body fat and helping with sleep.
“The studies are clear. Exercise is a good thing for children who have survived ALL. It doesn’t matter if it’s at the hospital or at home. It’s safe and has no negative effects on their health,” said Ashok B. Raj, M.D., pediatric hematologist/oncologist with Norton Children’s Cancer Institute, affiliated with the UofL Medical School.
ALL is the most common type of childhood cancer. Over the last half century, five-year survival for ALL has risen from close to zero to more than 80%. Treatment involves high doses of chemotherapy, radiotherapy or a combination of the two.
Because ALL begins in the bone marrow, it can result in osteopenia — weaker bones because of low bone density — and contribute to fractures in bones and vertebrae. Treatment also can result in obesity and metabolic syndrome in adult ALL survivors.
Weight gain in children treated for ALL often begins during therapy and continues after treatment ends. It is more prevalent in children diagnosed at a younger age and in those treated with cranial radiotherapy.
Norton Children’s Cancer Institute treats the whole child. The Adolescent and Young Adult Program offers fitness, art therapy, music therapy, educational classes, massage therapy and support groups.
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In addition, the high doses of chemotherapy, radiation or both can lead to inactivity and affect the heart and lungs. Chemotherapy also affects coordination, both during and after treatment.
Half of childhood ALL survivors in their 20s have at least one chronic medical condition.
“As survival has increased, so has our focus on treatment-related side effects that could develop into chronic disease over the long term,” Dr. Raj said.
To address the health of these children, a range of exercise programs has been tried, both at home and in the hospital, and both during and after treatment. The programs lasted from a few weeks to more than a year. They routinely reported improvements in areas such as strength, endurance and quality of life.
Studies have shown supervised physical activity during treatment is also beneficial.