Proton Therapy Fatigue and Exercise
- “Anne With An E” star Miranda McKeon, 20, was diagnosed with breast cancer on June 14. She then underwent eight rounds of chemotherapy, a preventative double mastectomy and surgery to remove all of her lymph nodes and a piece of skin on her left breast. Now, she’s undergoing proton therapy.
- She recently shared that she’s been working out to overcome radiation fatigue a side effect of proton therapy.
- Radiation therapy, in general, can affect the heart when given to breast cancer patients because the cancer is generally located near the heart. Patients who receive proton therapy may have side effects like fatigue even though this radiation method typically results in less damage to healthy cells.
- More research is needed on the effects of exercise during cancer treatment, but one of our experts says being in good shape during a cancer battle is beneficial.
After McKeon’s diagnosis, she underwent eight rounds of chemotherapy, a preventative double mastectomy and surgery to remove all of her lymph nodes and a piece of skin on her left breast. Now, she’s having proton therapy treatments and making the most of her college experience. She’s currently handling a full course load from University of Southern California virtually, but she plans to be back in person full-time by the beginning of March.
Read More“WooooWOOOO workout Wednesday,” she wrote in her caption. “Working out is one of the best ways to combat radiation fatigue so me and @codyrigsby & @allymisslove 's Peloton rides are becoming rlly good friends this month.”View this post on Instagram
What Kind of Radiation Is Miranda McKeon Having?
Proton therapy the form of treatment McKeon is undergoing is a relatively new form of radiation that does have its advantages, but it's generally more expensive than other treatment alternatives. It tends to work best for patients whose cancer has not yet spread to other parts of the body. The biggest advantage of this kind of radiation is that it minimizes damage to healthy cells since the protons stop at the target, compared to x-rays which continue to pass through the body and leave an exit dose.
RELATED: The Benefits of Proton Therapy
Still, there is some debate about whether proton therapy is really necessary given its cost and limited availability for large portions of the country. Dr. Keith Cengel, a radiation oncologist at the Hospital of the University of Pennsylvania, says x-ray or traditional photon radiation "are pretty darn good" for small, early stage lung cancers, but he did not comment on proton therapy for breast cancer.
Proton Therapy: When Is Expensive Cancer Treatment Really Worth it?
"As the technology gets better, we're going to get to a point where you can deliver protons the same way as you deliver regular X-rays in every small town in America, potentially," he said in a previous interview with SurvivorNet.
Cost of cancer care affects many things, including, unfortunately, therapy options. But it's important to try to get multiple opinions after a doctor makes a treatment recommendation. With proton therapy, for instance, other cheaper alternatives might be a better option when factoring in financials and availability. So, it's good to explore your options.
Understanding Radiation Fatigue
Radiation therapy, in general, can affect the heart when given to breast cancer patients.
“When the radiation is delivered, unfortunately, the heart happens to be somewhere very near to where they have their breast cancer and it becomes an innocent bystander absorbing some of the radiation,” Dr. Jean-Bernard Durand previously told SurvivorNet. “Shortness of breath, fatigue, development of heart failure. So, we make it a point to see them on a regular basis so that we can catch these things very early and treat them.”
Unfortunately, side effects might not even appear for “as much as 10 to 20 years after exposure” making consistent check ups all the more important. And even though proton therapy minimizes damage to healthy cells, recipients still can still see side effects like fatigue.
“Radiation is a form of energy. A form of energy that, when we give radiation, has an ability to what we call "scatter," Dr. Durand said. “Even though we may target, one particular area, that "scattering" of energy of protons, of radiation, can cause injury to the local surrounding structures including the heart. In response to injury, there can be swelling and, unfortunately, there can be the development of scar tissue.”
The scar tissue, Dr. Durand says, is what often causes problems.
“This scar tissue that develops within the heart’s electrical system, within the blood supply, within the muscle,” he explained. “We believe is what causes all the injury, that ultimately leads to the symptoms.”
Exercise and Cancer
Radiation fatigue, along with other cancer treatment side effects, can potentially be mitigated by exercise. In fact, MD Anderson Cancer Center says it’s important to keep exercise during cancer treatment “in most cases.” Carol Harrison, a senior exercise physiologist, from the cancer center believes “exercise has the potential to help reduce some of the fatigue experienced during and after treatment, especially if you’re undergoing radiation therapy.”
And SurvivorNet experts have also commented on the benefits of exercise. Dr. Sairah Ahmed, associate professor in the Division of Cancer Medicine at the University of Texas MD Anderson Cancer Center, wants the SurvivorNet community to know that being in good shape during your cancer battle is very beneficial.
What to know about diet and exercise if you have cancer
"I think that, in terms of cancer, oftentimes patients feel that they don't have any control over any part of their life, and that's not true," Ahmed told SurvivorNet in an earlier interview. "The more physically fit you are going through your cancer treatment, the less side effects you'll have and the faster you'll get back to your normal quality of life."
According to the National Cancer Institute, physical activity is beneficial for cancer survivors. The NCI cited findings from a report of the 2018 American College of Sports Medicine International Multidisciplinary Roundtable on physical activity and cancer prevention and control in saying that exercise is generally good for cancer survivors. The roundtable also found:
- Strong evidence that moderate-intensity aerobic training and/or resistance exercise during and after cancer treatment can reduce anxiety, depressive symptoms and fatigue and improve health-related quality of life and physical function.
- Strong evidence that exercise training is safe in persons who have or might develop breast-cancer-related lymphedema.
- Some evidence that exercise is beneficial for bone health and sleep quality.
- Insufficient evidence that physical activity can help prevent cardiotoxicity or chemotherapy-induced peripheral neuropathy or improve cognitive function, falls, nausea, pain, sexual function or treatment tolerance.
Learn more about SurvivorNet's rigorous medical review process.