Body
Fifty-one-year-old Anthony Z. has led an active life of fitness and athletics, from cycling to playing volleyball and soccer.
However, in 2021, the Chicago-based architect was diagnosed with stage 4 colon cancer, and the disease began to take a severe toll on his strength and overall fitness due to rapid, cancer-related weight and muscle loss.
Over a six-month period, Anthony lost a quarter of his body weight — 50 pounds total — from a condition called cachexia. Cachexia is a wasting of muscle seen in certain chronic illnesses, and is believed to be caused by high levels of inflammation in the body that disrupt muscles’ normal function.
As Anthony was losing a pound a week and feeling increasingly weakened, his oncologist referred him to Shirley Ryan AbilityLab’s Cancer Rehabilitation Program. The program treats cancer-related cachexia, as well as other impairments stemming from cancer and its treatments, through intensive rehabilitation and targeted interventions.
“I previously had undergone physical therapy for sports-related injuries, but it was never on my mind for cancer treatment,” Anthony said, reflecting on the start of his cancer rehabilitation.
The Importance of Counteracting Cachexia
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According to Ishan Roy, MD, PhD, Anthony’s physician at Shirley Ryan AbilityLab, nearly 50 percent of patients with cancer have cachexia at some point. Patients with cachexia may not respond as well to chemotherapy and may have more side effects. Plus, the condition impacts muscle, brain, cardiovascular and gastrointestinal function.
“There is strong rationale for directly addressing cachexia in parallel with treating cancer, and the cancer community is starting to understand that,” said Dr. Roy.
When Anthony first came to Shirley Ryan AbilityLab, he underwent a bioelectrical impedance analysis, which uses technology and small amounts of electricity to estimate body composition and track muscle mass. An initial scan showed that his muscle mass was like that of a much older person.
Dr. Roy said Anthony’s situation was complex. In addition to the weight loss, he was navigating his cancer treatments and side effects from chemotherapy and making other lifestyle changes to manage his disease.
“Our main goal was for Anthony to maintain and ideally even improve his functional independence and help him get to do the things he wanted to do in life,” said Dr. Roy.
Anthony needed to get stronger, and so Dr. Roy referred him to Shirley Ryan AbilityLab’s Adaptive Sports and Fitness Center.
“Anthony is pretty high functioning in his ability to do exercise,” said Dr. Roy. “That’s not always the case with patients, and we felt comfortable about establishing an exercise program for him. Our Adaptive Sports & Fitness Center is a perfect resource.”
Dr. Roy underscored how rare it is for a rehabilitation hospital to offer access to dedicated, individualized fitness training for patients with cancer. Further, Anthony was paired with a Shirley Ryan AbilityLab exercise physiologist, Josh, who brought unique experience in working with patients with cancer and cachexia.
With Anthony in experienced hands, it was time to get to work.
Getting Down to Fitness
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Anthony’s regimen includes fitness training sessions with Josh approximately six times a month, with a flexible schedule around three-day chemotherapy treatments twice a month.
Anthony’s program was specifically designed for patients with cancer, with exercises that support gaining strength and building muscle including chest press, shoulder press, lat pull downs, leg extensions and hamstring curls.
“Anthony’s mental toughness to consistently come in for training, even when he is fatigued from treatment, has been a huge factor in his growth,” said Josh. “Progress isn’t linear and some days inevitably feel harder than others, but he has persevered through the harder days to stay on track.”
This fitness program — marking Anthony’s first-ever formal training schedule — started off slowly, and he experienced initial post-workout soreness. Soon, though, he started to see the positive impact of training on his body and spirit.
“It has been an enlightening experience for me,” said Anthony. “I started getting muscle back and gaining weight. I regained strength relatively quickly, and I felt in control of my body and more at ease with my movement.”
Building Back Muscle & Gaining Strength
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Now several months into his training regimen, Anthony says his quality of life is greatly improved. In six months, his skeletal muscle mass has increased by 13 percent. Plus, his strength has improved greatly during this same period.
“We tested Anthony's strength at the beginning, and his chest press was 127 pounds and his leg press was 226 pounds,” said Josh. “In time, he has improved to 158 and 333 pounds, respectively. These are incredible gains.”
“I feel like I’m a healthier and more capable person because I’m stronger,” said Anthony.
Today, Anthony is focused on gaining more muscle and working on his flexibility. He is also part of Dr. Roy’s ongoing cachexia research, including participating in one prospective study that looks at biomarkers for muscle wasting.
For Anthony, Shirley Ryan AbilityLab’s cancer rehabilitation and training have helped him embrace a positive mind shift. He now recognizes how integral fitness and exercise are to his continued cancer journey.
“I’ve realized I can treat cancer as a chronic illness and work at it incrementally on a day-to-day basis for the rest of my life,” he said. “I’m focused on being strong for tomorrow and the day after that.”
