5 replies to this topic

[mdszj]

Happy 4th of July everyone!!  I would like like to get some feedback on exercise from you guys.

I know there are a lot of folks in here who are into exercise, as I am, and I have a question.  I am a believer that exercise helps the TKIs work better, maybe by increasing blood flow and getting the bad cells out where they are more available to be destroyed, etc;.  There have also been a few posts regarding the effect of exercise by some of you recently, which I agree with.  However I have never seen any actual data that proves this is the case, and both my regular hemo as well as my leukemia specialist both seem to think the idea is bogus.  Typical doctors, geezus...

My question is - is it better to do long slower, less intense exercise, such as walking for an hour a day or shorter but more intense "interval" type exercise, such as hitting a heavy bag (ie doing 3 x 2 minute rounds with 2 minute rest periods), also on a daily basis.  I dont have much to go on here but I just got back my latest PCR result done on 6/24/13 and it is 0.044% IS.  This is a reduction of ~62% compared to the previous value of 0.118% IS.  During this time period I was mostly hitting the bag, with a much smaller amount of walking.  My previous result of 0.118% IS was a reduction of ~ 98% compared to the previous value of 8.3% IS done on 11/6/12.  During this time I was doing a lot more walking (I think - I never kept any record or exercise log) and less bag work.

I know I do not have much to go on here as far as actual proof of anything and guess that none of us really knows the answer to this. 

The only other thing I can think of is that these reduction figures are really just natural noise and represent basically the same reduction rate number since there are so many variables (stomach acid level, what you eat, type/amt/frequency of exercise, uncertainty associated with the PCR test, time interval between tests, etc).

thx for any thoughts on this, Mike

[Trey]

I am of the opinion that these things can help, but not a lot.  After some level of exercise, stomach acid, etc the benefits are likely negligible.  The data is mostly intuitive, not based in research.  Just getting the blood pumping is probably good enough, and the marrow, although not  tied into the main arterial flow, will also be stimulated. 

And by the way, we have two circulatory systems, the arterial and the lymphatic.  The lymph system contains tons of WBCs that only move  as the muscles squeeze on the lymphatic vessels since this system has no pump.  So exercise gets the lymph fluid flowing faster, which is generally better for the body.  This is likely the more significant impact of exercise than simple blood flow through the arteries, although both are important. 

http://www.innerbody...age/lympov.html

[LivingWellWithCML]

This topic is always interesting to me.  I also believe that exercise might have some type of positive impact via bone marrow stimulation, but you're right -- there's nothing to support this.  What do you guys think about 'when' to take a TKI relative to exercise - before or after a workout?  Over the past few months, I've been focused on endurance road biking (between 25 - 40 miles per ride with ~ 2,000 ft of climbing, 5x/week), and it's been working the heck out of my heart.  My most recent rides get my heart rate pumping between 135 - 170 bpm for quite a while ... up to 2 hr 30 min+ on some rides.  Most of the time, I do a ride very early in the morning and take Gleevec 400mg about an hour after concluding my ride.  Although today I took Gleevec about 30 minutes before my ride, so it was absorbing into my bloodstream while I was on the ride with a fast heartbeat.

Any opinions on whether it'd be better to take a TKI right before, or right after?

[Trey]

I doubt there is much difference, so I would not over-think this issue.  But since you ask, TKI drugs only work inside the leukemic WBCs.  So as an intuitive approach, I would say it is better to have the blood plasma retain the TKI as long as possible.  That would argue for not mixing extreme exercise and TKI drugs.  Extreme exercise would push the blood through the liver faster, potentially removing the drug more quickly.  But re-read my first sentence. 

[mdszj]

I have thought about this also but was never able to come to any decision about the best sequence.  So I just went with what is easiest and most convenient for my schedule, which is that on weekdays I work out right after I get home and then take the pill with dinner an hour or 2 later.  On weekends I work out in the morning to get it over with, but still take my pill with dinner.  Unless something changes for me I will probably just keep doing that.

[mdszj]

Good info - especially about the lymph system, I never thought about that.