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HEALTH CONCERN? BioHealth Health Concerns

Leukemia and Physical Therapy - Advice

Contributing Author: Rubin, Josh O.T.

Josh RubinJoshua Rubin graduated from American International College with a B.S. in Occupational Therapy. After working with the geriatric population for many years, he decided to take his career to the next level. By incorporating corrective exercise, nutrition and lifestyle coaching with his rehabilitation background, he began working with individuals of all ages within the personal training industry. This is where he found his love for holistic coaching, and as a result of developing San Diego’s EastWest Healing & Performance in 2002, he is one of Southern California’s top Personal Trainer, Nutrition and Lifestyle Coach, and Rehabilitation Specialist.

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I am really impressed with the depth of authors and content of articles that are posted on PT on the Net. I have an interesting question that I'm sure some of these authors might be willing to give me some help with. I have recently started with a new client that has leukemia. She has undergone chemotherapy some many months ago and wants to get back into training at the gym. What would the exercise prescription or precautions look like for such a client and, even more importantly, what nutritional/dietary intake would be recommended? Are there any major deficiencies that need to be addressed?


Let me begin by stating this:

When it comes to being a trainer or any type of higher level practitioner, the best process to put in place to help someone heal is to develop a multidisciplinary team. This allows all aspects of the healing puzzle to come together in such a fashion that they fit the person’s needs. In our society today, people are becoming less vital. You no longer have people just coming in to lose weight. They come in with injuries, chronic pain, autoimmune disorders, and so forth. My recommendation is to be the team leader in this situation by assessing and recommending that she keep her MD in the loop, see a massage therapist, a TCM, and so forth—whichever health practitioners that you see fit with respect to helping her heal.

The following is a brief description of leukemia and its symptoms from

Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).

White blood cells, which are involved in fighting pathogens, may be suppressed or become dysfunctional. This could cause the patient's immune system (including white blood cells) to start attacking the body’s other cells.

Finally, red blood cell deficiency leads to anemia, which may cause dyspnea. All symptoms may be attributed to other diseases; for diagnosis, blood tests and a bone marrow examination are required.

A few other symptoms related to leukemia include:

  • Fever, chills, night sweats and other flu-like symptoms
  • Weakness and fatigue
  • Loss of appetite and/or weight
  • Swollen or bleeding gums
  • Excess bleeding (from a minor cut)
  • Neurological symptoms (headache)
  • Enlarged liver and spleen
  • Easy bruising
  • Frequent infection
  • Bone pain
  • Joint pains
  • Swollen tonsils

I recommend the following actions for such a client:

  1. Refer the client to some type of holistic nutrition and lifestyle coach. There are many foundational principles to follow that will strengthen her immune system and reduce the overall sympathetic state that she is in. I find that conventional foods lacking any nutritional value, toxic home/office cleaning and hygiene products, and plastics, are among the major contributing factors to disease.
  1. I recommend regular traditional Chinese medicine treatments (whether herbs, acupuncture, Qi Gong, etc.) to balance the five elements (wood-LV/GB, fire-HT/SI, earth-SP/ST, metal-LU/LI, and water-KD/UB) of the body. The symptoms listed above are common in TCM and correlate to Qi deficiencies of certain organs, interior heat in certain meridians, and lack of Wei Qi (the immune system).
  2. As for exercise, your best bet is to assess her, design a program that fits her needs, and one that also reduces her sympathetic overload. I would start small and work up from there each time you see her. You might have to get creative and play with the exercises, exercise types, and variables, depending on how she feels during each session. With clients such as her, I would focus first on nutrition and lifestyle, and then add in Qi Gong movements for a month or so. This gradual schedule allows the body to adapt to the stressors at hand, and then when she is able to handle more, you can create a low intensity, “functional” exercise program. Exercise is key to healing, but it might not be first on her healing totem pole!

Good luck!

Joshua Rubin