a practical guide to living with and after...

A practical guide to living with and after cancer

1 Gardening as a way to keep active

About this leaflet

This leaflet is about gardening and how it can help you keep active when you have cancer.

There are many benefits in taking part in physical activity before and after cancer treatment, including enabling you to take back control of your life. There are many types of physical activity that could work for you, and gardening may be one of them. Before you start gardening, check with your doctors. If you have low immunity, you may be at more risk of getting an infection.

We have included some quotes from people who have enjoyed gardening, which you might find helpful. They are from people who have chosen to share their experience on our Online Community (community.macmillan.org.uk).

There are also some useful gardening and physical activity websites at the end of this leaflet (see pages 20–23). We hope you find them useful.

Contents 2

ContentsBenefits of gardening 4

Benefits of physical activity 6

Preparing for physical activity 8

Gardening tips 11

If you don’t have a garden 18

Other physical activity 20

Gardening organisations 22

The National Garden Scheme 24

Further information and support 25

Quote textQuote name

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Benefits of gardening 4

Benefits of gardening

Like other forms of physical activity, gardening can have many benefits for your physical and mental health. It can help you prevent and manage some of the effects of treatment, such as fatigue, depression and risks to your heart health. And lots of people tell us that gardening helps them to feel more like their old self.

Many people find gardening relaxing and get a sense of achievement from watching flowers bloom or eating home-grown vegetables.

If you grow fruit or vegetables, it may encourage you to eat these foods more. Fruit and vegetables are a good source of vitamins, minerals and fibre and are low in fat. Eating healthily will give you more energy and help you to feel better.

Gardening is also an activity that can be shared with friends or family, and taking part in community gardening (see page 18) can be a good way to make new friends.

‘Waiting for new flowers to grow and bloom gave me something I could look forward to.’

Anne


You may be a little nervous about building up your activity levels if you’ve been inactive for a while. Gardening can be a good starting point, as the activities can be as gentle as you like.

Whether you’re new to gardening or have been doing it for many years, the most important thing is to enjoy yourself.

By following simple advice, and working within your own limits, you should be able to gradually increase your fitness levels.

‘When former certainties have been thrown into doubt, gardening can be therapeutic. It gives you an opportunity to get things into perspective.’

Roy

Benefits of physical activity 6

Benefits of physical activity

Cancer and its treatments can cause physical changes, and dealing with these is often stressful. Being physically active can let you take back control, which can help you cope with and recover from some of these changes.

Doctors used to advise people to rest as much as possible during treatment. But we now know that too much rest causes loss of muscle strength and low energy levels.

Being active during and after cancer treatment can:

• reduce treatment side effects

• reduce tiredness (fatigue)

• help look after your heart

• reduce depression and anxiety

• help look after your bones and joints

• give you more muscle strength

• help you maintain a healthy weight.

There is evidence that being active can reduce the risk of some cancers progressing or coming back. More research is needed, but there are good signs that being active can make a difference.


Preparing for physical activity

If you haven’t been active for a while, it’s important to start slowly and build up gradually. Don’t try to do too much in one go, and ask others for help if you need it.

Warming up and cooling down

It’s important to warm up before doing any physical activity, including gardening. Simple, gentle stretching exercises can help prevent straining your muscles. Warm-up exercises can include walking on the spot, lifting your knees and rolling your shoulders. Visit the NHS Choices website (nhs.uk) and search ‘how to warm up before exercise’ for more details.

When you’ve finished, allow your body to gradually cool down by doing a few gentle stretches. Visit the NHS Choices website and search for ‘how to stretch after exercising’ for more details.


How much activity is right for you?

Some people have concerns about becoming more active. But being active has fewer risks than being inactive.

Try taking a ‘little and often’ approach to physical activity, perhaps doing something every day. As you become fitter, you’ll find you can do more. You could keep a log of what you have done to help you track your progress.

The amount of activity you feel able to do will depend on:

• how fit you were before you were diagnosed

• the type of cancer and treatments you’ve had

• treatment side effects and any other symptoms you have

• your age and any other ongoing or long-term conditions.

You will be the best judge of which types of physical activity you’re able to do and how much. Don’t exercise if you feel unwell, or if you have any symptoms that worry you.


Stop and contact your doctor if you: • feel dizzy

• have chest pain

• have a racing heart

• have breathing problems

• have any other sudden symptoms.

If you’d like more advice on becoming more active, you could speak to a physiotherapist or an exercise specialist. Your GP or cancer specialist may be able to arrange a referral for you if there are particular problems you need advice about.

Our free Move more guide includes our booklet Physical activity and cancer treatment, a physical activity planner and tips about exercising. We also have a DVD called Get active, feel good, which includes activity programmes you can complete at home. To order these, call us on 0808 808 00 00 or visit macmillan.org.uk/movemore


Gardening tips

Some of the tips in this section are based on ideas from the Royal Horticultural Society and the charity Thrive. On their websites, you can read more information about low-maintenance gardening and gardening when you have a health condition. See page 23 for their contact details.

General advice • Wear well-fitting shoes such as trainers.

• Drink plenty of water so you don’t get dehydrated.

• Eat something healthy that includes carbohydrates about two hours before you start. Eat a healthy snack within 30 minutes of finishing.

• Avoid uneven surfaces and activities that increase the risk of falling or hurting yourself (especially if you have problems with your bones).

‘I found that exercise, fresh air and sunshine made me feel a great deal better during and after treatment.’

Susan

Gardening tips 12

Garden design and layout

Changing how your garden is designed may make it easier to look after.

• Focus on what is most important to you. If your main priority is tending to a vegetable patch or a particular flower bed, try to make sure the rest of the garden is easy to maintain.

• If there are features in your garden that require lots of work, try to put them close to your house or shed.

• Lawns often need the most work. You could let the grass grow long in some areas, to introduce wilder parts of the garden. This can look nice and supports wildlife. If your budget allows, you may want to consider using a professional lawn maintenance company.

• Think about installing a water point where you are most likely to need it. Automatic irrigation systems and timers can also help, especially if you have lots of plants.


Planting • Pick plants that are easy to grow and which grow slowly. Ask in your gardening centre or shop for advice or visit carryongardening.org.uk/plant-guide for suggestions.

• Choose plants that suit the conditions in your garden, such as the type of soil and the amount of shade.

• Consider plants without thorns, to reduce the risk of cuts. See page 15 for information about treating cuts.

• Choose plants you can easily take cuttings from. You can then use these to fill gaps elsewhere in the garden.

• Choose plants that are less prone to pests or diseases.

• It may be easier to control weeds by replacing perennial beds with shrubs.

For an introduction to planting and maintaining a garden, visit rhs.org.uk/advice/beginners-guide


Clothing and equipment

Your clothing should be comfortable and loose enough to allow you to move easily.

• Protect your hands from cuts or grazes by wearing gloves. This is especially important if you have any swelling (lymphoedema) in your hands or arms, or if you may be at risk of getting lymphoedema.

• If you do get any cuts or grazes, wash the area well under running water. Then dry and cover it with a plaster or bandage if necessary.

• Using small or lightweight equipment can make gardening easier. Garden kneelers are handy tools, which can make it more comfortable to kneel. Some can also be adjusted and used as seats.

‘After my treatment had finished, I was very weak but found I could garden from a deckchair. Gradually I started doing more without noticing because I was so absorbed in what I was doing.’

Anne

Gardening tips 16

Taking care in the sun

Some cancer treatments can make your skin more at risk of damage from the sun. For example, some chemotherapy drugs can make your skin more sensitive. This can sometimes last for several years after treatment.

• If you’ve had chemotherapy, you can ask your doctor whether you need to take special care to protect your skin.

• If you’ve had radiotherapy, the skin in the area that was treated will stay sensitive for many years. You should take extra care to protect it from the sun. Wearing protective clothing and using suncream with a high sun protection factor (SPF) can help to make sure your skin doesn’t burn. We recommend using a suncream that is at least SPF 30.


Bending and lifting

Many people get backache after spending too long bending over flower beds.

• If you can, raise your flower beds or pots so you’re not bending so far. You can wear knee pads or use a kneeling pad for extra support.

• After digging or bending, stand up, then gently lean backwards 5–10 times to ease the strain on your back. Stop if it feels painful. Long-handled gardening tools can help reduce the amount of bending and reaching you need to do.

• When lifting, keep the load close to your body. Bend from your knees (not your back) and push up with your legs.

• Avoid lifting and twisting at the same time.

• If you have recently had surgery, you may need to ask your doctor or physiotherapist about how much lifting you can do.

If you don’t have a garden 18

If you don’t have a garden

If you don’t have a garden, there are other ways that you can get into gardening. You could try one of the following options:

• Grow flowers or plants in window boxes. Or use containers on a patio or balcony. The Royal Horticultural Society (see page 23) has lots of practical advice about growing different plants and vegetables.

• Get involved in a community garden scheme. The Federation of City Farms and Community Gardens (see page 22) can give you more information about schemes in your area.

• Hire an allotment in your area. They are often popular and have long waiting lists. To start with, you should contact your local council. You can also get information from The National Allotment Society (see page 22).

• Some hospitals have community gardens that patients can get involved with. Maggie’s Centres – local support centres for people with cancer – offer gardening therapy groups. Visit maggiescentres.org to see if there is a centre near you.

• You can also visit rhs.org.uk/communities to find out about community gardening opportunities in your area.


As well as growing plants yourself, it can be good to get out and see what other people are doing. There are many public gardens you can visit.

If you’d like to get active outdoors, you may also be interested in some of the walking organisations we’ve listed opposite.

Other physical activity 20

Other physical activity

As well as gardening, there are other physical activities you can do to help you keep active when you have cancer. Our Physical activity and cancer booklet has more information. Call us on 0808 808 00 00 to order a free copy.

Walking is very popular. Macmillan is working with health walk programmes across the UK that offer free, short and friendly health walks. All health walks will have:

• short walks

• walks to suit people with long-term health conditions, including cancer

• friendly, knowledgeable, trained walk leaders

• safe routes to walk

• good company.

To find out more about what’s going on in your area, you can speak to the following organisations:

Walking for Health (England)020 7339 8541 www.walkingforhealth.org.uk

Paths for All (Scotland)01259 218 888 www.pathsforall.org.uk


Let’s Walk Cymru (Wales)02920 644308 www.letswalkcymru.org.uk

Walk NI (Northern Ireland)028 9030 3930 Contact the Physical Activity Co-ordinator in your local health trust to find out about health walks.

For more information about health walks, visit macmillan.org.uk/healthwalks

‘ What worked for me to begin with was a little light gardening or walking. The important thing is to do whatever you feel like doing. There is no right or wrong way.’

Ed

Gardening organisations 22

Federation of City Farms and Community GardensThe Green House, Hereford Street, Bristol BS3 4NA Tel 0117 923 1800 www.farmgarden.org.uk Supports and promotes community-managed farms, gardens, allotments and other green spaces in the UK.

The National Allotment SocietyO’Dell House, Hunters Road, Corby, Northamptonshire NN17 5JE Tel 01536 266 576 www.nsalg.org.uk Protects the interests and rights of allotment communities across the UK.

The National Garden SchemeHatchlands Park, East Clandon, Guildford GU4 7RT Tel 01483 211 535 www.ngs.org.uk Gives the public access to thousands of gardens in England and Wales. Details of these gardens can be found in their guide ‘The Garden Visitor’s Handbook’.

Gardening organisations


Royal Horticultural Society80 Vincent Square, London SW1P 2PE Tel 0845 260 5000 www.rhs.org.uk Dedicated to advancing horticulture and promoting good gardening in the UK. Provides detailed gardening tips on their website, including tips on low-maintenance gardening.

ThriveThe Geoffrey Udall Centre, Beech Hill, Reading RG7 2AT Email [email protected] Tel 0118 988 5688 www.thrive.org.uk A national charity that helps people with a disability start or continue gardening. Provides information and guidance through its website carryongardening.co.uk

The National Garden Scheme 24

The National Garden Scheme

The National Garden Scheme are Macmillan’s longest-standing partner and largest single donor. They promote the benefits of gardening and visiting gardens for people’s physical and mental well-being.

Each year, The National Garden Scheme produces a guide called The Garden Visitor’s Handbook. It lists around 3,700 private gardens that open to the public at certain times of the year, to raise money for nursing charities. You can find full details of all the gardens that open and order your copy of their handbook at ngs.org.uk

Macmillan and the National Garden Scheme also produce a gardening calendar. Each month’s page comes with a handy gardening tip and a delicious recipe for you to try. Order yours at shop.macmillan.org.uk

George Plumptre, Chief Executive of the National Garden Scheme, says: ‘We are passionate about the positive impact of gardening and being outdoors in beautiful gardens. Many of our gardeners have experienced health benefits from gardening, and they fully support our work with Macmillan to help people affected by cancer. We hope that the readers of this leaflet reap the rewards of being outdoors in the garden.’

For more information on our partnership, please visit macmillan.org.uk/ngs


Further information and support

Order our information

We have a wide range of cancer information available to order for free at be.macmillan.org.uk or call us on 0808 808 00 00. Our information is also available online at macmillan.org.uk/information-and-support

Talk to us

You can call our Macmillan Support Line on 0808 808 00 00. Our cancer support specialists can help with medical questions, money worries or just be there to listen if you need someone to talk to. Our free, confidential phone line is open Monday–Friday, 9am–8pm.

Talk to others

You might find it helpful to talk to other people going through similar things. This could be face to face in a support group. To find one in your area, visit macmillan.org.uk/supportgroups

Alternatively, you may want to join our online community. You can access it any time of day or night. Visit macmillan.org.uk/community

Disclaimer, Thanks and Sources 26

Disclaimer

We make every effort to ensure that the information we provide is

accurate and up to date but it should not be relied upon as a substitute

for specialist professional advice tailored to your situation. So far as

is permitted by law, Macmillan does not accept liability in relation to

the use of any information contained in this publication, or third-party

information or websites included or referred to in it.

Thanks

This leaflet was originally written by Mandy Trickett, Macmillan

Specialist Physiotherapist. It has been revised and edited by Macmillan

Cancer Support’s Cancer Information Development team. It has

been approved by our Chief Medical Editor, Tim Iveson, Macmillan

Consultant Medical Oncologist. With thanks to: Maxine Cumbo,

Sarcoma Specialist and Macmillan Physiotherapist; Tamzin Marsh,

Macmillan Marketing Officer; and Justin Webb, Macmillan Physical

Activity Engagement Manager. Thanks also to the people affected by

cancer who reviewed this edition, and those who shared their stories.

Sources

We’ve listed a sample of the sources used in this publication

below. If you’d like further information about the sources we use,

please contact us at [email protected]

Maggie’s Centres website. www.maggiescentres.org (accessed

December 2015).

Royal Horticultural Society website. www.rhs.org.uk/beginners-guide

(accessed October 2015).

Royal Horticultural Society website. www.rhs.org.uk/communities

(accessed December 2015).

Thrive website. www.carryongardening.org.uk (accessed October 2015).

© Macmillan Cancer Support, February 2016. 2nd edition. MAC14169. Next planned review 2018. Macmillan Cancer Support, registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Printed using sustainable material. Please recycle.

More than one in three of us will get cancer. For most of us it will be the toughest fight we ever face. And the feelings of isolation and loneliness that so many people experience make it even harder. But you don’t have to go through it alone. The Macmillan team is with you every step of the way.

We are the nurses and therapists helping you through treatment. The experts on the end of the phone. The advisers telling you which benefits you’re entitled to. The volunteers giving you a hand with the everyday things. The campaigners improving cancer care. The community there for you online, any time. The supporters who make it all possible.

Together, we are all Macmillan Cancer Support.

For cancer support every step of the way, call Macmillan on 0808 808 00 00 (Mon–Fri, 9am–8pm) or visit macmillan.org.uk

Hard of hearing? Use textphone 0808 808 0121, or Text Relay. Non-English speaker? Interpreters available. Braille and large print versions on request.

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