Cold Plunge for Cancer, Why Try it?
Consider our Safety Guidelines
Sitting with the discomfort of cold is trending now more then ever, thanks to Wimhof amongst other cold evangelists. The research of Dr. Søberg, Beijers AJM, Bonhof CS, Mols F amongst others is furthermore providing science and creditability to the concept of cooling our core. Maybe cold isn’t something we should run from after all?
In this blog we will address cold exposure or cold plunging for those with cancer. Cold plunging in this case involves more than just experiencing 10 seconds of cold; jumping in and out. We are defining cold exposure as being submerged neck down and/or exposing the body to a cold experience for a period of time, a protocol which we will elaborate on later.
In our protocol, we are aiming to provide accessible and safe cold plunging for those with cancer. As undergoing cancer treatment and being in the treatment phase, or being in the recovery stage of cancer rehab may come with its own precautions.
Wound health, skin health, blood pressure etc, need to be accounted for. Here are our SAFE Cancer + Cold Plunging Guidelines, that you may consider prior to starting our cold plunge protocol.
What does Cold Exposure Include?
We have defined cold plunge to include a cold bath, cold shower, or submerging into a cold body of water. At times patients may opt to use wet suit gloves or booties to start. Although some methods of cold exposure are more effective such as a plunge in comparison to a cold shower (referenced in current literature); for accessibility sake we are going to welcome them all.
Most cold experiences are similar, cold shower or cold plunge as blood is always shunting out of the periphery and into the core. We want to keep cold exposure accessible to all, so we will include all possible types and not get picky!
Let’s Make Cold Plunging Accessible and Safe For Those with Cancer.
Cold Plunging can Help with Cancer.
Cold Plunging can help with Chemotherapy Induced Peripheral Neuropathies (CIPN) Prevention.
The American Society of Clinical Oncology 2020 guidelines for the prevention of CIPN was created through a systematic review of 48 RCT’s studies. Almost all investigated interventions such as micro-nutrients, drugs and non drug interventions were deemed as ineffective; a side from the drug Cymbalta/Duloxetine. Drug free low risk interventions that needed more science were mentioned; such as vitamin B, low grade compression and cold therapy. Compression technologies are now is trial phases through out Europe such as the Luminate med Lilac product for hands and feet.
Cold exposure is also undergoing trials and it started with CIPN studies back in 2013 with Danish investigators noting that patients who received distal-extremity cryotherapy in the form of frozen mitts had reductions of Docetaxel induced neuropathies by approximately 50% (Eckhoff L et al. 2013).
Further studies continued including one larger unblinded RCT of 180 patients treated with oxaliplatin and/or docetaxel or paclitaxel who were assigned frozen mitts to wear during chemotherapy infusions. This study showed improvements in quality of life and reductions in neuropathy related symptoms. Excitingly, the research group has moved onto phase 3 trials (Beijers AJM 2020).
Currently at the BC Cancer Agency, depending on cancer/chemotherapy type, patients are being offered frozen mitts while undergoing chemotherapy infusions.
Cold Plunging can Help Reduce Inflammation and Enhance Well-Being.
We understand thus far that cold exposure supports a large dopamine release up to 300% which helps improve mood and feelings of motivation or focus. Lastly, repeated cold exposure over long periods of time can have an anti-inflammatory impact effecting levels of interleukin-6 a pro-inflammatory cytokine that contributes to chronic inflammation.
Cold Plunging can Help Boost Metabolism
As per the research of Dr. Søberg from the University of Denmark, cold plunging supports the activation of brown fat contributing to a metabolic boost. Brown fat activation and the consequential experience of shivering are both very metabolically demanding. In addition cold plunging can improve glucose metabolism and insulin sensitivity. In the case of hormone therapy related weight gain, this metabolic boost may be very helpful in supporting healthy weight maintenance and insulin regulation.
Cold Plunging may Help reduce Pain.
In the case of hormone therapy cold plunging can help. Symptoms of joint and muscle pain termed AIIMS (Aromatase inhibitor induced musculoskeletal syndrome), nausea and fatigue may improve with consistent cold exposure. There are reported cases of persistent neuralgia and neuropathies that have improved, but no studies have been completed on persistent pain and the impact of cold plunging.
In summary, cold plunging can help lessen the side effects of chemotherapy, help improve mental well being and may decrease pain.
Get Started with Cold Exposure Safely.
Getting starting should include reviewing our SAFE Cancer+ Cold Plunging guidelines to assure you don’t have any safety considerations.
One should start slowly, building into colder temperatures over time. Jumping off of a dock and racing out in panic isn’t recommended or effective. It’s best to slowly adapt your body to the cold shock, practicing your breathing right from the start; we recommend following our protocol for best results.
Avoid Panic and Slow down your Breathing Rate.
The cold is often uncomfortable; that is how we know it’s working. Starting slowly allows you to train yourself to focus on your breath as oppose to holding your breath, or panicking. You can begin with cool temperatures as opposed to cold and stay in longer. In addition, try decreasing the temperature over a 3 week time span. Another gradual strategy would be to be to gradually enter into the cold water; increasing your depth over a 3-5 min time period.
Focus on slowing down your breathing rate, breathing deep and diaphragmatically. Ideally, your breathing rate should be slow, consider James Nestor and his book on breath where he referenced the coherent breathing method of ~5.5 seconds in and out. Conversely, try just focusing on your exhale being a bit longer than your inhale and most importantly not holding your breath! There are a few breathing methods available, Wim Hof branded Tummo as an example, that can also help generate heat but for the sake of this blog, we’ll keep the focus on simply slowing down your breathing rate which is the safest.
Trust the process, in time the discomfort will pass, and your body will settle into the cold, this can take up to 3 minutes or more at times. It is very beneficial to leave the water feeling somewhat calm, promoting vagal stimulation as oppose to a state of panic.
On a more personal note, I have been emerging into the discomfort of cold since 2019 and it has helped me immensely, particularly with recovery and motivation.
Cold Exposure Protocol
1) When possible, cold plunging should be from the neck down or include our definition of cold exposure.
2) 11 minutes total/week (each exposure should be at least ~3 min in length, breathing rate is slowed and in a state of “calm” not panic)
3) A temperature that is uncomfortably cold such that you’d like to escape it. (Can decrease temperature over time).
*Consider our SAFE Cancer+ Cold Plunging Guidelines
Consistent safe and effective cold plunging can be an effective tool for managing the symptoms of cancer such as neuropathies, pain, weight gain and poor mental health amongst others. My hope is these simple tools in addition to the support of a personalized cancer rehab plan together will help you feel just a bit more like yourself again.
Thank you for your interest in science and rehab.
Kindly, The Cancer Physio
