For Marika Holmgren, fighting breast cancer was an uphill battle—literally. She got back on her mountain bike shortly after her diagnosis in February 2007, smack-dab in the middle of chemotherapy.gt;gt;"The treatment is so intense—it actually strips everything away. You’re physically and completely changed," says Holmgren, 40. "I was trying to retain some sense of normalcy. And truthfully, I felt a little badass being on my bike during treatment. I was giving cancer the middle finger."gt;gt;Tooling around on a mountain bike during chemotherapy sounds intense, maybe even unadvisable. But just the opposite is true: Holmgren was being a model patient.gt;gt;In the past, doctors often told cancer patients to take it easy during treatment. Although the appropriate amount of exercise varies from patient to patient, that conventional wisdom is now considered old hat. In fact, new guidelines on cancer and exercise from the American College of Sports Medicine (ACSM) urge cancer patients to be as physically active as possible both during and after their treatment. gt;gt;gt;"The idea that you should be staying put and resting is ultimately doing more harm than good," says Kathryn Schmitz, PhD, an epidemiologist at the University of Pennsylvania School of Medicine, in Philadelphia, who studies the role of physical activity in chronic diseases. Schmitz presented the guidelines at the American Society of Clinical Oncology’s annual meeting last week.gt;gt;It’s true that the last thing people overwhelmed by cancer’s psychological and physical impact may want to hear is "exercise more." During treatment, bone-crushing fatigue, nausea, and body-changing surgery, not to mention the emotional drain of coping with worried children, friends, and life partners, often puts exercise very last on the list of priorities.gt;gt;Still, experts now say that exercise may help with—not add to—those problems. It boosts energy, helps stave off the weight gain often associated with treatment, and provides a psychological pick-me-up at a time when a person’s morale is likely to be battered. gt;gt;gt;gt;Even small amounts helpgt;gt;How much exercise is enough? The ACSM recommends 150 minutes of moderate-intensity aerobic exercise per week, which works out to about 20 minutes a day—the same amount recommended to the general public. gt;gt;But that said, the organization is realistic about how cancer and its treatment can alter mood and energy levels. Any kind of activity—even a short walk—is better than none, ACSM says.gt;gt;"The risk of inactivity for cancer patients is so great that it’s best to just get started with something," says Schmitz. If you begin to feel worse or overtired, Schmitz recommends discussing it with your doctor.gt;gt;People who were sedentary before their diagnosis should commence by walking for 10 minutes each day, says Schmitz, and gradually increase their time by 10% to 15% each week until they can do 30 minutes at a stretch, five times per week.gt;gt; There may be days when you feel nauseous, exhausted, or utterly despondent. But friends or family can help. "A lot of it will be up to the caregivers because they are the ones who will know how to motivate patients facing an uphill battle," says Schmitz. "They’re the ones who can say, ‘Hey, let’s get dressed today,’ and then, ‘Hey, let’s get dressed and walk around the house.’ "gt;gt;It’s important to pick an activity you enjoy, says Alyson Moadel, PhD, the director of the psychosocial oncology program at the Albert Einstein Cancer Center, in the Bronx, N.Y. "It is not a one-size-fits-all answer, since patients may be more responsive and adherent to different fitness programs," she says. "It’s important to allow patients a choice and to tailor a fitness program to each patient."gt;gt;Fortunately the options are greater than ever before, as exercise programs for cancer patients have become increasingly popular nationwide. In 2007 the Lance Armstrong Foundation partnered with the YMCA to provide physical activities designed specifically for survivors, and more and more hospitals are creating their own programs as well. Cancer patients who aren’t willing or able to travel to a facility on a regular basis can sign up for programs that can be delivered by mail, phone, or the Internet. gt;gt;"Right now we’re working to develop a variety in the types of programs available," says Schmitz.gt;gt;Holmgren—a longtime mountain biker—took to the San Francisco hills with a group of women who ride with the Bay Area chapter of gt;Team LUNA Chixgt;, a program that brings together amateur bikers, runners, and triathletes, and is affiliated with the Breast Cancer Fund, a nonprofit advocacy organization based in San Francisco. gt;gt;"I had no hair, no eyelashes, and no eyebrows, and yet I didn’t think they would know I had cancer," says Holmgren. "The women were so fun and inspiring, and they never babied me. They just let me do my thing at my own pace."gt;gt;gt;gt;How exercise helpsgt;gt;Dozens of studies have demonstrated the benefits of staying active both during and after treatment. gt;gt;Regular exercise can help fight the weight gain that often comes with cancer treatment, including breast cancer. "It’s about what the typical American could expect to gain over the course of a couple of years, but it’s happening all at once," says Schmitz.gt;gt;But exercise is also important for cancer patients whose treatment can cause them to lose weight. Prostate cancer, cancers of the stomach and gut, and head and neck cancers can all lead to a significant decrease in muscle mass, as well as a loss of taste and an inability to process certain foods.gt;gt; "Those patients really need to focus on resistance exercises," says Schmitz. "That will help them increase their muscle mass and gain that functional tissue that they need."gt;gt;Even though most patients won’t be able to accomplish the same physical feats they were capable of before their diagnoses, adds Schmitz, staying active helps them achieve "a whole lot more than they would have been able to if they hadn’t been exercising."gt;gt;Exercising has more intangible benefits as well. In a 2007 study that followed advanced cancer patients who exercised while undergoing chemo, the participants were asked to keep diaries. Many of them noted the positive mental aspects of exercise. "It feels good to have a sense of an everyday life again," wrote one participant. "I have become incredibly energetic," wrote another.gt;gt;In addition to making patients feel normal again, staying active is a way for patients to measure the progress of their recovery. Holmgren stuck with her rides all summer while she was undergoing chemo. "They became a real benchmark for me," she says. "The more I would ride, the more I felt like I was getting back to my old self."gt;gt;Though Holmgren still can’t handle some of the climbs she conquered pre-diagnosis, mountain biking has helped her make peace with her changed body.gt;gt;"The hormone treatment, early menopause, early arthritis, the weight gain, the surgeries—breast cancer takes a huge toll on your body," she says. "I knew I was going to feel bad no matter what, so I figured I might as well be feeling bad on my bike doing something that I used to do—and something that people not going through cancer might not be able to do."

Given the choice, most people want to stay in their homes as they age. In one AARP survey, 89% of those 50 and older said they preferred to remain in their own residence, and the older the respondents, the stronger their feelings on the subject.gt;gt; "The people for whom it is hardest to stay in their house want to stay the most," says Elinor Ginzler, coauthor of gt;Caring for Your Parentsgt; and the director of livable communities at AARP, the Washington, D.C.–based lobbying group for older Americans. The good news: It may very well be possible. By carefully thinking through your options before you're in poor health, your home environment can meet your needs for the rest of your life. Here are some suggestions.gt;gt;gt;Modify your housegt;gt;Narrow hallways, slippery floors, steps—homes are filled with hazards for an aging person. Research suggests that making modifications and repairs can prevent about a third of home accidents. "Falls are the leading cause of death and disability among older people," says Ginzler. Increase safety with these simple, quick methods.gt;gt;gt;gt;Remove throw rugs to prevent trippinggt;gt;gt;gt;Install motion-sensor lighting to make nighttime trips to the bathroom less perilousgt;gt;gt;gt;Use a no-skid spray on slippery floor surfaces like tiles and linoleumgt;gt;gt;gt;Install grab bars in tubs and on stairsgt;gt;gt;gt;Remove knobs on cupboards and replace them with lever handles, which are easier to graspgt;gt;Of course, you may want to make more extensive renovations to your home, such as installing ramps or redesigning kitchens and baths. Think about working with a gt;certified aging-in-place specialistgt; (CAPS), a builder who has been trained by the National Association of Homebuilders to assess the improvements you may need.gt;gt; gt;Enlist your familygt;gt;Make sure your family knows you wish to remain in your home as long as possible. You can do that in an advanced care directive, which lays out the type of care you want toward the end of your life. Better to have forthright discussions up front so that you can discuss how your desire to stay at home can be achieved. Adult children may not realize that parents can be safe at home if the right modifications are made. gt;gt;gt;gt;Consider long-term-care insurancegt;gt;Paying someone to care for you in your home can be enormously pricey. At an average of $19 an hour, the services of a home health aide can add up to more than $3,000 a month for 9-to-5 care, Monday through Friday. Medicare, the government insurance program for the elderly, and private health insurance usually don't cover long-term care. To get this kind of help in your home, you must either pay for it out-of-pocket or use long-term-care insurance. Policies differ, but long-term-care coverage often kicks in if you are unable to perform at least two activities of daily living—like bathing, dressing, going to the toilet, or feeding yourself—for 90 days. It tends to be most affordable when purchased in middle age, long before most people develop health-related disabilities.gt;gt; meet your needs for the rest of your life. Here are some suggestions.gt;gt; "It's really a product that works best for people who think it through early," says Ginzler. "It's rarely appropriate for someone in his 70s, and less appropriate for people who have acute, chronic conditions."gt;gt;gt;Find the money in your housegt;gt;If you own your home, a reverse mortgage lets you convert the equity in your home into cash. "Quite often the house is the largest asset people have and it can be a good source of money," says Katana Abbott, a certified financial planner in Commerce, Mich., and the founder of gt;Designated Daughtergt;, a support network for caregivers. Those funds can then be used to hire a home help aide or make renovations.gt;gt;The more equity you have in your home, the more cash you can borrow. "A reverse mortgage is a good way to pay off what remains of your first or second mortgage, and free up cash to pay for medical expenses," says Barbara L. Steinberg, a certified financial planner and gt;registered financial gerontologistgt; in Lincoln Park, N.J. The loan only comes due if you sell your home, move out, or pass away. In the last case, your heirs can either sell the home or pay off the loan balance themselves—if you owe more than the home is worth, the lender takes the loss.gt;gt;You must be over the age of 62 to qualify for most reverse mortgages. In general, the older you are and the more your home is worth, the more equity you can access. (The AARP has an easy-to-use gt;reverse mortgage calculatorgt; on its website.) For reverse mortgages insured by the Federal Housing Administration, you may borrow up to $362,790 (depending where you live), as long as your home is appraised for more than that amount. You can receive the money in several ways: a lump sum payment, a line of credit, monthly payments, or some combination of all three. Closing costs are subtracted from your remaining equity, so there are few out-of-pocket expenses.gt;gt;There are a few drawbacks: Fees on a reverse mortgage are higher than on a regular mortgage, so it makes most sense if you intend to stay in your home for several more years. You also will not be able to leave the house unencumbered by debt to your children, which can be a factor if they have an emotional attachment to it.