Four years ago, we heard the words that would change our lives. My wife received a diagnosis of breast cancer. She was the fourth wife of my friends and fifth in our social group that had received the dreaded diagnosis. The good news was that the cancer was detected early and could be treated with surgery and radiation therapy. Even so, the effects are life-lasting. My wife constantly lives with the fear that her cancer could return at any time.
Our friends are also survivors. Each had a different experience with their diagnosis and treatment. Treatments ranged from radiation to chemo to a double mastectomy. All fortunately have passed the five-year mark successfully, but the trauma and fear still linger.
In 2018 more than 300,000 women and 2500 men in the US will be diagnosed with breast cancer.
Breast cancer is highly treatable today and many people survive and even go on to lead a somewhat normal life. I say somewhat normal, because for many, the thought of cancer returning is a daily fear. Every twitch or pain can bring on the anxiety that the cancer may return.
The act of following a structured exercise program can help survivors feel better and take some control over the fear and anxiety that comes with a diagnosis of breast cancer. Exercise has been shown to be a key element in improving the quality of life of many chronic conditions and can even reduce the incidence of all-cause mortality. In other words, people who exercise feel better, can do more and live longer than those who do not exercise. In fact, exercise has been shown to be more likely than other lifestyle factor to reduce the risk for the return of Breast Cancer and for all-cause mortality. Breast Cancer survivors who did not gain weight also have a reduced risk for recurrence and mortality.
Breast cancer has been the most-studied of all cancers in relationship to exercise. Enough studies have been completed for researchers to perform a meta-analysis, a review of studies, to determine what evidence exists to support exercise as a tool to help people with breast cancer live better lives.
Evidence suggests that exercise may improve not only survival but also quality of life.
Experts looked at exercise and breast cancer during chemotherapy or radiation therapy, as well as after therapy. The good news is that exercise is safe during treatment and following chemo or radiation therapy with little adverse effects. You may experience muscular soreness or other mild issues such as plantar fascitis when starting an exercise program.
These are common for anyone who takes up an exercise program. Some people may have to stop exercise post-surgery due to symptoms of swelling.
Muscular strength, aerobic fitness and flexibility showed significant improvement both during and following treatment. You can start strength training 4-6 weeks following surgery. Start slowly and increase resistance as your muscles adapt to the exercise routine. Aerobic fitness will help with overall health and weight maintenance.
Exercise had mixed effects on quality of life, fatigue and anxiety. Body size and body composition also showed mixed results from exercise training. This may be due to the type of training or length of the program or lack of nutritional guidance. Most studies did find a significant improvement in body image with exercise training.
There is some evidence that exercise can reduce the joint pain from moderate to mild that many women experience with hormone therapy following treatment.
Exercise has been found in some reviews to reduce the recurrence of breast cancer and mortality by as much as 40%. A weight gain of 10%, however, after diagnosis has been associated with increased mortality.
Exercise can also improve recovery time from treatment, stamina and overall improved mood and sense of wellness in survivors.
Two of the best things a survivor can do is to maintain a moderate intensity exercise program of 30 minutes on most days of the week and to maintain their weight. You can also reduce risk by working out for 75 minutes three times a week at a high intensity of effort and strength training two times a week.
Exercise may also help improve shoulder range of motion, sleep, bone density, hemoglobin levels, symptom management, pain, in-hospital stay and self-esteem and mood during treatment.
Following surgery and radiation treatment, exercise is extremely important to restore and maintain range of motion in the arm.
The research presents a strong case for exercise in breast cancer survivors, but more research is needed to determine how much, how hard and how long different types of exercise in patient and survivor groups is most beneficial. Before you start on an exercise program, speak to your physician or physical therapist to determine which exercises are safe, especially before drains and stitches are removed.
The physical and emotional scars of breast cancer may always cause my wife and other survivors, anxiety and pain, but exercise can help to reduce the magnitude of her fears and help her live a long, happy and healthy life.
American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors EXPERT PANEL Kathryn H. Schmitz, PhD, MPH, FACSM; Kerry S. Courneya, PhD; Charles Matthews, PhD, FACSM; Wendy Demark-Wahnefried, PhD; Daniel A. Galva˜o, PhD; Bernardine M. Pinto, PhD; Melinda L. Irwin, PhD, FACSM; Kathleen Y. Wolin, ScD, FACSM; Roanne J. Segal, MD, FRCP; Alejandro Lucia, MD, PhD; Carole M. Schneider, PhD, FACSM; Vivian E. von Gruenigen, MD; Anna L. Schwartz, PhD, FAAN. 2010.
Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Margaret L. McNeely, Kristin L. Campbell, Brian H. Rowe, Terry P. Klassen, John R. Mackey, and Kerry S. Courneva. CMAJ. 2006 July 4; 175(1): 34-41.
The Effects of Physical Activity on Breast Cancer Survivors after Diagnosis; Jeongseon, Kim; Wook Jin Choi; and Seung Hwa Jeong. Journal of Cancer Prevention. 2013 Sep; 18(3): 193-200.
Exercise has ‘astounding’ effect on breast cancer recurrence, mortality, Healio.com, May 12, 2017.
The Power of Exercise in Breast Cancer Survivors; American Cancer Society; Oct 22, 2014.
New Guidelines on Exercise and Nutrition During and After Cancer Treatment Released: Breastcancer.org.