*You should consult your physician or other health care professional before starting this or any other fitness program to determine if it is right for you.*
A diagnosis of breast cancer is life-changing. Understandably, your focus becomes getting through treatment and beginning recovery. However, it is becoming more evident that continuing exercise while going through treatment has tremendous benefits when it comes to managing the side effects of treatment, and lessening the chances of recurrence after treatment ends.
According to the Sidney Kimmel Comprehensive Cancer Center at John Hopkins University, “…Research has shown that women who exercise have an improved quality of life and have fewer side effects during and following treatment. Exercise has also been shown to enhance overall health and wellness, improve mood, reduce fatigue, and increase stamina. Some research suggests that exercise may reduce the chances of a breast cancer recurrence.”
A study published in the Journal of the National Cancer Institute looked at over 1300 patients, their activity levels before diagnosis, during treatment, and 1 and 2 years after treatment. Patients who met the minimum guidelines to be considered “moderately active” experienced a “statistically significant reduction in…recurrence and mortality.”
So, a breast cancer diagnosis is not the time to stop exercising. Instead, it can provide numerous benefits, both during and after treatment.
Why Exercise During Treatment
No matter who you are, too much time spent being inactive can cause muscle weakness, reduced range of motion, and loss of body movement capabilities. Exercising during cancer treatment helps with these issues and many others.
According to the American Cancer Society, here are some of the ways exercise may help you before, during, and after treatment:
- Help your body and brain work better
- Reduce feeling tired (fatigue)
- Help lessen depression and anxiety
- Help you sleep better
- Keep or improve your physical ability to get things done
- Improve your muscle strength, bone health, and range of motion
- Strengthen your immune system
- Increase your appetite
- Help you get to and maintain a healthy weight
- May help with breast cancer-related lymphedema (and does not increase risk)
- Decrease the chance that some types of cancer will come back
- Improve your quality of life
- Reduce treatment side effects
Terri Ross, a breast cancer survivor, and Cancer Exercise Specialist as well as a triathlete and power lifter, has first-hand experience with breast cancer and understands well the benefits of exercise to your physical and mental well-being after treatment. She explains how exercise helps lymphedema, which is a blockage of the lymphatic system, sometimes caused by surgery or cancer treatment.
“The lymphatic system is an important piece of our immune system, filtering out debris, waste, and germs. It runs alongside our circulatory system. But, unlike our circulatory system which uses the heart to pump, the lymphatic system has no pump. Our lymph relies on muscle contraction to move along. When our body stays stagnant, so does our lymph. It has been shown that exercise can help chemo and other drugs to be more effective by moving more blood, and therefore, more medicine directly to the tumor. “
Setting an Exercise Goal
The Department of Health and Human Services’ Physical Activity Guidelines for Americans encourage adults to get at least 150–300 minutes of moderate-intensity aerobic exercise or 75–150 minutes of vigorous-intensity aerobic exercise per week.
Some people with breast cancer may be able to meet or exceed these targets without risking overuse injuries, or excess fatigue. Meeting or exceeding these targets may help extend their survival and improve their quality of life during and after cancer treatments.
Other people with breast cancer may need to start with smaller targets. They may be able to build their range of motion, strength, and endurance gradually over time.
Ross offers advice to individuals looking to begin exercising again after treatment:
“The first order of business is to follow guidelines given to you by your surgeon, but most of the time walking is an important part of recovery and can be done right away. Seek a fitness professional and physical therapist that can evaluate your range of motion in abduction, flexion, extension, and internal and external rotation of your shoulders. To start a progressive strength program, you must have 90% of the normal range.”
Ross explains that any survivor who has had lymph nodes removed and/or radiation above the waist should include upper-extremity lymph drainage as part of their warm-up before exercising. She recommends beginning with 3-5 minutes of cardio, clearing the core with some pelvic tilts and crunches, and then moving into the rest of the lymph-drainage exercises as demonstrated in her Upper Lymphedema Warm-up video.
For survivors with lymph nodes removed or radiation below the waist, she recommends lower-extremity exercises as demonstrated in this Warm-up for Lower Extremity Lymphedema.
Things To Watch Out For
According to the American Cancer Society, things to watch out for when you do begin exercising include:
- Getting weaker, losing your balance, or falling
- Pain that gets worse
- Experiencing new heaviness, aching, tightness, or other strange sensations in your arm
- Unusual swelling or swelling that gets worse
- Headaches, dizziness, blurred vision, new numbness, or tingling in your arms or chest
In addition, Ross stresses being aware of:
- Pain which is more than just discomfort
- Fatigue – your workout should leave you feeling energized, not more tired
- Swelling, as mentioned above, as it could be a sign of lymphedema
If any of these occur, it is important to be evaluated by your doctor.
It is common for women who have experienced breast cancer and treatment to have fears of exercise. Ross states that a common fear, both for herself and her clients is “breaking something by damaging the incisions or tissues underneath. It is common to feel extra tight, and nerve damage makes movement feel different at first.” However, she is also emphatic that exploring new movements in your body is an important first step. And, just as importantly, she notes that while moving is important, it is also important to give yourself grace when you are feeling less than motivated.