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Fitness and Breast Cancer

By Betsy Lee-Frye

Updated June 16, 2008

(LifeWire) - As women make the journey through breast cancer diagnosis, treatment and post treatment, exercise can provide energy, a sense of self-worth and relief from treatment side effects. There is even evidence that exercise has a positive impact on recovery and survival.

But women who survive breast cancer will likely have questions about the benefits of exercise, how to get started and when to hold back.

Benefits of Staying Fit

Studies show that people who exercise during breast cancer treatment have better outcomes than their sedentary peers. This holds true for every type of breast cancer therapy. And the exercise regimens do not need to be grueling or time-consuming. In fact, a May 2005 study of 3,000 breast cancer patients found that women who engaged in just 1 hour of walking each week significantly increased the likelihood they would recover from the disease.

For women undergoing chemotherapy, exercise may help prevent the weight gain typically associated with this form of treatment. Exercise can also help prevent the decrease in bone density that accompanies chemotherapy. One study found that women who engaged in weekly aerobic exercise while using weights lost nearly 6% less bone density than individuals who were not getting aerobic exercise.

Aerobic exercise involves raising the heart rate so the lungs and heart work harder to pump blood through the body. Examples of aerobic exercises include walking, jogging, step aerobics, water aerobics and swimming.

For women undergoing radiation therapy, side effects of this treatment may include fatigue, depression and anemia. Many experts regard anemia, which is marked by a reduction in red blood cells, as the key problem leading to these side effects. A 2006 study in Cancer, the journal of the American Cancer Society, concluded that even a single exercise session could help patients maintain their red blood cell levels.

Exercise can also assist in the recovery process for women who undergo a mastectomy. Stretching and working with weights can rebuild any muscle strength lost due to surgery, improve flexibility and range of motion, and may increase a patient's overall sense of well-being.

Types of Safe Exercise

As with any exercise program, it is important to choose a type of exercise that you will enjoy and stick with. According to the American Cancer Society, a variety of options that meet this criteria include walking, stretching or yoga. If engaging in an organized class, breast cancer patients and survivors should notify the instructor of their diagnosis. The fitness instructor may suggest modified movements or different levels of exertion to incorporate during exercise. You may even want to consult a personal trainer who is familiar with breast cancer survivor fitness programs. Many medical centers and local YMCAs offer fitness tailored toward breast cancer survivors.

In addition, patients should talk to a physician before beginning an exercise program.

Walking, a common fitness choice, offers the benefits of aerobic exercise without overly straining the body. According to a 2005 study in the Journal of the American Medical Association, the benefits of walking peak when a breast cancer patient or survivor walks 3 to 5 hours weekly at a pace of 2 to 3 miles per hour.

Additionally, studies have shown that breast cancer patients and breast cancer survivors are capable of participating in quite vigorous physical activity. One study employed a 3 week aerobic program utilizing "flex" stretching bands, and encouraged participants to exercise for 25 minutes until they reached 60% to 80% of their maximum heart rate. This study found that participants experienced improved body image, increased shoulder flexibility and elevated cardiovascular health.

Many women also incorporate yoga into their fitness routine. Yoga, which is designed to be a calming exercise, strengthens and tones the body without raising the heart rate. According to one study, women who attended daily 60-minute yoga sessions experienced fewer instances of nausea with chemotherapy than patients who did not participate in a fitness routine. Another study involving both breast cancer patients and survivors found that individuals who took part in yoga classes for 12 weeks showed improvements in mood and higher levels of emotional well-being. However, the study also reported that only 69% of women attended all 12 weeks of classes, many citing fatigue as the reason for missing a class.

Other exercises, such as swimming, biking, karate, and pilates, are all options for breast cancer patients and survivors. Just make sure to talk to a physician before beginning an exercise program, and pay attention to symptoms of overexertion, such as dizziness, racing heart, difficulty breathing, pain that worsens with exercise, unusual swelling, headaches or numbness in the limbs.

Special Concerns

Until recovery is complete, experts recommend that breast cancer patients and survivors avoid activities that can put them at risk of injury or illness.

For example, some chemotherapy patients experience a drop in their white blood cell count due to treatment. These patients should avoid public gyms, exercise classes and swimming until their immune system is fully functional. Swimming is unsafe for patients undergoing radiation therapy because the chlorine in the pool water can cause irritation at the treatment site.

Patients who are anemic and have reduced red blood cell levels should limit the intensity of their exercise. Anemia can cause fatigue, which vigorous exercise can exacerbate.

Women who have a mastectomy, or other surgery to remove tumors, should talk to their doctor before starting a weight-training program. According to the American Cancer Society, lifting can cause a dangerous type of arm swelling, called lymphedema. However, a 2006 study in the Journal of Clinical Oncology concluded that carefully structured weight-training programs do not increase the risk of swelling.

Do Not Overdo It

Women who were sedentary prior to their diagnosis should begin any exercise program slowly, adding only a few minutes of exercise each day. If you were active prior to treatment, listen to your body. In particular, pay attention to any signs of overexertion.

Women who opt for surgical treatment should watch for any new swelling or tenderness at the surgical site. According to the American Cancer Society, some tingling or soreness in the chest, neck and arm is normal during the first four weeks after surgery. However, if these sensations persist or worsen, talk to a doctor.

Sources:

Courneya, K.S., et. al.. "Effects of Aerobic and Resistance Exercise in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Multicenter Randomized Controlled Trial." Journal of Clinical Oncology. 25. 28. 01 Oct. 2007. 4396-4404. 22 Apr. 2008. (subscription).

"Exercises After Breast Surgery." Cancer.org. 6 Aug. 2007. American Cancer Society. 22 Apr. 2008. .

"Exercise Can Improve Breast Cancer Survival." Cancer.org. 25 May 2005. American Cancer Society. 22 Apr. 2008.

"Exercise Helps Breast Cancer Patients Avoid Anemia." Cancer.org. 9 Oct. 2006. American Cancer Society. 22 Apr. 2008.

"For the Person Who Has Cancer." Cancer.org. 15 Mar. 2007. American Cancer Society. 22 Apr. 2008.

Moadel, A.B., et. al.. "Randomized Controlled Trial of Yoga Among a Multiethnic Sample of Breast Cancer Patients: Effects on Quality of Life." Journal of Clinical Oncology. 25. 28 01 Oct. 2007. 4387-4395. 22 Apr. 2008. (subscription).

"Nutrition and Physical Activity During and After Cancer Treatment: Answers To Common Questions." Cancer.org. 29 Nov. 2006. American Cancer Society. 22 Apr. 2008.

Raghavendra, R.M., et. al.. "Effects of an Integrated Yoga Programme on Chemotherapy-Induced Nausea and Emesis in Breast Cancer Patients." European Journal of Cancer Care. 16. 6. Nov. 2006. 462-474. 22 Apr. 2008. (subscription).

Schwartz, A.L., K. Winters-Stone and B. Gallucci. "Exercise Effects on Bone Mineral Density in Women With Breast Cancer Receiving Adjuvant Chemotherapy." Oncology Nursing Forum. 34. 3. May 2007. 627-633. 22 Apr. 2008.

So H.S., I.S. Kim, J.H. Yoon and O.J. Park. "Effects of Aerobic Exercise Using a Flex-Band on Physical Functions and Body Image in Women Undergoing Radiation Therapy After a Mastectomy." Taehan Kanho Hakhoe chi. 36. 7 Dec. 2006. 1111-1122. 22 Apr. 2008.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo. Her work has appeared in The Dallas Morning News, Better Homes and Gardens Special Interest Publications and the St. Joseph News-Press.
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