By Laura Q. Rogers, M.D., MPH, FACSM
Breast cancer diagnosis and treatment often leaves a patient suffering side effects such as reduced ability to function physically, poor quality of life, fatigue, difficulty sleeping, depression, and weight gain. However, such side effects may improve with regular exercise.
Also important to know is that regular exercise may reduce a woman’s risk of developing a recurrence of breast cancer or of dying from the disease. Therefore, health professionals and breast cancer survivors are becoming more aware of the importance of exercising regularly after a breast cancer diagnosis.
Exercising during primary treatment with chemotherapy or radiation may improve fatigue and quality of life while helping to prevent weight gain and loss of physical endurance. Although it has proven safe during treatment, it must be done with caution. A patient interested in exercising during treatment should discuss this with her physician. A patient should be cautious about changes in balance with treatment, as well as weakness from nausea or poor diet intake. If blood counts are low, a patient should not exercise too vigorously, engage in high-impact sports, or perform activities that increase risk of infections (e.g., swimming). During treatment, a patient should aim for 20 to 30 minutes of physical activity per day three to five days per week. It is important to remember that the patient may have days she doesn’t feel well, and on those days, the patient should only exercise as much as is tolerable. Every little bit helps!
After completing chemotherapy or radiation, getting in the habit of a regular exercise program is very important. If treatment has been particularly difficult, the breast cancer survivor may need a strengthening rehabilitation program through a physical therapist before engaging in frequent aerobic activity. However, most breast cancer survivors are able to begin a simple walking program after completing treatment. After treatment, exercise continues to help a survivors deal with physical functioning, quality of life, fatigue, sleep, and weight-gain side effects. Although an initial goal of 150 minutes of moderate-intensity exercise per week is recommended, exercising more can further reduce breast cancer risk and enhance the prevention of weight gain.
Safety is key. If the breast cancer survivor has other medical conditions such as heart, lung or kidney disease, she should contact her physician before starting an exercise program. Nevertheless, most survivors can begin a program on their own. Survivors should purchase and wear athletic shoes with adequate cushion and support. An exercise program should be started slowly and gradually increase. For example, the survivor should walk at a lower speed until she is able to walk for 30 minutes, five days a week. Once this can be done, she should gradually increase the walking speed to a brisk rate.
Staying active can be a challenge in our busy world. Breast cancer survivors often have family and job responsibilities that make it difficult to find time to exercise. Therefore, survivors can use time management strategies such as scheduling exercise sessions for the week ahead of time and having a “plan B” for days that don’t turn out as expected. Survivors should be encouraged to have a plan for dealing with barriers to exercise. Also, survivors may need to change the way they think about exercise, viewing it as a priority. They should not feel guilty about taking time away from something else to exercise. Exercise is a necessity – their life may depend on it! Exercise may better enable them to care for their loved ones. Other ways to stay active include choosing enjoyable exercise, finding an exercise partner, or asking family members to provide encouragement.
Survivors should not become discouraged if they have a “bad week.” Every day is a new day, so it is never too late to try again.
Additional information on exercise and breast cancer:
Susan G. Komen for the Cure