Exercise and physical activity with breast cancer

By Barbara Broggelwirth, RDN, CDN

 

Over the past two decades, exercise-oncology research, particularly with breast cancer, has made great strides and revealed very positive results.  The research confirms that “exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors” (1).

 

According to the American College of Sports Medicine, exercise is considered as effective as medicine in preventing and reducing symptoms in conditions and disease and as such should be “prescribed” by Physicians (2).  Breast Cancer is no exception.  The American Cancer Society recommends 150 minutes of physical activity a week after breast cancer surgery, no matter what type of surgery or radiation therapy you underwent, but it is important to follow safety guidelines (3).

Research has also shown that exercise can help to reduce weight, lower estrogen levels, and boost the body’s immune system; all of which has been shown to lower the risk of breast cancer (4).

What about Lymphedema?

Both surgery and radiation can result in lymphedema (swelling in soft tissue of arm, trunk, breast).  Strength training was once considered a risk factor for lymphedema; however, new evidence suggests that starting very light and progressively lifting heavier weights may reduce the risk of developing it (1,3).

People who have recently undergone treatment for breast cancer should be cautious as there are some exercises that might not be appropriate for patients who have recently undergone surgery or radiation such as:

  • Body weight exercises such as pull ups or push-ups – Might put too much stress on shoulders and arms.
  • Downward dog and inversion yoga poses – Might place too much weight on arms.
  • P90X – May need to modify movements, especially in arms and shoulders.
  • Elliptical/cross-training – May need to wait until your arms and shoulders are stronger before you begin these.

Increasing All Physical Activity Counts

If you don’t exercise on a regular basis, don’t be discouraged.  All physical activity counts.  Here are some ways to increase your physical activity:

  • Energetic housework or gardening
  • Park your car a little further away from the shops or work and walk the rest of the way
  • Get off the bus a stop earlier than you need to and walk more
  • Use the stairs instead of talking the elevator
  • Sit less and stand more. For example, you could walk around when talking on the phone

 

It is VERY important to obtain your physician’s approval before beginning any exercise following surgery.  Ask if there are any movements to avoid or limit.  If you have been diagnosed with lymphedema, talk to your lymphedema specialist about any precautions you will need to consider.

Lastly, make slow and steady progress.  Expect to improve gradually keeping in mind that consistency is key.

 

References:

  1. Dieli-Conwright C, Orozco B. Exercise after breast cancer treatment: current perspectives. Breast Cancer: Targets and Therapy. 2015:353. doi:10.2147/bctt.s82039
  2. Swisher A. Editorial: Yes, “Exercise is Medicine”….but It Is So Much More!. Cardiopulm Phys Ther J. 2010;21(4):4. doi:10.1097/01823246-201021040-00001
  3. Exercise Safely. Breastcancer.org. https://www.breastcancer.org/tips/exercise/safe. Published 2019. Accessed September 10, 2019.
  4. Ww5.komen.org. https://ww5.komen.org/Breastcancer/Lackofexercise.html. Published 2019. Accessed September 10, 2019.

Barbara Broggelwirth, RDN, CDN is a registered dietitian nutritionist who works with Bariatric and Medical Weight Management patients to help them achieve their health and weight loss goals.