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  • Writer's pictureSurviving Breast Cancer

Exercise and Breast Cancer

By Kelly Hsu

Exercise has numerous positive effects on physical and mental health. Many people are familiar with the relationship between exercise and diseases such as heart disease and diabetes. However, what is the relationship between exercise and breast cancer?


Different exercise regimens may work for people at different points of their disease trajectory. A vast body of research has shown the beneficial effects of exercise for patients at all different points of their illnesses.


Exercise during treatment can improve symptoms.

  • While chemotherapy can typically cause decreased cardiovascular fitness, a study showed that patients who completed a 12-week supervised exercise program during neoadjuvant chemotherapy had no change in cardiovascular fitness by the end of the program [1].

  • One study showed that mobilization stretching exercises improved chest flexibility for patients after breast surgery [2].

  • A study demonstrated that breast cancer survivors receiving adjuvant chemotherapy benefited from supervised heavy-load resistance exercise, with no increased risk of lymphedema [3].

  • A randomized trial of a resistance exercise intervention in patients starting adjuvant chemotherapy led to decreased physical fatigue and improved quality of life [4].


Exercise can have beneficial effects on cancer outcomes.

  • A study showed that patients who underwent a year-long diet and exercise intervention during neoadjuvant chemotherapy had improved pathological complete response (a prognostic factor associated with longer survival after treatment) than those who received usual care [5].

  • Research shows that aerobic and stretching exercises improved quality of life and also reduced depression severity for patients after completing treatment [6].

  • A review evaluating various studies looking at diet, exercise, and combined diet and exercise interventions found that fat loss was consistently associated with decreased risk of cancer recurrence [7].

  • Reviews across different studies have found that increased physical activity is associated with decreased incidence of breast cancer-related death [8, 9].


For cancer survivors, the American Cancer Society recommends starting slowly and building up to “150-300 minutes of moderate intensity (or 75-150 minutes of vigorous intensity) activity each week [9].” Examples of moderate intensity exercises include but are not limited to brisk walking, tennis, gardening, dance, yoga, or pushing a lawn mower. Vigorous intensity exercises may include jogging, running, hiking, or shoveling.


Getting into a regular exercise routine is hard, and even harder after a cancer diagnosis. All exercise plans should be tailored to the individual at their unique stage and recovery progress. If you are at the beginning of treatment, the key is to start gently and do what is appropriate for your body without overexerting yourself. Even light walks can go a long way in improving physical health and mood. Keep in mind that it is always important to consult your clinician prior to starting any new exercise programs.


Exercise can be done alone, but evidence also shows that group exercise can have a tremendous impact on improving mental wellness in addition to physical wellness. If you are looking for a place to start or supplement your current exercise regimen, 2Unstoppable is a non-profit offering a multitude of oncology fitness resources, including the option to be connected to an in-person or virtual fitness partner.


“It is well known that a fitness buddy or exercise community motivates us to get up and move … moreover, with a group or buddy we are likely to exercise harder, more consistently, and for the longer term.


The magic is that it is actually a reciprocal relationship.


Motivation and accountability from others helps get us moving, but physical activity also opens us up to connect further with other women, helping us to find the emotional support women with breast cancer really need. In her book The Joy of Movement, Kelly McGonigal posits that ‘regular exercise may lower your threshold for feeling connected to others – allowing for more spontaneous feelings of closeness, companionship, and belonging.’


Further, ‘the link between physical activity and social connections offers a compelling reason to be active. It also serves as an important reminder that we humans need one another to thrive.’


2Unstoppable leverages that important link to help more women improve their own outcomes. 2Unstoppable offers the unique combination of oncology exercise, coupled with social support, offered on the virtual platform, and designed specifically for women with cancer.


2Unstoppable offers education, oncology exercise classes, monthly challenges, resources, and a free online fitness buddy matching program – all to inspire and support women with a cancer diagnosis to get moving and improve their own outcomes.”


- Michelle Stravitz, CEO & Co-Founder of 2Unstoppable


Check out SBC’s upcoming events for free virtual movement programs!


Learn More:


References:


  1. Teplinsky, E., Podolski, A., Bessada, K., Rutledge, J., Burke, B., Christoudias, M., Klein, L., & Abbate, K. (December 2022). Breast Cancer Patients Undergoing Chemotherapy: Results from the STRENGTH Trial. Poster presented at the San Antonio Breast Cancer Symposium, San Antonio, TX.

  2. Wilson D. J. (2017). Exercise for the Patient after Breast Cancer Surgery. Seminars in oncology nursing, 33(1), 98–105.

  3. Bloomquist, K., Adamsen, L., Hayes, S. C., Lillelund, C., Andersen, C., Christensen, K. B., Oturai, P., Ejlertsen, B., Tuxen, M. K., & Møller, T. (2019). Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: a randomized trial. Acta oncologica (Stockholm, Sweden), 58(12), 1667–1675.

  4. Schmidt, M. E., Wiskemann, J., Armbrust, P., Schneeweiss, A., Ulrich, C. M., & Steindorf, K. (2015). Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: A randomized controlled trial. International journal of cancer, 137(2), 471–480.

  5. Ferrucci, L., Sanft, T. B., Harrigan, M., Cartmel, B., Li, F., Zupa, M., McGowan, C., Puklin, L., Nguyen, T. H., Tanasijevic, A. M., Neuhouser, M. L., Hershman, D., Basen-Engquist, K., Jones, B., Knobf, T., Chagpar, A. B., Silber, A. L. M., Ligibel, J. A., & Irwin, M. L. (December 2022). Randomized trial of exercise and nutrition on pathological complete response among women with breast cancer receiving neoadjuvant chemotherapy: the Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) Study. Poster presented at the San Antonio Breast Cancer Symposium, San Antonio, TX.

  6. Aydin, M., Kose, E., Odabas, I., Bindul, B. M., Demirci, D., & Aydin Z. (2021). The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients. Asian pacific journal of cancer prevention, 22(3), 725-732.

  7. Dieli-Conwright, C.M., Lee, K. & Kiwata, J.L. Reducing the Risk of Breast Cancer Recurrence: an Evaluation of the Effects and Mechanisms of Diet and Exercise. Curr Breast Cancer Rep 8, 139–150 (2016).

  8. Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta oncologica (Stockholm, Sweden), 54(5), 635–654.

  9. Spei, M. E., Samoli, E., Bravi, F., La Vecchia, C., Bamia, C., & Benetou, V. (2019). Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival. Breast (Edinburgh, Scotland), 44, 144–152.

  10. American Cancer Society. (2020 June 9). Physical Activity and the Person With Cancer. https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention/guidelines.html


Author bio: Kelly Hsu

I am a recent graduate of Wellesley College (Class of ‘21), where I studied neuroscience. I am currently working as a Clinical Research Coordinator at the Massachusetts General Hospital Cancer Center on several patient-centered outcomes research studies. Through my experiences, I have developed passions for health education, psychosocial oncology, and palliative care. I plan to attend medical school next fall, where I hope to keep pursuing these interests.



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