Unfortunately, the majority of people in Australia will know of someone close by that has been diagnosed with breast cancer. According to Cancer Australia, in 2017, it was estimated that 17,730 new cases of breast cancer will be diagnosed in Australia (144 males and 17,586 females). In 2014, breast cancer was the fourth leading cause of cancer death in Australia, as well as the 2nd most common cause of death from cancer among females. It is estimated that it will remain the 4th most common cause of death from cancer in 2017 and the 2nd most common cause of death from cancer among females in 2017.
However, research has consistently shown the vital role exercise can play in improving the lives of those breast cancer patients and survivors, specifically relating to:
- Reduced side effects
- Reduced risk of recurrence
- Dramatically improve survival rates
Exercise during Treatment
Hormone Therapy: Recently it has been shown that exercise can help reduce joint pain caused by the hormone therapy required by some women following breast cancer surgery, its aim being to reduce risk of recurrence. Woman have the option to stop taking this type of medication as the pain may be too much. It was shown that women who exercised were more likely to report a reduction in pain. This supports adherence to medication, better quality of life and improved prognosis.
A side effect of this treatment can be reduction in lumbar spine bone mineral density. Studies comparing exercise vs. no exercise in woman undergoing the treatment saw a large improvement in bone mass maintenance in the weight bearing exercise group.
Chemotherapy: During chemotherapy, exercise can be used to reduce fatigue levels commonly experienced, as well as perceived energy levels. Exercise is not an alternative to chemotherapy but a critical synergistic medicine to ensure quality of life, energy, and mental health are maintained.
IGF-1: A factor contributing to breast cancer, is high levels of IGF-1 in the body (a hormone-like substance). Amongst breast cancer survivors, exercise has showed to reduce IGF-1 levels, thus controlling chances of recurrence.
Weight loss: A more obvious risk of recurrence and death from breast cancer is being overweight or obese. With the widely known effects of fat reduction via exercise, recurrence can be reduced with exercise prescription.
Exercise can improve overall quality of life in cancer patients and survivors. This includes:
- Body image
- Emotional well-being
- Sleep disturbance
- Social functioning
Amongst survivors, physical activity was found to reduce fatigue and depression and to improve physical and social functioning, as well as mental health.
How Much Exercise?
Recent studies by Yale Cancer centre have shown that few patients and survivors are not undertaking enough exercise to achieve the proven benefits. The potential barriers to this are cost, and knowledge on specifically what to do.
Although something is better than nothing, it is vital to ensure the correct volume, intensity, and type of exercise is achieved, not only to ensure cancer-related fatigue and other side effects do not worsen, but to ensure that the exercise being performed is enough to achieve the specific benefit.
The leading authorities (ESSA, American Cancer Society, U.S. Centers for Disease Control and Prevention) recommend that cancer survivors accumulate 150 minutes of moderate or 75 minutes of vigorous intensity physical activity each week, as well as at least 2 strength training sessions.
Consistent evidence has shown correlation with physical activity after breast cancer diagnosis with better outcomes. It has been shown that women who exercised moderately (comparable with walking 3 – 5 hours per week at moderate intensity) following breast cancer diagnosis had around 40 – 50% lower risks of breast cancer recurrence, death due to breast cancer, and death from any cause compared to more sedentary women.
- A moderate intensity stroll of half an hour a day can achieve some benefits
- Resistance exercise is just as important as aerobic exercise for body composition, bone mass, and the other aforementioned benefits.
- A supervised, gradual return to/beginning to exercise is essential
- Cancer related/treatment related fatigue and pain must be taken into account. This means intensity and volume of exercise must be closely monitored.