• Share this page
    Pin It
  • Live Chat
  • (888) 825-3636

The Importance of Exercise and Healthy Eating for Breast Cancer Survivors

By Marion Webb

After having undergone a double mastectomy and reconstructive breast surgery, Kay Balmer recalls feeling like her body was completely out of whack with shooting pains traveling up and down her spine and into her legs. It wasn’t until she hired a personal trainer who specializes in working with cancer patients, that the now 56-year old breast cancer survivor felt a restored sense of well-being with her body intact.

Exercise as a Life-Saver for Breast Cancer

According to the American Cancer Society, breast cancer is the most common cancer affecting 2.5 million American women. It is the second leading cause of cancer deaths in women after lung cancer. Researchers have found strong evidence that regular physical activity and a healthy diet are critical to help prevent recurrence of breast cancer and to increase survival rates. Women who are overweight and obese are at a greater risk for developing breast cancer than normal weight women. At the UCSD cancer center, doctors educate their overweight and obese cancer patients on the importance of regular workouts and a healthy diet to prevent recurrence of the disease.

“We see a huge problem if women (who have been diagnosed with breast cancer) don’t do anything (in terms of physical activity),” says Dr. John Pierce, an epidemiologist and head of cancer prevention at the Moores Cancer Center at the University of California, San Diego. Pierce cites recent findings from a study of overweight and obese women with breast cancer who after walking 30 minutes daily at a moderate pace and eating a “five-a-day” fruit and vegetable diet had a much greater survival rate than women who didn’t exercise at all.

Another study published in Sept. 2007 in the European Journal of Cancer Supplements followed 203 women with early-stage breast cancer. The women who were assigned to a 12-week, supervised group exercise program reaped multiple physical benefits: A significant increase in meter walked in 12 minutes, greater shoulder mobility and better breast cancer-specific quality of life. They were also less fatigued and depressed than the non-supervised exercising control group. At the six-month follow-up period, the exercising group said they valued the expert guidance of their instructor and enjoyed exercising as a group to draw support. By contrast, the women in the control group said they didn’t enjoy participation in the standard exercise classes. Researchers concluded that supervised group exercise provided short and long-term physical and psychological benefits for early-stage breast cancer women undergoing therapy. They also provided incentive for clinicians to encourage physical activity for their patients and policy makers to consider including exercise as part of cancer services.

Balmer can attest to these findings. After completing chemotherapy, she joined a breast cancer group of Dragon boaters, a team paddling sport, for the joy of being physically active as much as for the emotional support.

Like many breast cancer patients, Balmer opted for a surgical procedure called trans (short for transverse rectus abdominis myocutaneous) flap, where the breast is reconstructed using one’s own abdominal tissue rather than a foreign implant. The downside is that the removal of these muscles weakens the abdominal area, often causing serious back pain, which Balmer soon experienced.

Knowing the healing powers of exercise, Balmer first read a book entitled “Essential Exercises for Breast Cancer Survivors” before her oncologist referred her unknowingly to the book’s co-author, Andrea Leonard, a fellow Oregonian. Leonard, a 24-year thyroid cancer survivor and ACE-certified Personal Trainer, has spent the last 16 years working with cancer patients and educating fitness professionals on the issue. Balmer remains grateful to Leonard, saying “Within a couple of sessions, the shooting pains in my legs stopped.”

Leonard, who has trained Balmer and her friend twice-a-week for the last three years, points to her progress: “When I started working with Kay she was unable to balance sitting on a physio ball. Now she has amazing balance and can do opposite arm and knee raises on the ball, balance on a foam roller and perform a number of exercises that require movements in all planes.”

As president of the Cancer Exercise Training Institute (www.thecancerspecialist.com) located in West Linn, Ore., Leonard urges women who have undergone breast cancer surgery and treatment to consult their physicians before embarking on an exercise program. Women who have been diagnosed with lymphedema, or are experiencing symptoms of lymphedema, such as swelling in the affected arm after exercise or tightness around the arm or hand at the side of treatment, need to take extra precaution.

Lymphedema

Lymphedma, caused by excess fluid that builds up in the arm after surgery or radiation, occurs in about 15 to 20 percent of breast cancer survivors. It can develop within months, or even years after cancer treatment. Triggers include injury, repetitive motion, air travel, insect bites, vigorous massage, or becoming overweight or obese. In Balmer’s case, an infection caused lymphedma. She knows that exercise helps increase range of movement and regain lost strength, but counts on Leonard to keep her safe.

“Andrea is very careful that I don’t do any further damage,” Balmer says. Not all trainers are qualified to work with breast cancer survivors. Hence, consumers should inquire about a trainer’s qualifications and experience before hiring them. A qualified trainer should be certified by an NCCA-accredited fitness organization, such as ACE, and have completed relevant continuing education coursework in the area of exercise and cancer.

Balmer can still recall participating in a workout with other breast cancer patients and after explaining to the trainer that she no longer had abdominal muscles, the trainer answered: “You will by the time you leave here.” She left, in her words, “feeling a bit freakish.”

Exercise Recommendations

Dr. Cheryl Rock, professor of family and preventive medicine at the University of California, San Diego Cancer Prevention & Control Program offers the following physical activity guidelines based on recommendations provided by the American Cancer Society.

  • • Breast cancer survivors with severe anemia or severe fatigue should delay exercise until they feel better
  • • Women with compromised immune systems should avoid public gyms and public pools to thwart off the risk for infections
  • • Women undergoing radiation therapy should not swim, because chlorine can irritate the skin
  • • Women with indwelling catheters should also not swim
  • • Patients undergoing treatment and having trouble maintaining their balance should stay away from balancing exercises, walking on treadmills, bicycling outdoors, and other activities requiring balancing
The American Cancer Society stresses the importance of exercise to aid the healing process and lessen side effects given the doctor’s approval. For instance, after surgery specific exercises will help patients manage their daily activities; during radiation, exercise will help keep the affected arm flexible and enhance shoulder and arm motion.

Rock says, “A lot of our patients (mostly overweight and obese) are more motivated than healthy people to exercise, because they know exercise (can help avoid) recurrence.” She has found that people will only stick with activities they truly enjoy.

“Some people like to swim, some walk, others are social creatures (exercising in groups) and some have exercise equipment at home, or ride a stationary bike while watching TV.” Others, like Balmer, value the relationship with a personal trainer.

Says Balmer, “Andrea is a motivator and I like that she mixes up the routine, so it doesn’t get stale. I can do aerobics on my own, but I rely on Andrea to help me with my core and weight-training, so I don’t hurt myself.”
Marion Webb is the managing editor for the American Council on Exercise. For specific fitness-related story ideas or comments, please e-mail her directly at marion.webb@acefitness.org.