For someone who has been diagnosed with breast cancer, just the thought of having to undergo surgery, chemotherapy or radiation treatments, can make even the most stalwart person feel overwhelmed, anxious, and less likely to maintain a regular exercise program. Once the surgery is over and treatment begins, fatigue, range of motion issues, and other side effects can zap energy and make exercise seem far too much of a chore, with everything else that is going on. But, as it turns out, exercise may be just “what the doctor ordered” to reduce feelings of fatigue, manage stress, lighten mood and improve general quality of life. In fact, recent research strongly suggests that exercise during and after treatment for breast cancer is important to your mental and emotional wellbeing, can improve physical function, help heart and blood vessel fitness, as well as build muscle strength and improve body composition (in other words, how much of your body is made up of fat, bone, or muscle).
Talk to your doctor about oncology rehabilitation.
Depending on the type of surgery you have and the subsequent treatments you are going through, your doctor might prescribe an oncology rehabilitation program under the direction of a physical therapist, an occupational therapist or other specialized professional. No matter what kind of surgery you had, it is important to do exercises that can help keep your arms and shoulders flexible. Even without surgery, radiation therapy can affect your agility and range of motion. These therapists have special training in the appropriate exercises for oncology patients, not only to optimize your physical function, but to help you with activities of daily living, such as dressing, showering, doing your hair, etc. Your physician and therapists will work together to develop an individual plan of care geared toward meeting your goals, and taking into account your physical needs and limitations.
Well-Being spoke with Kimberly Willis, PT, DPT, Clinical Coordinator for Oncology Rehab at St. Dominic’s Hospital.
“A patient’s therapy may begin almost immediately after surgery or it could be several weeks later, depending on the protocols observed by the physician and the patient’s physical condition and stamina,” notes Willis. “We work with patients to help them regain function in the areas that are most important to them. For example, some patients, need to regain the ability to care for their child, and all of the activities that are required for that are the top of their list. For others, the goal is to be able to get back to work. Each patient is different.”
Regular exercise as part of your treatment and follow-up plan.
Besides the range of motion exercises that are designed to build and maintain the flexibility of your arm and shoulder, aerobic exercises are also beneficial and important to women who have had breast cancer. There is evidence that fitness and weight loss may actually help reduce the risk of recurrence with some types of cancer.
Other exercises can help you reduce the risk of lymphedema, a condition of chronic swelling in the arm due to excess fluid that collects in the tissue. These might be a combination of gentle range of motion exercises with therapeutic massage to prevent or reduce the swelling that is associated with the condition.
Strength building exercises are also recommended as a part of a regular exercise regimen for women with breast cancer. These exercises are not begun until approximately four to six weeks after surgery, and should be customized to your general health, medical condition and fitness level. Strength building may start with small hand weights, and may be increased slowly over time. It is a good idea to start strength training in a supervised setting under the direction of a trained therapist or exercise trainer, who has received education on how to work with breast cancer survivors, to be sure you are doing the exercises properly.
“When our rehab patients finish their program with us, we give them a packet that includes exercises they will need to keep up with at home or at the gym,” continues Willis. “We stress to all of our patients the importance of being as active as possible, within the limitations their physician sets for them. We also educate them about lymphedema precautions and problems for them to watch out for. Through education, we help them feel they can take control of the situation instead of their cancer and cancer treatment controlling them. That’s very important to their overall outlook on life and dealing with the challenges of their treatment.”
Some studies of survivors of breast, colorectal, prostate and ovarian cancers with higher levels of physical activity after diagnosis lived longer and had less incidence of cancer coming back than those who had lower levels of activity.
Take it easy at first and build up stamina.
Depending on your level of fitness before breast cancer and current physical condition, it is important to consult your physician to determine the best exercise plan for you. The main goal should be to stay as active and flexible as possible and slowly increase the level of physical activity over time.
Stop exercising and talk to your doctor if you experience any of the following:
• Get weaker and start losing your balance or falling.
• Have pain that gets worse.
• Have new heaviness, aching, tightness, or other strange sensations in your arm.
• Have unusual swelling or swelling gets worse.
• Have headaches, dizziness, blurred vision, new numbness or tingling in your arms or chest.
Take special precautions if…
• You are suffering from anemia or low blood cell count, in which case you should delay activity until your anemia can be treated and your red blood count improved.
• Your immune systems are weak (elevated white blood count). Avoid public gyms and other public places until your white count is at a safe level.
• You are receiving radiation therapy. Avoid swimming pools, spas, etc., as chlorine may irritate your skin at the treatment area.
Most importantly, keep moving. You don’t have to run a marathon, just take a brisk walk, play with your kids or ride your bike around the block. Studies show that women who exercise during and after breast cancer treatment had less fatigue-related disruptions to their daily activities, experienced less depression and scored higher on tests measuring quality of life.
Pilates and Breast Cancer.
After undergoing breast cancer surgery and starting treatment, a woman may face physical challenges as well as emotional stress. Pilates may provide an exercise technique that can help both mind and body.
Fatigue, both during and after cancer treatment can leave a woman feeling unable to function and handle daily activities. Pilates offers a gentle, low-impact form of exercise that can help you regain strength and endurance.
Pain and loss of range of motion in the shoulder and arm are common problems that can hinder exercise after treatment. Because Pilates are performed in the supine position, the back and neck are supported making it easier to feel which muscles are working and insure that you are using the right ones to help build strength and regain muscular balance.
Posture is a concern after breast cancer surgery, because often a woman’s back may become rounded and her shoulders and head will be flexed forward, without the proper training to stretch the chest muscles and strengthen the back. Pilates teaches you to resume an erect posture.
Before starting Pilates or any form of exercise, talk to your doctor to be sure that your physical condition, and your stage of recuperation will allow you to withstand the level of activity the program will require.