Category Archives: Exercise and Breast Cancer

Exercise Resources for Breast Cancer Patients

While I will continue to add my own exercise information to this blog, I will also share other resources as well.  Fortunately, there are more and more resources becoming available for cancer patients.  Check with your local hospital or oncologist to see if there is a fitness/exercise program specifically for cancer patients that you can participate in yourself.

Pacific Cancer Fitness – This is a non-profit organization based in north San Diego county.  I was fortunate to get to know Susan Webster, founder of PCF, when I lived in San Diego.  Susan offers fitness classes for all patients and survivors of all types of cancers and, like myself, is a breast cancer survivor.

Carol Micheal’s Fitness – Carol is based on the east coast of the United States, but offers DVDs for sale that are specific to Breast Cancer Recovery.

Regaining Posture After Breast Cancer Surgery

Regaining a good, strong posture after breast cancer surgery is one of the first and most important things to work on, in my opinion.  Having poor posture not only affects your entire musculoskeletal system, but it can also hinder proper breathing.  The ability to breath well and deeply provides much needed oxygen and nutrients to  your cells, which promotes healing.

Breast cancer surgery is a considerable trauma for your body, and your body’s natural reaction is to protect itself.  In doing so, your shoulders will round forward to protect the chest, leading to weakened scapular, back and abdominal muscles, shortened chest muscles, and possibly lower back pain.  TRAM Flap reconstructive surgery is especially detrimental to posture due to the manipulation of the rectus abdominus muscle, a main core stabilizer.

As a fitness professional, I am very aware of my body, and make a conscious effort to hold good posture throughout the day.  After my bilateral mastectomy and reconstructive surgery, I felt my shoulders drooping forward and my upper body starting to “hunch over”.  It just sort of snuck up on me, but it was happening.  Time to get to work.

To work on good posture, several factors come in to play.  Strengthening your scapular muscles, stretching your chest muscles, and strengthening your core musculature are all necessary.  I suggest you first work on learning how to “pack your scapula”.  This simple movement will help strengthen your scapular muscles, open up your chest, and allow you to breath easier.

This can be done either sitting or standing.

Step 1

Starting Position: Stand or sit with your feet hip-width apart, toes pointing forward, arms by your sides. Engage your abdominal muscles to stabilize your spine. By engage, I mean tighten your abdominals as if someone was going to punch you in the stomach.  Keep the chest lifted and your chin tilted slightly up.

Step 2

Inhale.  Exhale and pull the shoulder blades down and squeeze your shoulder blades together. Picture trying to put your shoulder blades into the back pockets of your pants.  Do not allow your low back to arch. Hold the contraction for 5-10 seconds for a total of 2-4 repetitions.

Practice this exercise whenever you can – watching tv, sitting at the computer or a restaurant, or driving your car.

Weight Gain and Breast Cancer

Unfortunately, many breast cancer patients and survivors gain weight either during or after treatment.  Certain chemotherapy drugs can cause weight gain in cancer patients, in part due to the instant onset of menopause brought on by those drugs, as well as the extreme fatigue that is a common side effect, making it more difficult to exercise.  Breast cancer drugs that block estrogren (such as Tamoxifen and Arimidex) can also cause weight gain.

Why is it important to minimize or avoid weight gain that accompanies a cancer diagnosis?

1.  First and foremost – survivorship.  Interestingly, studies have shown that excess weight does not seem to increase the risk for pre-menopausal women.  However, plenty of evidence has shown that being overweight or obese can increase risk of recurrence, and has a negative impact on survivorship among post-menopausal women.  That catch is that even if you are pre-menopausal at diagnosis, like I was, and you end up doing chemotherapy, like I did, you are most likely going to become menopausal during treatment.

2.  Excess weight increases circulating estrogen, which is especially bad for women with hormone-receptor positive cancers, like mine.  Fat tissue is the largest source of estrogen for post-menopausal women.

3.  Obesity increases risk of lymphedema.

4.  Excess weight increases risk of cardiovascular disease, diabetes, and other cancers, not to mention high blood pressure, higher cholesterol, and stroke.

Research has established that maintaining a healthy body weight can decrease overall cancer risk, increase survivorship, improve quality of life, increase energy, and have a positive effect on sex life!

So what exactly is a healthy body weight?  One guideline is BMI, or Body Mass Index.  Click on this link to determine your BMI.  If you are in the overweight or obese range, talk to your doctor about a healthy diet and exercise plan.

 

My Services

In-Home Recovery Fitness

Exercising after surgery, or during radiation or chemotherapy, can seem incredibly daunting.  You may not know how to begin; you may feel uncomfortable going to a public facility if you have lost your hair; you may not have the energy to leave the house some days; you may need to avoid public facilities if your immune system is compromised.  In addition, depending on the type of surgery you had, and reconstruction, if any, the approach to recovery exercise will vary. If you are currently dealing with a breast cancer diagnosis or treatment, and live in the Coachella Valley, please contact me for personalized, private, in-home fitness recovery sessions.

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Beginning a Fitness Program after Breast Cancer

It is important to engage in a fitness program after breast cancer surgery and treatment, as soon as you are able and have been cleared by your surgeon or oncologist.  A good fitness program after breast cancer should include a combination of cardiovascular, balance, stretching and strength exercises.

When beginning an exercise program after breast cancer, there are several factors to consider.

1. First and foremost, obtain permission from your surgeon or oncologist. Most people can safely begin to exercise six weeks after surgery, but everyone is different, so be sure to get your doctor’s ok.

2. Start slowly, especially if you are new to exercise. Start by working on regaining posture, balance, flexibility (stretching) and range of motion exercises, along with moderate cardiovascular exercise such as walking.  Try to walk every day, or three days a week at the least.  Visit the Beat Fatigue post for more information on beginning a walking program.

3. When you have regained a good amount of flexibility and range of motion, then begin strength training exercises. Start with no weights, or very light weights, 1 to 2 pounds.

4. If you are new to exercise, or have very limited functionality, find a fitness professional to work with – someone who has knowledge of working with cancer patients, or even a physical therapist.

5. If you have lymphedema, wear a compression garment during exercise. You may want to consult with a lymphedema specialist. If you have neuropathy, avoid using hand held weights, especially if you are experiencing neuropathy during exercise sessions.

6. Warm up and cool down before and after each session, rest when needed, and stop if you experience any pain.

7.  Stay hydrated.  Many factors can cause dehydration – heat, medications, chemotherapy, and drinking too little.  Try to consume 12 ounces of water prior to exercise.  Have a bottle of water available to sip from during exercise, and drink at least another 12 ounces of water after exercise.

Effects of Exercise on Breast Cancer Recovery

Exercise is an important, if not imperative, part of the cancer recovery process. Adapting a regular exercise program will:
– help restore functional capacity lost to inactivity or medical treatments
– increase lean muscle mass
– decrease body fat
– reduce loss of bone density (important for post-menopausal women taking hormone blocking medications)
– stimulate the immune system (very important during and after chemotherapy)
Exercise may also help reduce treatment-related nausea, fatigue and pain.

An article posted on the American Council on Exercise website states:

“Compared to sedentary women, regular exercisers, who have been diagnosed with breast cancer, have a much lower risk of breast cancer recurrence, breast cancer death, and all causes of death.

About 50-96% of female breast cancer patients experience weight gain, with an increase in fat weight and a loss of muscle weight. Regular aerobic exercise and resistance training can help mitigate and reverse these effects.

Breast cancer surgery often reduces shoulder mobility. Flexibility exercise helps restore a normal range of motion.

Increased physical activity after cancer treatment has been consistently linked to better physical function, reduced fatigue, and bodily pain.

Physically active survivors typically score higher on measures of emotional well-being and overall quality of life compared to their less active or sedentary peers.

Despite these well-established benefits of exercise after breast cancer, only half of all survivors exercise regularly, often due to concerns about lymphedema and a lack of information about safe and effective exercise. Recent studies have shown that neither aerobic exercise nor resistance training is linked to developing or worsening of breast cancer-related lymphedema. Better yet, one study found that women who followed a slow, progressive strength-training program lowered their risk of developing lymphedema by 35 percent; women who had at least five lymph nodes removed and started lifting weights reduced their risk by 70 percent. Not only is strength-training ideal for preventing lymphedema, it also helps build strong bones, good posture, and overall strength.”

Beat Fatigue – Start a Walking Program

Most breast cancer patients undergoing chemotherapy and/or radiation treatments will experience various levels of fatigue and a decline in cardiovascular function. And while exercise may be the last thing you want to do during these times, according to the latest research, it may well be one of the best things you can do.

We are so fortunate that researchers are now touting the benefits of exercise before, during and after a breast cancer diagnosis. Exercise improves the physical body as well as the state of mind and quality of life. One of the easiest and most effective ways to improve cardiovascular efficiency – and my personal favorite, is walking.

Walking is one of the few activtites you can do during treatment as well. I continued walking during my chemotherapy treatments, although somedays I could barely make it down to the mailbox. Even so, on days I felt stronger, I walked longer. Due to the effects of the chemotherapy on my cardiovascular and muscular system, I found myself huffing and puffing and having to stop and rest on a walk that, had I not been receiving the treatment, I could have easily done without getting out of breath at all. If you are currently undergoing chemotherapy or radiation, or have already done so, you are familiar with this overwhelming fatigue. Of course one of the best ways to help lessen the fatigue, is exercise.

If you are new to exercise and/or currently undergoing treatment:
1. Start slow. Try to walk everyday, or at least every other day.
2. Strive for walking 15-20 minutes, working up to a moderate intensity pace (feels mildly challenging).
3. As you become stronger, slowly increase the walking time and intensity.
4. Pump your arms to help boost your heart rate and burn more calories. Don’t worry about incorporating any kind of weight, be it ankle weights (which I strongly oppose) or dumbbells, at this stage. Just moving your upper body will be enough.
5. Incorporate inclines and declines if you can – either on a treadmill or on an outdoor street or trail.
6. Use a tech fitness device or download an app on your smart phone to keep track of your time, distance and average pace. I use the RunKeeper app on my phone.

If you are a regular exerciser and/or have completed treatments:

1. Start by walking at a moderatley brisk pace for 30-45 minutes. Increase the time and intensity as you feel stronger.
2. Try Interval Walking to help improve cardiovascular strength. Walk fast or jog for 2-4 minutes, then slow for 1-2 minutes. Repeat for the a total of 10-12 intervals.
3. Incorporate inclines and declines into your walk route.
4. Keep track of your progress with a tech device or mobile app.

My personal pointers:

1. Pick a beautiful place to walk outside. A tree-lined path, a nature trail, a sandy beach, someplace that you makes feel good. Fresh air and sunshine (don’t forget the sunscreen) help make exercise so much more fun!
2. I have to listen to music when I walk or run. I find energizing songs with strong beats that really make my heart pump and my legs move. With the right music, the exercise sometimes seems effortless.
3. Invest in a good pair of shoes – walking or running. If you workout on a trail, buy a trail shoe. Go to a store with knowledgeable sales personnel who will help you pick the best shoe for you. Choose a pair with good heel-toe stability and support.
4. Be consistent – don’t give up. Grab a friend if you need to and encourage each other.