No one likes to hear the phrase, "you've got cancer". True, recent advances in treatment of cancer are absolutely astounding. However, wouldn't it be great if there was a pill you could take that would help prevent cancer, or keep it from returning? Well, today's scientists are increasingly thinking that exercise may be that 'pill' for many people. Let's discuss why exercise is so important in prevention of new and recurring cancer, and specifically what you should be doing to exercise safely after breast cancer surgery.
A recently published article reviewing over 70 research articles on exercise and cancer recurrence concluded that lifestyle changes are essential for newly diagnosed and recurring instances of breast cancer. Regular exercise may be even more important than good sleep habits and stress reduction. How much is needed to get benefits? 150 minutes of aerobic activity per week is recommended (that's 30 minutes, 5 days per week). Only 13% of women get that amount of exercise. Yuck! Anything that moves your body counts, as long as you are off the couch! Here are some ideas:
- Use stairs rather than an elevator.
- Walk or bike to your destination, and walk around the block after dinner.
- Exercise at lunch with your family or friends.
- Go dancing.
- Wear a pedometer every day and watch your daily steps increase.
- Join a sports team.
- Walk to visit co-workers rather than send an e-mail.
- Use a stationary bike or do sit-ups, leg lifts and push-ups while watching TV.
- Park a little farther from your office, the store or the library for a nice walk.
- When the weather is too poor to be outside, grab a partner and "walk the mall."
- Vary your type of exercise so you won't get bored or think it's a chore.
Exercise lessens the effects of chemotherapy, and assists in losing weight. Excess weight can increase your chance of recurrence. Gaining weight and cancer do not go together. Exercise releases pain killing chemicals in your body, and no prescription is needed! Almost every level of fitness can be accommodated by the correct exercise prescription, even if it means walking in place. The key is to get evaluated and set up by a professional.
Now lets talk about exercising after breast cancer surgery, which is a common treatment for certain breast cancers.
The most common issues that affect post-mastectomy patients are "upper-crossed syndrome" and range of motion limitations in the affected shoulder. Upper cross syndrome is the combination of forward head posture, rounded shoulders, and exaggerated spinal bending. As a result of these postural deviations, mastectomy, lymph node dissection, and/or radiation, the chest muscles may become tight, shortened and spastic. This not only exacerbates the postural deviations, but may limit the ability of the patient to move their arm/shoulder through normal motions needed to function. It's harder to want to exercise when you are stiff, sore, and tired!
The most important factor in the safety and benefit of the exercise program is the initial assessment. At the very least this should include a comprehensive postural assessment as well as shoulder range of motion measurements taken with a special tool in every physical therapists office. The well-trained therapist will be able to deduce, from the results, which muscles need to be stretched and which need to be strengthened. By selecting the wrong combinations of exercises, the results may not only be undesirable, they may in fact be detrimental. In short, go to experts who have seen this before: this is not the time to improvise or listen to what worked for your neighbor. No two cancer patients are exactly alike!
In our offices, we strongly advocate restoring as much range of motion as possible before starting on strengthening. Please go to www.pptandfitness/cancer-exercise-videos to see our commonly prescribed routines shown on video. Here you can see very basic exercises that the patient can do on their own; front wall walks, side wall walks, pendulum swings, and corner stretch, or active isolated stretching that can be executed with the assistance of a professional. The combination of both stretching, followed by strengthening will increase the speed of improvement in most cases.
Once close to full range of motion is achieved, the emphasis can be on strength training. Not only will this help to correct the postural and range of motion deviations, it will help increase bone density and lean muscle mass. Many woman will either be of menopausal age, or thrown into menopause from their cancer treatment. With estrogen no longer being produced, the risk of osteoporosis increases. To make things even more complicated, the long-term side-effects of chemotherapy include osteoporosis, diabetes, and damage to the heart and lungs; all of which can be avoided or improved through proper exercise recommendations.
It is my hope that you can see how beneficial the right amount of exercise can help during and after a diagnosis of cancer, and can even prevent new and recurring cancer, as well as practical tips on how to exercise safely and effectively.