Breast cancer

Cancer poses many challenges, and ongoing evidence continues to strongly identify the beneficial impact exercise engagement plays in both the physiological and psychological aspects of cancer recovery, both during and post-treatment.

Benefits of exercise engagement

We highly encourage integrating exercise into your daily life as part of both short & long term treatment and recovery strategies. 

Your goals and the therapeutic effects of exercise are always variable given the complexity of Breast Cancer, and dependent on your diagnosis and treatment path. There are particular benefits of exercise engagement which multitudes of evidence support in regards to treatment tolerance, as well as reducing secondary effects and recurrence. These include;

Physical

  • Cancer-Related Fatigue management 
  • Shoulder functioning and mobility
  • Reduced risk of secondary effects; Lymphoedema, Cardiotoxicity, Peripheral Neuropathy, Axillary Web Syndrome (Cording)
  • Improved bone health & management of body composition
  • Reduced severity of Bone, Arthralgia (Joint), Mylagia (muscle), and Post-Surgical Pain

Psychosocial

  • Anxiety and Depression management
  • Reduced Cognitive impairment, and enhanced brain functioning  
  • Promoting positive sleep hygiene
  • Emotional wellbeing
  • Social engagement, with reduced isolation
  • Improved body image
  • Vocational re-attachment, and establishing a positive return to work if appropriate
  • Improved quality of life

“Breast Cancer survivors who are physically active have a 42% lower risk of mortality from any cause, and a 40% lower risk of mortality from breast cancer than those who are inactive”

Spei et al, 2019

Tips to Consider: 

Guided and specific exercise programming adaptations are required based on disease and treatment-related adverse effects, anticipated disease trajectory, and current health status. Some considerations to remember when you are engaging in exercise include:

  • Exercise tolerance during and directly post-treatment can vary depending on your treatment dosage.
  • Medication adverse effects – for example, Taxane chemotherapy agents are linked to heightened CIPN (Chemo-induced Peripheral Neuropathy).
  • Compromised immune function – having a higher risk of infection will require adjusting your exercise environment accordingly.
  • Elevated fracture risk with hormone therapy, bony metastases, or Osteoporosis.
  • Complete exercise sessions during times of least fatigue to avoid exacerbation – pacing and monitoring activity regularly.

Evidence-Based Exercise Guidelines:

  • Find something you enjoy; individual variability is important
  • Current exercise status;
    • Just starting out: slowly spread exercise out across the week – gradually increasing bout durations as you tolerated.
    • Already active with good symptom control: high intensity exercise is not discouraged, as long as appropriate progression to intensity has occurred
  • Exercise with a friend or family member – sharing your experience of cancer and developing social connections.
  • Stay motivated through exercise tracking and diaries to support establishing a routine
  • Tailor and progress exercise as appropriate – guided by a Qualified Therapist

Further Information & References:

Breast Cancer Network Australia: https://www.bcna.org.au/resources/

Cancer Australia: https://canceraustralia.gov.au/

Exercise is medicine: http://exerciseismedicine.com.au/resources/

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References

Spei ME., et al. (2019). Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival. Breast; 44:144-15

Schmitz,KH., et al. (2010). American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors, Medicine & Science in Sports & Exercise. 42, 1409-1426

Speck, RM., et al. (2010). An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Journal of Cancer Survivorship, 4, 87–100

Ballard-Barbash, R., et al. (2012). Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst, 104(11): p. 815-40

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