I’ve talked about exercise on The Brio Blog ad nauseum because it’s so darn important after cancer. (Read here and here) The plain fact is - people that exercise during therapy and beyond do better - you feel better, your cancer-related outcomes are better, your overall health outcomes are better, and your well being is better.
Better is good, right?
That’s why I won’t stop talking about it. Never ever ever. I talk about it all day with my patients in the clinic and I’m talking about it with you here - again, and again, and again. Because I want you to feel great and exercise is a means to that end. It will make a huge difference for your health.
So. With that said, exercise anyone?
Exercise After Breast Cancer
Many epidemiological studies (population based disease studies) have noted that physical activity in breast cancer survivors is associated with a decrease in breast cancer recurrence. The benefit is plain. Your chance of the cancer coming back is lower when you exercise.
The proposed mechanism for this is interesting. Pictures are worth a million words, so check out this table from the 2016 study “Reducing the Risk of Breast Cancer Recurrence: an Evaluation of the Effects and Mechanisms of Diet and Exercise.”
It’s all very sciency and chemically, but the basic explanation is this:
Exercise decreases fat mass and increases skeletal muscle in your body.
This has the positive effect of decreasing hormones and biochemicals that support tumor growth.
This in turn decreases the chance your breast tumor will grow and decreases cancer recurrence.
I believe most people in our society understand, due to public health efforts over the past decades, exercise is good for you. Some people choose to exercise and other don’t. Their reasons and motivations for doing so are their’s alone. But for breast cancer survivors, there’s a huge up side to engaging in regular, intentional physical activity. It could keep your cancer from coming back - that’s a huge opportunity I encourage you not to miss.
I found an awesome resource for breast cancer survivors considering exercise. It’s a program created by an organization called Strength and Courage you can download and try at home. Not everyone has geographic access to physical therapists and lymphedema specialists, so you’ve gotta love a specialized program anybody can access from the comfort of your own home, no matter your location!
By the way, this is not an official endorsement of the breast cancer exercise program by Strength and Courage, and I don’t get any kind of kick back for mentioning them, but I love what they’re doing and think you could benefit. Check them out here:
Obesity and Exercise
The specter of obesity hangs over any discussion of exercise after breast cancer. I think the graphic above does a good job of showing why. Fat mass has a direct effect on the production of tumor supporting chemicals. It’s simply good to decrease your fat mass because it decreases levels of those chemicals, and exercise helps in the effort.
I want to say, because I think many people misunderstand, the benefit of exercise isn’t necessarily to burn calories to lose weight. It’s virtually impossible to deficit your calories enough with exercise to result in weight loss.
I think it’s more beneficial to think about exercise as a way to talk to your body and tell it, “Hey, it’s OK to normalize my metabolism because I’m making you happy by moving around.”
Yes, exercise is what your body was born to do. Moving is part of a system of triggers that tells our cells to metabolize harmoniously. Does that make sense to you? I think our society is so hung up on beauty and weight loss, we don’t communicate the right way about exercise.
Think about our ancient ancestors. What were they doing with their days? They were travelling long distances - WALKING - to hunt and gather food and find shelter. They were using and conserving energy to stay alive and the body evolved to cooperate with this goal.
Then we stopped walking because we got cars and computers, and now our bodies don’t know what to do. Our cells speak the language of movement. The human body doesn’t understand what to do when you’re constantly still, physically static.
It’s simple - you’ll derange your metabolism if you don’t move. Movement tells our cells to use and store energy efficiently, allowing the elegance of the body’s systems to shine, unhindered by the mixed message of plentiful food and a sedentary lifestyle.
Exercise and Lymphedema
Breast cancer survivors are at risk for lymphedema I know you’re acutely aware of this phenomenon. I fear some of you reading this are afflicted with this uncomfortable and frustrating circumstance.
Lymphedema is swelling of one or both limbs as a result of the removal of, or damage to, lymph nodes during cancer treatment. The lymph drainage system becomes blocked by the damage, preventing lymph fluid from draining out of the limb resulting in uncomfortable and potentially severe swelling. If lymphedema develops, it often becomes a chronic condition which must be actively managed to prevent exacerbation.
A full discussion of lymphedema is beyond the scope of this humble blog post, but I mention it because breast cancer survivors need to take great care when exercising if they are at risk of or have this condition. Exercising incorrectly and/or too vigorously when you’re yet not ready could put you at risk for lymphedema, particularly if you’ve had an aggressive lymph node dissection. The best advice is to get clearance from your cancer care team and find an exercise specialist to work with you to prevent lymphedema.
I am incredibly impressed by the education resources available for people dealing with lymphedema. Here is a sampling you should check out if you’re curious or affected by the condition:
Find in-depth lymphedema info from breastcancer.org at https://www.breastcancer.org/treatment/lymphedema.
The National Lymphedema Network provides access to a network of lymphedema specialists. In addition, their position papers are very informative on a variety of lymphedmea related topics: https://www.lymphnet.org/
The Lymphedema Treatment Act provides an incredible list of resources here: https://lymphedematreatmentact.org/resources/
The Pink October Series: Closing Words
Writing about issues affecting breast cancer survivors has taught me a lot. I hope you’ve enjoyed The Pink October Series as much as I have. The breast cancer community has contributed a large body of medical literature related to wellness after cancer for which I am thankful. Their contribution does nothing but move the entire Oncology community forward.
Let’s face it - women are engaged health and wellness consumers because they know the benefits of keeping themselves and their loved ones well. Women are the carers in our society, the center of the family, and the people in our lives who know how to get things done and make us feel safe. Breast cancer is the most common malignancy affecting these women in the United States. So I don’t know about you, but I’m going to do everything I can to take care of them, as best I can.
That’s right, I’m going to stay pink - eat pink, laugh pink, move pink, and love pink - all year long.
“Reducing the Risk of Breast Cancer Recurrence: an Evaluation of the Effects and Mechanisms of Diet and Exercise.”