Exercise benefits in patients diagnosed with cancer are perhaps the least controversial subject in oncology yet it remains to be the most underutilized tool in the management of cancer patients. In this post, I will review recent publications showing the benefits of exercise in cancer patients in general and in breast cancer patients in particular. I will also attempt to provide practical recommendations for patients and clinicians to promote the idea of utilizing physical exercise.
physician permission is requred prior to initiating a supervised Exercise program.
Clinical Evidence: multiple published studies demonstrated significant health advantage of pursuing physical exercise in breast cancer patients during treatment and after treatment completion, I will go over a few, the American College of Sports Medicine (ACSM) published “Roundtable on Exercise Guidelines for Cancer Survivors”. The panel reviewed multiple randomised clinical trials and concluded the safety of exercise training during and after cancer treatment as well as resulting improvement in physical functioning, quality of life (QOL), and cancer-related fatigue in breast cancer patients as well as other cancer groups. The ACSM gave further recommendations with regard to pre-exercise assessments, and goal setting(please see summary diagram below). Other observational studies demonstrated positive association between moderate physical activity and breast cancer outcome, in the Nurses Health Study, nearly 3000 women diagnosed with stage I to IIIa breast cancer, women with physical activity equivalent of walking at an average pace of three hours per week had 50 percent lower risk of breast cancer recurrence, death, and all-cause mortality compared to women with physical activity of less than an hour of moderate physical activity per week.
In breast cancer patients there is few contraindications to start An Exercise program.
The American College of Sports Medicine (ACSM), the American Cancer Society, and Worldwide Cancer Research (among other national and international agencies) recommend 150 minutes per week of moderate-intensity physical activity for cancer survivors.
Trainers Resources: fitness professionals seeking cancer specific training and certification have the following options,
- ACSM and the American Cancer Society (ACS) have a certification program
- The ACSM developed a six-session cancer exercise trainer certification Webinar
What is Next: Breast cancer survivors are encouraged to seek local venues with trainers who are familiar and experienced in cancer survivors exercise training, for example, the Lance Armstrong Foundation has partnered with the YMCA to help train fitness staff at YMCAs across the country to work with and meet the needs of cancer survivors, similar programs are sometimes offered by trainers studios, hospital etc.
Mobile apps: as we are living in the age of smartphones, mobile apps, iWatch, Fitbit watch there is no shortage of valuable mobile apps to track activity, miles run, calorie count etc. I am not in a position to recommend any specific product. It is interesting to see that there is a trial is looking specifically at the feasibility of utilization of such mobile app in breast cancer patients.
Conclusion: I believe that physical exercise is the most underutilized tool in the fight against breast cancer, busy oncologist and often overwhelmed patients often overlook the tremendous and achievable benefit exercise can bring to breast cancer patients. I hope this blog can help change that.
For copy of survivorship plan please click here