Published on February 16, 2021
Benefits of Exercise for Patients with Breast Cancer
Regular exercise provides many benefits for people living with breast cancer. Patients who exercise regularly report a good quality of life and studies have linked exercise to lower anxiety and depression in people with breast cancer and other conditions.1,2 As more is understood about the benefits of engaging in recreational activity before, during and after treatment, experts believe that regular sweat sessions can also increase life spans and reduce the effects of lymphedema.
Increasing Life Span with Exercise
During the last decade, evidence has shown that people who are active before receiving a breast cancer diagnosis experience better overall survival rates than their less active counterparts.3,4 The encouraging news is that it’s never too late to start exercising.
A study published in the Journal of the National Cancer Institute showed that physical activity can decrease the risk of mortality in patients with breast cancer.5 Researchers enrolled 1,340 patients in the Diet, Exercise, Lifestyle and Cancer Prognosis study. All had been diagnosed with high-risk, stage I to III breast cancer and all were undergoing chemotherapy treatment.
The study authors reviewed participant activity levels before diagnosis, during treatment and at the one- and two-year marks after completing chemotherapy. They examined relationships according to the minimum exercise guidelines defined by the U.S. Department of Health and Human Services as “at least 150 minutes of moderate-intensity aerobic activity per week.” The team concluded that meeting the minimum guidelines for physical activity before diagnosis and after treatment significantly reduces the risk of recurrence and mortality among people with breast cancer.
Starting or continuing an exercise routine can be challenging during treatment when energy levels and appetite wane. For some, “a body in motion stays in motion” is easier said than done, especially when dealing with treatment-related fatigue and other side effects. However, the feeling at the end of a walk or light workout and the proven health benefits of exercise are worth the time and effort.
Reducing Lymphedema with Weight-Bearing Exercises
One of the ways specialists can determine if breast cancer has spread is by removing lymph nodes, which are part of the circulatory system. Shaped like a small bean, lymph nodes filter substances in the lymphatic fluid and contain white blood cells that help the body fight infection. After the lymph nodes are removed, they are tested to see if the cancer has progressed beyond the chest wall. A common side effect of lymph node removal is lymphedema, which makes the arm with the removed lymph node(s) swell and feel tight and heavy. Compression garments can help—and so can exercise.
For years, doctors warned patients who had their lymph nodes removed that certain exercises may cause or exacerbate lymphedema. Based on recent studies, however, the old advice to not lift anything over five or 10 pounds has been revised.
In another study published in the Journal of the American Medical Association, one patient group participated in a 12-week supervised progressive resistance training program while a second group was instructed to walk. By the end of the study, lymphedema symptoms had lessened more in the resistance training group, leading the study authors to conclude that progressive resistance training with heavy loads is safe (in terms of lymphedema risk) and beneficial for patients with breast cancer.6 Of course, the term “heavy” varies from person to person, so this is not the time to overdo it. It is important to talk to your doctor before starting any new exercise program.
In an additional study, published in JAMA Oncology, 154 breast cancer survivors who had at least two lymph nodes removed were divided into two groups. One group was given a gym membership and a program of slowly progressive weightlifting; the other group was not. When researchers followed up at the one-year mark, they did not find an increased incidence of lymphedema in the weight-lifting group, dispelling the antiquated belief that exercise is unsafe for patients with lymphedema.7
With the guidance of a lymphedema expert and the approval of your treating physician, strength training can be an integral part of recovery. The hope is that future research will be able to identify which patients develop lymphedema, and why, so that prevention strategies such as new surgical techniques can be used to help people with breast cancer experience fewer side effects and a better quality of life.
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1Haller H, Choi KE, Lange S, et al. Effects of an Integrative Mind-body-medicine Group Program for Breast Cancer Patients during Chemotherapy: An Observational Study. Curr Pharm Des. 2020 Dec 10.
2Aguiñaga S, Ehlers DK, Cosman J, et al. Effects of physical activity on psychological well-being outcomes in breast cancer survivors from prediagnosis to post-treatment survivorship. Psychooncology. 2018 Aug;27(8):1987-1994.
3Cleveland RJ, Eng SM, Stevens J, et al. Influence of prediagnostic recreational physical activity on survival from breast cancer. Eur J Cancer Prev. 2012 Jan;21(1):46-54.
4Physical activity and survival of postmenopausal, hormone receptor-positive breast cancer patients: results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study. Cancer. 2014 Sep 15;120(18):2847-54.
5Cannioto RA, Hutson A, Dighe, et al. Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival. J Natl Cancer Inst. 2021 Jan 4;113(1):54-63.
6Ammitzbøll G, Oksbjerg Dalton S. Mounting evidence supports the safety of weight lifting after breast cancer. Acta Oncol. 2019 Dec;58(12):1665-66.
7Schmitz KH, Ahmed Rl, Troxel AB, et al. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA. 2010 Dec 22;304(24):2699-705.
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