Exercising During Chemotherapy Reduces Side Effects

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Much research has shown that exercise can help women feel better, both physically and emotionally, during and after breast cancer treatment.

Research suggests that exercise can help women being treated for breast cancer by:

  • easing nausea during chemotherapy
  • improving blood flow to the legs, reducing the risk of blood clots
  • easing constipation by stimulating digestion and elimination systems
  • revving up your sex drive
  • easing fatigue

Results from a Dutch study echo these earlier findings: Women diagnosed with breast cancer who followed either a moderate- or low-intensity exercise program while being treated with chemotherapy had less fatigue, nausea, and pain, as well as better physical fitness than women who didn’t exercise during chemotherapy.

The study was published online on April 27, 2015 by the Journal of Clinical Oncology. Read the abstract of “Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial.”

In the study, called the PACES (Physical exercise during Adjuvant Chemotherapy Effectiveness Study) trial, 230 women diagnosed with breast cancer who were scheduled to receive chemotherapy after surgery were randomly assigned to one of three exercise groups:

  • OnTrack (76 women): OnTrack is a moderate- to high-intensity combined resistance and aerobic exercise program. The women went to two sessions per week and were supervised by specially trained physical therapists. Each session lasted 50 minutes and included 20 minutes of resistance training and 30 minutes of aerobic exercise. The women also were encouraged to be physically active 5 days per week and to keep an activity diary.
  • Onco-Move (77 women): Onco-Move is a low-intensity exercise program that the women did at home and managed themselves. Specially trained nurses encouraged the women to do at least 30 minutes of physical activity per day, 5 days per week, at a moderate level. The women also kept an activity diary that was discussed at each chemotherapy session.
  • Usual care (77 women): These women weren’t encouraged to exercise during chemotherapy and followed no special activity program.

The OnTrack and Onco-Move exercise programs started at the same time as the first chemotherapy cycle and ended 3 weeks after the last chemotherapy cycle.

The women were tested for muscle strength, cardiovascular fitness, fatigue, and quality of life factors, as well as completing questionnaires three times during the study:

  • before they were assigned to an exercise group
  • when chemotherapy was done
  • 6 months after chemotherapy was done

Compared to the women who didn’t follow an exercise program, the researchers found that women in the OnTrack and Onco-Move groups:

  • could physically function better
  • were more fit
  • had less nausea
  • had less pain
  • returned to work earlier and worked for more hours per week

These differences were significant, which means they were likely because the women exercised and not just due to chance.

Compared to the women who didn’t follow an exercise program, the women in the OnTrack program had:

  • better muscle strength
  • less fatigue

These differences also were significant, which means they were likely because of the exercise.

The OnTrack program also seemed to help women tolerate chemotherapy better. A smaller percentage of women in the OnTrack program had to have their chemotherapy dose adjusted compared to women in the Onco-Move and usual care groups.

“In the past, patients who received chemotherapy were advised to take it slow,” said Neil Aaronson, Ph.D., of the Netherlands Cancer Institute who was the lead author of the study. “But actually, it is better for these patients to be as active as possible. Our study shows that even low intensity exercise has a positive effect on the side effects of chemotherapy. That is good news for those who really don’t feel like going to the gym. Small amounts of exercise are beneficial compared to being non-active.”

If you’re being treated for breast cancer, try to make exercise a part of your daily routine. Think of exercise as another important part of your overall treatment plan that helps you recover and stay healthy. Talk to your doctor about how much and how often you should exercise. Ask around and see if any breast cancer support groups near you have organized exercise classes. If you can't find an exercise class through a breast cancer group, consider joining another exercise class or start walking with a friend. There's a good chance that exercising with other people will give you the motivation and support to make regular exercise part of your recovery. Find the right exercise routine for YOU and then do your best to stick with it! It can make a difference both physically and mentally, today and tomorrow.

In the Breastcancer.org Exercise section, you can learn about:

  • the benefits of exercise
  • types of exercise
  • how to exercise safely
  • when you can and can't exercise during treatment
  • tips on finding a trainer


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