Exercise

Exercise

Exercise can ease treatment-related side effects and reduce the risk of breast cancer recurrence, as well as the risk of developing breast cancer in the first place.

Regular exercise is an important part of being as healthy as you can be. Being physically active can reduce your risk of developing breast cancer. And if you’ve been diagnosed with breast cancer, exercise can reduce the risk of the cancer coming back (recurrence). Exercise also can help ease troubling treatment side effects, such as fatigue, pain, depression, and lymphedema.

The American College of Sports Medicine brings together exercise oncology experts so they can review research on exercise for people diagnosed with cancer, as well as research on exercise and cancer prevention.

These experts say that exercise is safe during and after all breast cancer treatments, as long as you take any needed precautions and keep the intensity low.

The American Cancer Society supports the American College of Sports Medicine’s general physical activity recommendations for people who’ve been diagnosed with cancer:

  • Avoid inactivity and return to normal daily activities as soon as possible after diagnosis and treatment.

  • Take part in regular physical activity.

  • Start slowly and build up the amount of physical activity over time.

  • Build up to at least 150 minutes of moderate or 75 minutes of vigorous intensity activity each week.

  • Exercise several times a week for at least 10 minutes at a time.

  • Include resistance training exercise at least two days a week.

  • Do stretching exercises at least two days each week.

In 2022, the American Society of Clinical Oncology also put out guidelines on exercise, diet, and weight management during cancer treatment, saying doctors should recommend regular aerobic and resistance exercise for people receiving cancer treatment.

If you’ve been diagnosed with metastatic breast cancer, cancer exercise specialist Sami Mansfield offers some tips to help you start exercising and gives examples of exercises you can do safely at home on The Breastcancer.org Podcast.

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Exercise for People Diagnosed With Metastatic Breast Cancer

Feb. 23, 2019
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Benefits of exercise

Exercise can help lower your risk of developing breast cancer. We know that women who exercise have a lower risk of developing breast cancer than women who don’t exercise. Doctors don’t fully understand how exercise lowers risk. But many doctors believe being active helps regulate insulin and estrogen — hormones that can cause breast cancer to grow. Maintaining a healthy weight with regular exercise can also help regulate hormones, reduce inflammation, and keep the immune system healthy.

Exercise can help lower your risk of recurrence if you’ve been diagnosed with breast cancer. A number of studies have shown that women who exercise regularly have a lower risk of recurrence and were also less likely to die from breast cancer. Doctors don’t fully understand why exercise can also lower the risk of breast cancer recurrence. But many doctors think that maintaining a healthy weight and keeping hormones like insulin and estrogen regulated can help lower the risk of breast cancer recurrence (just as it can help lower breast cancer risk).

Exercise may help you have fewer and less severe side effects from treatment. Research shows that exercise can help:

  • ease fatigue

  • lessen anxiety

  • improve quality of life

  • reduce the risk of lymphedema

  • improve physical function

  • strengthen bones

  • improve sleep

  • ease bone and joint pain

Exercise can help you maintain or build muscle mass and be stronger. As most people age, they tend to lose muscle and gain fat. Chemotherapy and hormonal therapy medicines can suddenly throw you into early menopause. The decrease in estrogen that comes with menopause is linked to decreased muscle mass. Strength training exercises can help make sure you increase lean muscle mass and reduce body fat — so you can carry groceries, pick up heavy things, and even put your suitcase in the overhead bin on an airplane.

Exercise can help you keep your bones healthy. As you age, you lose bone mass. If you’ve been diagnosed with breast cancer, maintaining healthy bones is especially important for you. We know that some breast cancer treatments can lead to bone loss. Plus, women are about twice as likely as men to develop osteoporosis after age 50. Osteoporosis is a bone disease that thins and weakens the bones so they are more likely to break. Weight-bearing exercise, such as jogging or walking, and strength training can all strengthen bones and slow bone loss.

Exercise can help improve mobility. Scar tissue that forms after breast cancer surgery, reconstruction, or radiation can make your arm and shoulder muscles feel tight. If you don’t use your arm and shoulder as much after treatment, the muscles in those areas also can lose flexibility. Over time, careful stretching exercises can improve range of motion in the arm and shoulder.

 

Types of exercise

There are three main types of exercise: aerobic exercise, flexibility exercise, and strength or resistance exercise.

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Exercising safely

Exercise offers many benefits for people who’ve been diagnosed with breast cancer, but it’s important to exercise safely.

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Exercise during and after breast cancer treatment

Your ability to exercise during and after treatment depends on what your overall health and physical condition was before your diagnosis. If you didn’t exercise at all before you were diagnosed, then it’s a good idea to start slowly and carefully. If you exercised regularly before your diagnosis, then scaling back a bit on your old routine may help you feel more like yourself. Either way, it’s important you have your doctor’s OK before you start exercising again.

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How Breast Cancer Treatment Affects Your Ability to Exercise

Oct. 19, 2016
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You may want to visit a physical therapist with experience in diagnosing lymphedema for a structural evaluation before you start exercising — either after surgery or during other breast cancer treatments. Besides looking for lymphedema, a physical therapist can check for any other issues unrelated to breast cancer that may limit your ability to exercise. The physical therapist also can help you develop an exercise plan that’s right for you.

If you’re experiencing extreme fatigue, a low red blood cell count (anemia), or a lack of muscle coordination (ataxia), don’t exercise. It’s also a good idea to skip aerobic exercise if your platelet count or white blood cell count is low. A platelet is a disc-shaped piece of cell that helps the body form clots to stop bleeding.

If you have any shortness of breath, pain, or tightness in your chest, stop exercising immediately. Tell your doctor so you can work together to develop an exercise plan that is right for you.

 

Finding a certified trainer

If you’re planning to exercise during or after breast cancer treatment — especially strength training — you may want to work out with: 

  • a certified trainer with experience working with people diagnosed with breast cancer

  • a physical therapist trained in lymphedema diagnosis and management

A qualified trainer can help you start slowly, explain which precautions you need to take, and push you enough but not too much.

It’s important to make sure your trainer is certified by a national organization. There are a few well-known, respected organizations, including the American College of Sports Medicine, the National Academy of Sports Medicine, and the American Council on Exercise.

A trainer who is certified in cancer exercise training by the American College of Sports Medicine has done additional work with people who’ve been diagnosed with cancer. The American College of Sports Medicine’s cancer and exercise training program prepares trainers to understand how cancer therapy — especially surgery and chemotherapy — can increase the risk of injury and other complications, such as lymphedema. The organization also offers an exercise program directory you can use to search for a certified cancer exercise trainer and exercise and rehabilitation programs specifically for cancer survivors via its Moving Through Cancer program. For best results, put in only your two-letter state abbreviation.

Although a college degree isn’t necessary to be a good trainer, it’s helpful to have a degree in a field related to exercise physiology.

Here are some questions you may want to ask a potential trainer:

  • Have you worked with people diagnosed with breast cancer before?

  • Are you certified? If so, which organization is your certification from?

  • Are you certified in cancer exercise training?

  • May I have the names of three of your current clients as references?

 

How to stick to an exercise routine

For many people, the hardest part of exercising is sticking to a steady routine. Once the initial enthusiasm wears off, you may find yourself making excuses not to exercise. Here are some tips to help keep you motivated.

  • Make it fun. If you like being around people, you may want to take a yoga class or sign up for a local biking or hiking club. If you’re happier on your own, try walking in a park or location with a nice view.

  • Switch things up so you don’t get bored. Walk one day and lift light weights the next. Ride a bike, dance, take a yoga class — doing anything is better than doing nothing.

  • Make exercise social. If you make a commitment to exercise with someone else, you’re more likely to stick to a routine than if you work out alone. Plus, you get to catch up with a friend and keep each other motivated.

  • Make exercise a priority. Think of exercising as a necessary part of life, like breathing, sleeping, and eating. You also can think of it as an important part of your breast cancer recovery plan. It’s what you do to be as healthy as you can be. Schedule exercise like you do any other important activity. Put it on your daily to-do list.

  • Exercise first thing in the morning. Some experts say you’re more likely to stick to your routine if you exercise in the morning. As the day goes on, you’re more likely to come up with excuses or have delays in your schedule that can make it hard to exercise. Another bonus of morning exercise: you’re energized for the day ahead.

  • Exercise on your way home from work. If you can’t exercise first thing in the morning, working out on your way home from work is the next best thing. Make sure you don’t go home first. Once you change and sit down, it’s difficult to motivate yourself to go back out again. A bonus of after-work exercise: you melt away the day’s stress and irritations.

  • Exercise even when you think you’re too tired. Exercise makes your brain release endorphins, which elevate your mood and make your whole body feel better. You also breathe deeply, which can make you feel calm and relaxed.

  • Keep an exercise journal. Write down the exercise statistics that are important to you: how long you exercised for, how far you walked (or ran or biked), how much weight you lifted, and how many reps you did. Seeing your progress can help keep you motivated to keep going.

  • Reward yourself. Set some goals and as you achieve them, reward yourself. When you’re able to walk for 30 minutes without stopping, consider buying yourself a new pair of walking shoes. When you can do Eagle Pose in yoga, consider buying yourself a new pair of yoga pants. Do whatever works for you.

  • Be flexible. If you’re truly too busy or feel run down, take a break. The important thing is to get back on track as soon as you can.

 

Exercise resource guide

Here are some helpful resources that may help as you put together an exercise plan to review with your doctor before getting started.

Strength and Courage

Dr. Sharon Cowden, pediatrician, golfer, and breast cancer survivor, and Janette Poppenberg, a cancer exercise trainer certified by the American College of Sports Medicine and the American Cancer Society developed the Strength & Courage: Exercises for Breast Cancer Survivors program for breast cancer survivors.

Exercises After Breast Surgery

The American Cancer Society offers a list of exercises that people diagnosed with breast cancer can do in the first three to seven days after surgery. Each exercise has an accompanying illustration.

Guideline for Diet and Physical Activity for Cancer Prevention

The American Cancer Society releases updated nutrition and physical activity guidelines every five years. The organization includes a detailed summary of the guidelines, as well as a link to the full guidelines written for health professionals.

Exercise and Physical Fitness

A service of the National Library of Medicine and the National Institutes of Health, MedlinePlus offers exercise tips, research, tools, and statistics.

President’s Council on Sports, Fitness, and Nutrition

The President’s Council on Sports, Fitness, and Nutrition is a committee of up to 25 volunteer citizens appointed by the president to serve in an advisory capacity through the Secretary of Health and Human Services. The committee offers news, blogs, videos, and resources on healthy eating and physical activity

LIVESTRONG at the YMCA

LIVESTRONG at the YMCA is a 12-week, small group exercise program for adults who’ve been diagnosed with cancer. The program is in more than 791 YMCA locations. You can learn more about the program and how you can bring LIVESTRONG to your local YMCA.

 

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Written by: Jamie DePolo, senior editor

— Last updated on August 23, 2022, 7:49 PM

Reviewed by 1 medical adviser
 
Kathryn Schmitz, PhD, MPH
Penn State University College of Medicine, Hershey, PA
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