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Is exercise ok after breast cancer?

“But I thought I was done with all of this,” My clients would say this with either a heavy sigh or arms crossed in front of their chest. Whether someone was sad or irritated, there was frustration. I have evaluated many women and men who are frustrated by the long-lasting effects breast cancer treatment forced to face daily, monthly, and even years later.

My name is Bettina, and I am a physical therapist working in the U.S. I have been honored to treat women and men who have gone all types of cancer: breast, colon, ovarian, stomach, pancreatic, testicular and even uterine cancer. My clients have faced their diagnosis and treatment bravely and head-on. For many, the focus begins to shift from treatment to life-after- treatment.

During our time together, my clients would tend to ask the same questions. I noted this after several months after specializing in this area, and decided to create a blog and course to answer these FAQs.

  1. Is it normal to feel tired this long after cancer treatment?

Yes. Every person has a different recovery rate, and different lifestyle that they are used to. If you are dealing with cancer treatment and have a toddler at home, it is very stressful. If you have always been the main provider and still are working through treatment, even part-time work can feel like overtime each and every day. I have had some women tell me that they feel frustrated that they can’t do all the household chores they used to do.

“ I have a whole day of activity planned, but only ½ a day worth of energy.”

This frustration often leaves my clients feeling as though they will be judged for having little motivation or discipline to return back to normal life. This is especially true if the cancer treatment was over 6 months to one year ago.

The anguish is real.

Fatigue is a daily struggle for many women.

So, can you expect to ever feel like you can go through a whole day full of vibrant energy? Yes, you can, but having patience with yourself is key. It is also good to know that your body is healing. The body will use up resources to heal, resources that normally be used to do the laundry.

Take your nap, but more importantly, take your time. In fact, fatigue is also described on site, which also describes different symptoms of fatigue.

These include:

· Lack of energy · Sleeping more · Trouble thinking · Word finding difficulty

What many clients found shocking is that fatigue may present itself as a mental processing trouble. They would often describe how they felt themselves withdraw not only physically from activity, but also emotionally because they were not able pay attention as long or as in depth as they were prior to treatment. The truth is that several breast cancer treatment can cause fatigue. Surgery, chemotherapy, radiation, hormone treatment, and pain medication.

One article published in the Asian Pacific Journal of Cancer Prevention reported that depression and anxiety were two of the most common issues arising in those having gone through breast cancer treatment. Receiving the diagnosis of breast cancer and going through the treatment leads to very high emotional stress, which also leads to fatigue.

2. Should I focus on exercising after my cancer treatment?

Great question. The reality is that exercise is important for a body to heal, but it does not have to involve hours and hours of lifting, stretching, cycling or swimming. The more physically active a person was prior to cancer treatment, a quicker recovery is observed after treatment. Of course, this is a generalized statement, as the type of cancer, length and type of treatment also have to be considered. Women typically reduce the amount of activity they participate in after their diagnosis. However, this number increases to 25% if they have received radiation and 50% if they have had chemotherapy. A reduction in activity leads to weight gain, decreased lean body mass, increased fatigue and increased emotional states such as depression and anxiety.

One of the best methods for someone to ease back into an exercise routine is to walk on a regular basis. The benefits of walking are not always celebrated, but that doesn’t mean that they don’t exist. The benefit of exercise is not often examined by researchers, and therefore are not often discussed while women go through treatment. However, this article described that those who participate in exercise on a regular basis (3x a week minimum) report a higher quality of life, less depression and increased muscle strength. This study just examined the reports of women over the course of 4 months, but just imagine if this is continued over the course of a women’s lifetime!

It is a great cardiovascular activity to start out with. One of the best methods for someone to ease back into an exercise routine is to walk on a regular basis. The benefits of walking are not always celebrated, but that doesn’t mean that they don’t exist.

3. Does exercise really help reduce the risk of having the cancer come back?

The answer is yes to that as well. The link between increased weight and diabetes and risk of cardiovascular issues is more commonly known. However, there is an association between obesity and the risk of developing breast cancer. This risk increases after women have gone through menopause. There are some further thoughts that a reduction in the body’s inflammation further reduces the risk of beast cancer. Some research studies have shown a risk reduction from 40- to nearly 70%. Again, there never is a guarantee, especially when it comes to the human body. But even exercises (which walking is a part of) 2 hours a week can make a difference.

Many of my clients have asked me if what they eat is as important as the increased activity. There are certainly foods that have been associated with increased lymphedema, especially dairy and gluten products. There has been some research looking into the type of diet and the risk of certain breast cancers. Doctors provide the odds when describing risks and rewards of treatment. These odds extend into post-treatment as well!

4. Can I workout with a personal trainer?

Yup! So, this question is one of the most common questions people will ask me as a physical therapist. From my experience, many people are able to complete those 2.5 hours much better if they are held accountable to doing them. This can be with a friend, family member or even a personal trainer. Now, a personal trainer (pt) and a Physical therapist (PT) are not the same with regard to their education, and the legal allowances each professional possess.

It is important to interview both your personal trainer and physical therapist to learn what their education and background is in cancer rehab. From my experience, personal trainers want to have a specific list of what they can and can not do for you.

Again, everyone is different, but I never want anyone to shy away from getting the support they need.

5. Do I have to be evaluated by a Physical or Occupational Therapist every year? I don’t believe you do. From my experience, most people are able to gather the information, exercises, stretches they need from one series of visits. Now, if something feels different later, there is prolonged swelling, there is new pain, there is extra fatigue, it is always important to follow up with your doctors. But, you are allowed to see a therapist specializing in cancer rehab again. It is never a one-time deal. Our bodies and our needs change as we age. And our body keeps track of everything that has ever happened to us. (That bad ankle sprain in your 20s leads to early onset of arthritis later on, etc.) So, I encourage everyone to know that even though each person has their own experience, no person is alone. Seek out professional help whenever you have the opportunity, as it can make a big difference in your life.

Take Home Message:

· Fatigue is normal, and this may last several months, to several years after your treatment. · Never underestimate the impact psychological stress has in you. · Focus on increasing your activity level 2-3 times a week, knowing that this will make a difference. · Don’t compare your progress to anyone else’s. There are so many more questions and discussions that occur with women during our one-on-one sessions. I created a course to review the basic questions, provide a short stretching and exercise program, and discuss rehab options in more detail.