Health & Exercise Forum

October is National Breast Cancer Awareness Month and there is good news to report!

A recent study in the Journal of the American Medical Association from Harvard has found that regular exercise can improve the survival of patients with breast cancer. I have discussed these findings with local physician, Dr. Christopher Peters of Northeast Radiation Oncology Center and he says that he regularly councils his patients about the value of exercise in the recovery from breast cancer. As found in the study, he recommends aerobic exercise such as walking and/or biking and mild resistance exercise. He also encourages patients to enroll in a formal rehabilitation program, especially to prevent a frozen shoulder if invasive surgery was performed.

Previous studies have shown many benefits of exercise for breast cancer patients including improving immune functioning and controlling depression. However, new research recently presented at the American Association for Cancer Research annual meeting was the first report to conclude that physical exercise may improve survival in breast cancer patients. Additional studies have shown other benefits of exercise. For example, a study conducted at Vanderbilt University found that women who had high activity levels throughout life were less likely to develop endometrial cancer. At the Hutchinson Cancer Research Center in Seattle, researchers found that exercise with moderate intensity can reduce serum markers of inflammation (C-reactive protein), which, when elevated, are associated with chronic disease and poor cancer survival.

In the current study, conducted at Harvard University, researchers compared survival rates in women with breast cancer with exercise levels in terms of metabolic equivalent (MET) hours per week. While women with high activity levels of exercise had the best outcomes, even women with moderate exercise benefited.

Benefits of exercise in women with breast cancer:

• May increase breast cancer survival
• Lessen risk of endometrial cancer
• Improved C-reactive protein levels
• Improve autoimmune function
• Control Depression
• Psycho-Social Value
  • builds confidence, fosters control, develops new skills
  • promotes health mind, body, & spirit

In conclusion, current research supports the fact that exercise may improve breast cancer survival.  The following guidelines are proposed:

• Medical Clearance
  • Talk to your physician to get clearance for exercise
  • Remember, each patient must be individually evaluated by their physician to determine the extent of their problem and the appropriateness for exercise. Once medically cleared, seek the advice of a physical therapist to assess your needs and specifically design a program for you.
• Aerobic Exercise
  • 3-5 days per week
  • Moderate intensity
  • 20 to 60 minutes
• Strength Training
  • 2-3 days per weekLight to moderate weight

FLEXIBILITY EXERCISES:

Flexibility Exercises involve moving the arms, legs and trunk through comfortable range of motion to give you more mobility in order to improve your ability to perform daily activities such as tucking in a shirt, tying shoes or fastening a bra. Best if performed after strength exercises because the muscles and joints will be warm and limber. Always perform slowly with slight stretch sensation and no pain. No bouncing or overstretching!

Examples of Flexibility Exercises for the Upper Body:

These exercises are to be performed while sitting in a chair with a backrest, slowly, 5 repetitions, 3-5 times per week.

• To Be Performed While Sitting In A Chair With A Backrest:
  • Shoulder Raise – clasp hands together, raise arms up to forehead, then above head, as high as comfortably possible
  • Hands Behind Head – raise arms behind head by first touching ears, then back of head
  • Hands Behind Back – bring arms behind back by first touching the side pocket, then back pocket and toward small of back as comfortably possible

Examples of Flexibility Exercises for the Lower Body:

• To Be Performed While Lying On Back In Bed:
  • Knees to Chest – bring knee toward chest using hands
  • Right Leg 5 Times – Left Leg 5 Times -  Both Legs 5 Times
  • Leg Spread – Spread legs apart by sliding heels on bed
  • Leg Cross – Bring legs together touch by sliding heels on bed
  • Gas Pedals – pump ankles up and down like gas pedal

BALANCE EXERCISES:

Balance Exercises involve strengthening muscles that keep the body upright and stable in standing in order to improve your ability to perform daily activities without falling. According to the NIH, 300,000 US hospital admissions for broken hips occur each year due to falls. Check with your physician if you have a history of dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Always use a countertop or back of chair to hold onto for support.

Examples of Balance Exercises:

• Sitting Squat – Squat up and down in a chair
  • First use both arms to assist, then one arm.
• Standing March – March legs up and down while holding onto countertop
• Standing Scissors – Bring leg out and cross over like a scissors one leg at a time
• Standing Squat – Squat down by bending at hips and knees 20-30 degrees while holding onto countertop
• Dance – Slow dancing with a partner is great fun and a very helpful exercise to improve balance.

ENDURANCE EXERCISES:

Endurance Exercises involve any activity such as walking, swimming, biking or raking leaves that elevates your heart rate and breathing for an extended period of time. Check with your physician if you have a history of heart problems or dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Start off slowly for only 5 minutes and add 1-2 minutes each week or 2. Wear good and comfortable shoes – no heels!

Examples of Endurance Exercises:

While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.

• Walk Around the House – Start walking around the house for 1-2 minutes nonstop               
  • Every 1-2 hours. Then, add 1-2 minutes every week.
• Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds.
  • Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.
• Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day. Then, add 1-2 times per day.
• Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.
• Recumbent Bike – If balance is a problem, but you can tolerate more extensive endurance exercise, use a recumbent bike (a bike with a backrest)

Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!   

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!