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Harvard Commentaries
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Don't Take Breast Cancer Lying Down (Part 2 of 2)

May 04, 2014

By Paulette Chandler M.D.

Brigham and Women's Hospital

In Part 1 I discussed why exercise is an important weapon in the fight against breast cancer. Now I will talk about specific exercises for breast cancer patients.

Have you ever restored an old piece of furniture or renovated a room in your home? The excitement of seeing the finished product drives you to tolerate the discomforts of dust and clutter, the inconvenience of not being able to use the room or furniture, and the frustrations and challenges of planning the project. If you have breast cancer, your body may be ravaged from the chemotherapy or the scalpel. While cancer cells have been destroyed, healthy cells have also been injured. Your body needs restoration and cleansing from all the cellular debris that has accumulated in your body. How can you help speed your recovery? Exercise. Exercise is a wonderful complementary therapy that everyone can engage in at some level and experience great benefits.

The typical exercise program for breast cancer patients should include four areas: aerobic exercise training, strength training, stretching, and mind-body training. Listed below are suggested activities for each area. Your exercise prescription will be based on your personal situation — such as how long ago you had surgery, your present cycle of chemotherapy, your level of pain, and how fit you were prior to your diagnosis.

Cycling is great because it minimizes the effects of an unsteady gait, limitations in arm movement related to the surgery and lymphedema (swelling of the arm after surgical removal of lymph nodes). Walking is another excellent choice because it is safe and tolerable for most people. Women who have breast cancer that has spread to the bones are at high risk for fractures and should avoid high-impact exercises and contact sports.

Strength training
Dumbbells, band exercises or machines can be used for strength training. Work major muscle groups for two or three sets that include 10 to 12 repetitions for each muscle group. Avoid weight lifting after breast cancer surgery until you have detailed instructions from your surgeon and oncologist.

Stretching is especially good for areas affected by surgery such as the shoulder and arm. You can begin simple stretches while lying in bed during the first few days after surgery. Try to do two stretching sessions each day repeating each stretch 10 to 12 times.

While doing each exercise, you should feel a gentle stretch, but stop if you feel a sharp pain or excessive pulling of the muscles. Do each stretch as fully as you can. You'll find the exercises progressively easier to do each day. Do exercises with both arms. This will increase your sense of balance, and give you an idea of the flexibility and strength that you are trying to gain in the affected arm.

Shoulder/neck rolls
Position: Sit or stand.
Motion: Shrug shoulders up, squeeze back down and forward in a circular motion. Repeat in reverse direction. Let your head roll forward with chin toward chest. Then let head tilt to one shoulder, the other shoulder and then toward the back.

Wall walk
Position: Sit or stand with one side of body facing a wall.
Motion: Using arm nearest wall, slowly walk your fingers up the wall as far as you can reach. Each day stand a little closer to the wall.

Arm circles
Position: Sit or stand or sit with arms stretched out to sides at shoulder height and parallel to floor. Do not lock elbows.
Motion: Make little circles with your arms while slowly raising them to your ears. Reverse the direction of the circles and slowly lower your arms to your thighs.

Rope pulling
Position: Sit or stand.
Motion: Bend arms at chest height with palms facing floor. Imagine you are climbing a rope and raise one arm as high as you can toward the ceiling. Lower arm and repeat with other arm.

Clapping hands
Position: Sit or stand.
Motion: Raise both arms above your head palms up. Try to clap your hands overhead. Slowly lower arms to shoulder height. Take four counts to reach over your head and four counts to lower to shoulder position.

Mind-body training
Try deep breathing and relaxation exercises. Use soft music to help focus relaxation and visualization. Visualize healthy breast cells displacing the bad cancer cells and rejuvenated blood cells flowing throughout your body like a river with many branches. Prayer and meditation are also healing mental exercises that ignite your immune system.

Exercise Precautions

Avoid overstressing an arm prone to lymphedema. Stop exercising and call your doctor if you notice excessive drainage, throbbing, or swelling at the surgical site or severe pain radiating down your arm.

Paulette Chandler, M.D., M.P.H., is a clinical instructor of medicine at Harvard Medical School and an attending physician at Brigham and Women's Hospital.

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