June 10, 2014
News Review From Harvard Medical School -- Exercise Often Drops after Breast Cancer
Exercise can aid in recovery from breast cancer. But many women actually exercise less after their diagnosis, a new study finds. Regular exercise has been linked with longer and better quality of life after breast cancer treatment. The new study included 1,735 women recently diagnosed with breast cancer. Researchers asked them about their exercise habits. They asked again 6 months later. About 59% reported doing less physical activity than they did before diagnosis. Only 35% met current national guidelines for exercise 6 months after diagnosis. African-American women were 38% less likely to meet those guidelines than white women. They also had larger declines in exercise. The journal Cancer published the study online. HealthDay News wrote about it June 9.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Exercise can help with recovery from breast cancer. By getting regular exercise and staying physically active in other ways, women can:
- Improve their quality of life
- Decrease their risk that the cancer will return
- Increase their odds of living longer
However, in this study, researchers found that 59% of women were less active after their breast cancer diagnosis than they were before. The largest decline occurred among African-American women.
This study did not look at why women became less active or why the decline was greater in African-American women. However, other studies and focus groups suggest some reasons:
- Many women, especially African-American women, are not aware that regular exercise and increased physical activity improve quality of life and prognosis.
- Many women do not recall their doctors emphasizing the importance of exercise and physical activity after diagnosis.
- Fatigue, pain, nausea and other symptoms reduce any desire to exercise. Women often don't ask how to manage these symptoms so they can stay more active.
Most women in the study were less physically active after the breast cancer diagnosis. But 1 in 5 women actually became more active. On average, they exercised 30 minutes more each week after the diagnosis than they did before. In other studies, women having breast cancer treatment report a great sense of accomplishment when they increase their exercise.
Scientists aren't sure why exercise and physical activity improve survival from breast cancer. Here are some theories:
- Exercise reduces levels of estrogen and progesterone. These female hormones can stimulate breast cancer growth.
- Women who are more physically active have lower insulin levels. This hormone also may promote breast cancer growth.
Staying active helps to reduce weight gain. Heavier women with more body fat have a greater risk of a return of breast cancer after treatment.
What Changes Can I Make Now?
Current guidelines say that we should get at least 150 minutes of moderate-intensity exercise per week. Doing 75 minutes of vigorous exercise per week is another option. If you were recently diagnosed with breast cancer, your eventual goal will be the same.
Getting to that goal will take time. Start with small amounts of activity several times per day. Rest in between. You can stretch out the time and intensity as you get stronger.
Here are some other tips:
- If you drive, park far away from where you need to go,
- If you take a bus or train, don't wait at the nearest stop. Walk to the next one. Or, at the end of your journey, get off a stop early and finish up on foot.
- Swing your arms when you walk.
- Wash and dry the dishes by hand. The drying alone is a mini-workout for the arms.
- Do at least some of your own home cleaning. Fifteen minutes burns about 80 calories.
- Stand up when you're on the phone. Even standing for a minute or two increases your metabolism.
- Take the stairs instead of the elevator or escalator whenever you can.
Get yourself a pedometer that you wear every day. It's an easy way to track your progress.
What Can I Expect Looking to the Future?
Many cancer specialists already recommend exercise. They consider it an important part of breast cancer treatment. In the future, this will become standard advice to improve quality of life and prolong survival.
However, the more difficult challenge will be to make sure women follow through on the advice. Future studies are needed to find the most effective strategies to keep women with breast cancer -- especially African-American women -- physically active.