How a Physio can help you safely Exercise with Breast Cancer

Breast cancer is the most common cancer among Australian women. Over the past two decades, advancements in treatment have significantly increased survival rates for individuals with breast cancer, with 5-year survival rates now exceeding 90%.

The impact of breast cancer treatment side effects on the body has been compared to rapid aging. For example, just 12 weeks of chemotherapy can lead to declines in cardiovascular fitness similar to what one might experience over a decade of natural aging. Add to this the physical changes such as hair loss, the mental challenges that naturally occur and the effect of the sudden change of hormones on the body. However, the good news is that exercise can not only halt this decline but also improve cardiovascular fitness.

In addition to its positive effects on fitness, exercise plays a crucial role in counteracting adverse treatment effects such as muscle weakness, bone density loss, balance issues, and the prevention or reduction of side effects like fatigue and lymphedema.

Exercise also has a profound impact on mood and one’s sense of control following breast cancer. Importantly, there is strong evidence linking physical activity with improved survival rates, as individuals who exercise regularly after breast cancer diagnosis are less likely to die from breast cancer and experience a lower risk of recurrence.

After surgical procedures like biopsy, lumpectomy, mastectomy, or reconstruction, it is essential to follow the post-surgical guidelines provided by the surgeon to ensure optimal wound healing.

Post-operative exercises often involve simple range of motion movements. During the initial recovery phase, low-impact aerobic exercises like walking and stationary cycling are generally safe, but sweating may be discouraged in some cases. Physios can guide you through this process and can prescribe lower body strength and balance exercises once it is deemed safe.

Around six weeks after surgery, when cleared by a surgeon, it is advisable to continue working on regaining arm range of motion and gradually build strength and cardiovascular fitness.

Lymphedema, a potential side effect of breast cancer surgery involving the removal of lymph nodes, is a common concern. However, when exercise is prescribed correctly and introduced gradually, even high-intensity workouts have been shown to improve lymphedema-associated symptoms without negative effects. In fact, movement plays a crucial role in managing lymphedema, as the muscle pump effect, blood flow, and pressure changes during exercise help move the lymphatic fluid. A Physiotherapist can provide valuable guidance in this regard.

Different types of exercise offer various benefits for individuals with breast cancer:

• Aerobic exercise: This type of exercise improves body composition, cardiovascular fitness, and heart health.
• Resistance exercise: It benefits body composition, strength, and bone density.
• Balance exercise: It helps improve balance and manage peripheral neuropathy side effects.
• Core strengthening: Especially important for individuals who have undergone breast reconstruction involving the abdominal muscles.
• Range of motion and flexibility exercises: Particularly crucial for regaining arm and shoulder mobility.

It is crucial to consult with a Physiotherapist if any of the following conditions are present:

1. Bone metastases
2. Lymphedema
3. PICC line (catheter) usage
4. Movement issues

Here are some important points to keep in mind:

• Gradually increase weights and loads over time based on symptoms and post-exercise recovery.
• Avoid guarding behaviour, such as rounding shoulders and restricting arm movement on the affected side, to prevent shoulder impingement syndrome or frozen shoulder.
• Fatigue levels may fluctuate during treatment, so exercise according to individual tolerance and monitor recovery.
• If symptoms of a heart problem develop, such as shortness of breath, chest pain, or swelling in the neck or ankles, stop exercising and seek medical attention.
• Minimize tripping hazards if peripheral neuropathy is present.
• If unusual swelling occurs, whether at the operation site, in the arm, shoulder, chest, or breast, it should be discussed with a member of the cancer team or a general practitioner.
• Consult with a Physiotherapist who can conduct a thorough assessment to prescribe a safe and effective exercise program tailored to individual needs, guiding the correct exercise mode and intensity.

Our Women’s health team love to help our patients who need some guidance, help and physical training in this area. Please ask if you’d like to discuss this with our team.