Exercise for Breast Cancer Survivors
by Carole M. Schneider, PhD
Exercise is beneficial for breast cancer survivors. In fact, you should avoid inactivity, which can add to your fatigue and make you feel worse.
Exercise during and following your treatment will make you less fatigued, help you tolerate your treatment, help you maintain your strength for daily activities, improve your shoulder range of motion, reduce your anxiety, and improve your quality of life. You need to allow yourself some time for upper-body healing, but you should return to daily activities as soon as possible. Begin working the upper body with a trained physical therapist who can teach you basic range-of-motion and shouldermobility exercises. At the same time, since treatment affects your entire body, you should exercise the lower body during the healing process, either in a supervised environment or with a homebased walking program.
Building Your Own Exercise
Your exercise program should include variety and balance. You can achieve this by ensuring you focus on the main components of exercise: frequency, duration, intensity, and progression.
You should begin your program by exercising more than once per day (2 to 3 times) for short periods (5 to 10 minutes) followed by rest periods for a minimum of three days per week. Once you can tolerate short bouts, you may progress to longer, continuous periods (30 to 45 minutes) of exercise two to four times per week.
Weight training is especially beneficial for cancer survivors.
You should work out at a low intensity to start. There are many ways to determine how hard you should work out. The easiest way is to monitor your heart rate in beats per minute (bpm). Your heart rate intensity is determined using the following equation: 220 minus your age (which is your predicted maximum heart rate), multiplied by a percentage of how hard you want to work out.
For example, if you are 50 years old and you want to exercise at a low intensity (50% to 60% of your predicted maximum heart rate), the formula would look like this: 220 – 50 years = 170, multiplied by 50% (0.5) = 85 bpm; likewise, 60% = 102 bpm. Your goal is to exercise between 85 bpm and 102 bpm. You can monitor your heart rate using a heart rate monitor, or you can count your heartbeats for 15 seconds and multiply that number by 4 to get your bpm. When exercise at 50% to 60% (85 to 102 bpm) becomes too easy, increase your heart rate to a moderate intensity (65% to 75%; 111 to 128 bpm).
During treatment, you may feel better on some days and want to exercise at a moderate intensity, or you may feel poorly and want to exercise at a lower intensity. Following treatment, you can steadily increase either the duration (how long your workout lasts), the frequency (days per week), or the intensity (how hard you work out) of exercise, but progress slowly. The best rule is to increase duration and frequency before increasing intensity.
The exercises you do should depend on where you are in your recovery process. Walking is always the best activity to begin your program. Once you are out of treatment and you feel comfortable with walking, you may progress to jogging, cycling, or any activity that uses large muscle groups.
The Benefits of Weight Training
Weight training is especially beneficial for cancer survivors. Once your physician has cleared you, begin strengthening your upper and lower body. Begin slowly by using exercise bands two to three times a day for 10 minutes. Progress to using free weights for the upper body while still using the bands for the lower body. The idea is to progress slowly, especially with your upper body exercises.
Once you feel strong enough, you may begin to use stationary machines, heavier bands, or heavier free weights. Don’t forget your core. Try sit-ups or curls on an exercise ball to strengthen all of the muscles in the abdomen and back. Cancer survivors must also work on balance. You can use balance pads, foam rollers, balance discs, and balance beams. If you are experiencing lymphedema, you can still exercise (even weight training); however, you should wear a well-fitting compression garment during exercise.
Your goal for exercise should be to do a full-body workout (for example, walking, strength exercises, and balance) two to three days per week for 45 to 60 minutes per day. Take control of your life and make yourself feel better, stronger, and less anxious with exercise.
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Dr. Carole Schneider is the founder and director of the Rocky Mountain Cancer Rehabilitation Institute, which is located on the campus of the University of Northern Colorado in Greeley, CO. She is also a professor in Exercise Physiology at the university.
This article was published in Coping® with Cancer magazine, September/October 2011.