The benefits of exercise on breast cancer!

A large portion of our population is affected by breast cancer, particularly women. This makes breast cancer a prominent issue in modern society. 

Firstly, breast cancer is the most commonly diagnosed cancer among women. Additionally, it is the second most common cancer overall, accounting for 14% of all cancer diagnosis!

Secondly, in Australia alone 19,974 are estimated to be diagnosed with breast cancer in 2020 (19,807 of which are in women). That’s 55 new cases every day! In addition to this, 1 in 7 women and 1 in 675 men will be diagnosed within their lifetime. 

Thirdly, breast cancer will result in approximately 3,301 deaths in Australia this year, 2,997 being women – that’s 8 deaths every day! The mortality rate for breast cancer is the 5th highest among cancers, accounting for 6.4% of all cancer related deaths!

October happens to be Breast Cancer Awareness Month! So it’s a great opportunity discuss this important topic. In today’s post, we will dive into the world of breast cancer. We will start our journey with a quick explanation of what breast cancer is and how it affects us before discussing how exercise can help! Without further ado, let’s get started!

What is Breast Cancer?

To put it simply, breast cancer is the abnormal growth of cancerous cells in the breast lobules or ducts. These cells grow uncontrollably and have the potential to spread to different parts of the body.

Risk Factors (and Causes)

Certain factors can increase the risk of breast cancer. Some of these factors are uncontrollable and cannot be changed. These unmodifiable risk factors include:

      • Increasing age
      • Family history
      • Genetics (inheritance of mutations)
      • Increased oestrogen and progesterone exposure
      • Previous breast cancer diagnosis
      • History of non-cancerous breast conditions.

Conversely, controllable lifestyle factors can also increase the risk of breast cancer. By positively adjusting the following factors we are able to actively reduce our likelihood of a diagnosis:

      • Increased body weight (overweight or obesity)
      • Sedentary lifestyle (decreased physical activity)
      • Excess alcohol consumption.

Diagnosis

Before a breast cancer diagnosis is given, there are a variety of tests that may be administered. These can include a physical examination, Mammogram, Ultrasound or Biopsy. 

This is a manual examination that aims to find any lumps that are within the breast. If there are lumps, further investigating will be completed.

An X-Ray is used to look for changes (or lumps) in the breast tissues that may be too small to be felt during a physical examination. There are two types of Mammogram:

      1. Screening Mammogram: checks for breast cancer when no signs or symptoms are present
      2. Diagnostic Mammogram: checks for breast cancer after a lump (or other sign or symptom) has been found. 

An ultrasound is used to gather further information if the mammogram has picked up tissue changes. It is a painless scan that uses sound-waves to create a picture of the breast.

A biopsy is completed after an ultrasound. It involves removing part of the affected breast tissue for further examination under a microscope.

If cancer is detected, additional scans (such as a CT or MRI scan) help determine the grade and stage of the cancer. They also determine if the cancer is centralised to the breast or if it has spread to other parts of the body.

Treatments

Treatment of breast cancer depends on its stage and severity. The various treatment methods that may be used include: Staging, Surgery, Chemotherapy, Radiotherapy and Hormone Therapy.

This is an assessment that determines the size of the breast cancer and whether or not it has spread to the lymph nodes under the arm. To do this, CT scans of the chest and liver, as well as a bone scan, are completed to check the sites to which it most commonly spreads to.

For localised cancer, surgery may be completed to remove the breast and lymph nodes under the arms. There are two types of surgery that may be performed:

    1. Lumpectomy (or breast conserving surgery): the removal of only part of the breast 
    2. Mastectomy: the removal of the whole breast. This may be followed with reconstructive surgery.

Chemotherapy helps shrink the cancer prior to surgery, as well as reducing the risk of the cancer returning after surgery. It can also be administered after surgery if the cancer returns. It can also be given in conjunction with other treatments such as radiotherapy.

Radiotherapy (or radiation therapy) is used to destroy any cancer cells. This can be applied in isolation or as an adjacent treatment with surgery or chemotherapy.

This method uses drugs to reduce the levels of oestrogen and progesterone within the body. It aims to stop or slow the growth of hormone receptor positive cancer cells. which require these hormones to survive and spread.  

The Side Effects of Treatment

While breast cancer treatment can be quite effective at treating the cancerous cells, it also has many potential side effects. These side effects include, but are not limited to:

      • Fatigue
      • Musculoskeletal dysfunction or atrophy
      • Reduced bone mineral density
      • Lymphedema
      • Changes in body composition
      • Peripheral neuropathy or other nerve problems
      • Arthralgia / Myalgia
      • Cardiovascular toxicity
      • Increased stress and anxiety
      • Changes in mood
      • Decreased concentration and focus
      • Functional decline
      • Compromised immune system

Thankfully, exercise helps reduce the impact of many of these side effects. Speaking of which, let’s now have a look at the role of exercise in helping breast cancer patients and survivors!

Exercise for Breast Cancer

Physical activity is an effective intervention for breast cancer patients. Research concludes that exercise is helpful for patients both during and after cancer treatment.

Goals of Exercise

Exercise goals vary depending on the stage of cancer treatment, the treatments prescribed and the resultant symptoms experienced by an individual.

As I mentioned earlier, exercise prior to a cancer diagnosis can have a positive impact on some lifestyle factors known to be linked with cancer development. This makes exercise a great option in helping reduce the risk of cancer development in the first place – as they say, prevention is the best form of treatment!

Once diagnosed, exercise can provide many benefits throughout treatment. During this stage, it aims to reduce the associated symptoms, in addition to maintaining physical capabilities and function along with maintaining your quality of life.

In addition, exercise also provides many post-treatment benefits for survivors. After treatment, exercise aims to help the survivor return to their pre-treatment physical function, in addition to reducing the risk of cancer reoccurrence. 

Benefits of Exercise for Breast Cancer

No matter the stage of treatment, the benefits remain the same – the only difference is the goal!

Overall, an effective exercise intervention can allow patients and survivors to:

      • Improve their:
        • Physical function (ability to complete daily activities)
        • Physical fitness, including:
          • Cardiorespiratory fitness
          • Muscular strength and endurance
          • Muscle mass
        • Self-esteem and quality of life
        • Energy levels (or reducing fatigue)
        • Body composition
        • Tolerance of treatment and completion rate (or efficacy)
        • Cancer survival rate
      • Reduce their:
        • Risk of reoccurrence
        • Stress and anxiety
        • Risk of depression

So how much exercise should I do?

Exercise and Sport Science Australia (ESSA) suggests that breast cancer patients and survivors should follow the national physical activity guidelines and complete a minimum of 150 minutes of moderate, or 75 minutes of vigorous intensity aerobic physical activity (cardiovascular training) each week. In addition, it is recommended to complete at least 2 strength training sessions each week. That’s equivalent to 30 minutes of moderate exercise or 15 minutes of vigorous exercise 5 days a week. 

Of course, it is important to consider that everyone has different physical capabilities. Although this level of exercise may be realistic for some people, for others it won’t be. Hence, it is important to start at a level that is realistic for you to complete and gradually build up until you reach these recommendations. And at the end of the day, something is always better than nothing! 

If you are not sure how you can fit 30 minutes of exercise into your daily schedule, you could complete your exercise in intervals throughout the day. For example, you could complete 15 minutes in the morning and another 15 minutes in the evening. That would still be 30 minutes for the day – it doesn’t have to be completed all at once!

I want to start, but I'm not sure how to...

There are many ways to exercise, but it is recommended that we use a mixture of strength and cardiovascular training. This will ensure that we are maximising the benefits for both our muscles (regarding strength, endurance and mass) and our lungs (cardiovascular fitness). Having some variety can also be a great way to keep things interesting and fresh – as they say, variety is the spice of life!

If you would like some suggestions on some various exercises that you could use, check out our No gym? No problem! Effective ways to exercise outside the gym! post. It has some great suggestions of strength exercises and cardiovascular activities that you can complete at home, as well as providing an insight on how to complete them. Here is a sneak peek of the bodyweight and resistance band exercises that are discussed in this post:

Bodyweight exercises

Resistance band exercises

Keep in mind that you can purchase your own resistance band from Simply Stronger. We are able to post it to you anywhere in Australia at $5/m plus postage – contact us for more information.

Preventing muscle soreness

Anyone that exercises frequently can tell you about the muscle soreness that you can get after a good workout! It happens to everyone. In particular if you are starting to exercise more frequently – any increase in overall load can result in this soreness, which can potentially hold you back.

There are many ways to help manage our load to help prevent this. Some of these strategies include gradually building up your load, self-massage and stretching. Our 5 strategies to avoid that post-exercise muscle soreness! post addresses this topic in depth and can help you avoid that soreness and maximise the exercise benefits.

Keeping your exercise safe

As it is with any form of exercise, it is important to consult an exercise professional before getting started. This is especially important if you are currently going through cancer treatment. 

Although exercise provides many health benefits, it is important to make sure that you are completing the right exercises for your situation. Exercise professionals, such as Exercise Physiologists are able to help with identifying the most effective and safest exercises for your particular situation to ensure that you are maximising the benefits without any additional risk.

One Foot Forward Update!

As I mentioned in last weeks One foot forward for mental health! post, I am embarking on the journey to complete 100km of walking to help raise awareness for mental health. As promised, I’ve got a quick update ready for you.

So far, I have managed to walk 78.9km! Thats right, I’ve somehow managed to surpass 75% of my goal even though we are only half way through the month. For those who are wondering, I’ve been focussing on staying on my feet throughout the day and allocating time each day to go out for walks around my neighbourhood.

However, I never expected to go this far so quickly – maybe I underestimated my capabilities? So, I’ve decided that I’ll increase my goal to 150km. This is still realistic to achieve, as I will only need to maintain what I am already doing to achieve it. At the end of the day, the goal needs to be challenging and realistic at the same time, and I think this adjustment will help with that.

Stay tuned for next weeks post as I will provide you with another update! Make sure to let us know in the comments section how you are going with your One Foot Forward challenge!

Need Some Help?

Whether it is Breast Cancer or another health condition, exercise can provide tremendous benefits! Exercise Physiologist’s specialise in helping those with various medical conditions with exercise-based treatment. So, if you would like some assistance with this or in achieving your health or performance goals, contact us to organise an appointment with one of our Exercise Physiologists.

Check out some of our other posts!

Keep your eyes open for more posts coming in the near future – there will be a new post every Wednesday!

Here are some related posts that may interest you:

Keep your eyes open for more posts coming in the near future – there will be a new post every Wednesday! In particular, we are working on a brand new series “How I live strong and prosper”. In this series, we’ll be chatting with Simply Stronger clients and finding out what they do to live strong and prosper!

Please leave a comment below if you have any topic ideas that you would like us to discuss!

Follow us on Social Media!

References and Useful Resources

Australian Government – Cancer Australia, 2020. Breast Cancer in Australia Statistics, viewed 11/10/2020. https://www.canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/statistics

Bernstein, L., Henderson, B.E., Hanisch, R., Sullivan-Halley, J. and Ross, R.K., 1994. Physical exercise and reduced risk of breast cancer in young womenJNCI: Journal of the National Cancer Institute86(18), pp.1403-1408.

Cancer Council, 2020. Breast Cancer, viewed 11/10/2020. https://www.cancer.org.au/cancer-information/types-of-cancer/breast-cancer 

Courneya, K.S., Mackey, J.R., Bell, G.J., Jones, L.W., Field, C.J. and Fairey, A.S., 2003. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomesJournal of clinical oncology21(9), pp.1660-1668.

Hayes, S.C., Newton, R.U., Spence, R.R. and Galvão, D.A., 2019. The Exercise and Sports Science Australia position statement: Exercise medicine in cancer management. Journal of science and medicine in sport22(11), pp.1175-1199.

McNeely, M.L., Campbell, K.L., Rowe, B.H., Klassen, T.P., Mackey, J.R. and Courneya, K.S., 2006. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysisCmaj175(1), pp.34-41.

Mock V, Dow KH, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncology Nursing Forum. 1997 Jul;24(6):991-1000.

National Breast Cancer Foundation, 2020. Breast Cancer Stats, viewed 11/10/2020. https://nbcf.org.au/about-breast-cancer/breast-cancer-stats/?gclid=Cj0KCQjwt4X8BRCPARIsABmcnOp6W6x_mQUpRxDTLRNn-pWEhwDYRpPii1GVH8IQRK1ihKQS6X1h5hYaApt1EALw_wcB

Photos provided by Angiola Harry, Jenny Hill, Jon Tyson, Marcelo Leal and Peter Boccia via Unsplash.com

Schwartz, A.L., Mori, M.O.T.O.M.I., Gao, R.E.N.L.U., NAIL, L.M. and KING, M.E., 2001. Exercise reduces daily fatigue in women with breast cancer receiving chemotherapyMedicine & Science in Sports & Exercise33(5), pp.718-723.

The fight against prostate cancer – physical activity is on your side!

Prostate cancer is the second most common cancer diagnosed in men. 1 in 6 men will be diagnosed with prostate cancer before the age of 85. In addition, it is the third most common cause of cancer related deaths! This form of cancer is most common in older men, with 63% of cases diagnosed in those over the age of 65. 

This year alone, an estimated 16,754 males will be diagnosed with prostate cancer resulting in an as many as 3,152 deaths! The news is not all bad the 5 year survival rate for prostate cancer is certainly something to smile about. Of the men diagnosed with prostate cancer between 2012 and 2016 95% have survived at least 5 years!

Like all forms of cancer, prostate cancer is a very serious condition and is life threatening if it is not treated. However, the statistics indicate that the majority of men will survive – the treatment works! The downside? The treatments can have major side effects that can reduce overall function, physical capabilities and quality of life. Luckily, exercise is a fantastic way of reducing these side effects and, in some cases, preventing them completely! This is what we will explore in this post, but first let’s start by understanding exactly what prostate cancer is.

What is Prostate Cancer?

Our bodies are made up of billions of cells that reproduce and multiply in a controlled and purposeful way. Cancer occurs when these cells become abnormal and grow uncontrollably to form tumours. Specifically, prostate cancer occurs when these tumours form within the prostate gland.

Certain factors can increase your risk of prostate cancer. These include age (especially above 50 y.o.), family history of cancer and a father or brother diagnosed with prostate cancer before the age of 60. In addition, research suggests that there is a link between high testosterone levels and prostate cancer.

How is prostate cancer classified?

There are three different classifications of Prostate Cancer:

      • Early (or localised) Prostate Cancer: Cancer cells have grown, but do not appear to have spread beyond the prostate
      • Locally Advanced Prostate Cancer: Cancer cells have spread to parts of the body outside, but close to the prostate
      • Metastatic Prostate Cancer: Cancer cells have spread to distant parts of the body

Treatment of Prostate Cancer

As we mentioned earlier, the survival rate for prostate cancer is high, indicating that the treatment is effective!

Prostate cancer treatment is influenced by the TNM staging system. This system uses five key pieces of information: 

      1. The extent of the primary tumour (T)
      2. Has the cancer spread to the nearby lymph nodes? (N)
      3. Has the cancer metastasised (spread) to other parts of the body (M)
      4. The PSA level at the time of diagnosis
      5. The Gleason Score, which measures how likely the cancer is to grow and spread

The importance of PSA testing!

A PSA blood test measures the amount of a protein know as prostate-specific antigen in your blood. This test does not determine if you have prostate cancer or not.  Simply put it informs us of overactivity within the prostate, this over activity may or may not be related to cancerous cells.

It is important to stress that only one-third of individuals with increased PSA levels have prostate cancer! This test is used as an indicator and for the purpose of early detection. As we know, the earlier we can identify it the greater our chances of recovery and survival. If you are a male over 50 years old it is recommended that you discuss having a PSA test with your GP, that way you and your GP can monitor any changes in your PSA.

Treatment Options

In this phase, the prostate cancer is monitored as it is not causing symptoms and is considered low risk. Because there are minimal or no associated symptoms, the treatment may do more harm than good. Due to this, monitoring the prostate cancer to ensure it is not progressing is the optimal approach.

Those with slightly more progressed cancer go into this form of active surveillance. Progression of the cancer is still considered low risk, however more frequent PSA testing and check ups are completed to closely monitor the situation and ensure it is not worsening. Some men may move in and out of this phase depending on the success of other treatments.

A prostatectomy is performed which, to put it simply, removing the affected prostate and therefore the cancerous cells. The aim of this is to remove it before it spreads to the rest of the body.

Beams of radiation are used to target the affected areas in an attempt to damage or destroy the cancerous cells. This would prevent them from multiplying to spread or create larger tumours.

This treatment is a form of hormone therapy. Prostate cancer requires testosterone in order to grow and spread. Hence, an implant is inserted with the aim to suppress the production of testosterone and therefore slow down the spread of the cancer.

This method is commonly used alongside other treatments and can be applied successfully for many years.

During Chemotherapy, anti-cancer drugs are used to prevent the cancer from growing and spreading. This can be done using oral tablets, injections or an intravenous drip.

This form of treatment typically occurs in cycles, and treatment can occur for as long as six months, a year or for as long as it works.

The Affects of Treatment

As is the case with any treatment, cancer treatments can have negative side effects. These side effects can include (but are not limited to):

      • Fatigue or lack of energy
      • Compromised immune system
      • Incontinence
      • Muscle weakness or atrophy
      • Reduced bone mineral density
      • Hair loss 
      • Easily bruising or bleeding
      • Nausea, vomiting or appetite changes
      • Peripheral Neuropathy or other nerve problems
      • Changes in weight (loss or gain)
      • Digestive problems
      • Decreased concentration and focus
      • Mood changes
      • Changes in libido and sexual function
      • Increased risk of:
        • Hypertension
        • Heart Disease
        • Diabetes
        • Dyslipidemia
        • Depression
This is where exercise can help and join in the fight against cancer!

What is the role of physical activity?

Individuals living with prostate cancer have been shown to gain tremendous benefits from regular exercise training. Evidence shows that exercise can help prostate cancer patients in many ways. Exercise has been proven to reduce the impact of the side effects of cancer treatments, enable patients to undergo more treatment cycles, and return to physical function faster post-treatment.

Managing Side Effects

Prostate cancer treatment can result in many side effects, as discussed earlier. Both aerobic and resistance training have been shown to help reduce or completely prevent these side effects. In particular, exercise training helps prostate cancer patients by:

      • Reducing fatigue and increasing energy levels
      • Maintaining and in some cases improving muscular strength and endurance
      • Improving aerobic fitness
      • Maintaining bone minerals density
      • Limiting gains in adipose tissue (body fat) 
      • Reducing incontinence symptoms
      • Improving quality of life
      • Boosting the immune system function
      • Improving mood, focus and concentration
      • Aiding in prevention of:
        • Hypertension
        • Heart Disease
        • Diabetes
        • Dyslipidemia
        • Depression

Returning to Physical Health

The improvements from exercise training mentioned above can be obtained either during and after prostate cancer treatment. As such, exercise is a great ally not only during the fight against cancer but also on the recovery path after the war has been won!

The goal of exercise during treatment is to maintain and try to limit the loss of physical function. This is with a particular focus on fatigue (or energy levels) and maintaining a healthy body composition including minimising muscle atrophy. By minimising these changes the road to recovery after treatment will be that bit easier. However, if have completed your treatment and are now looking to regain what you may have lost exercise is there for you too. This is especially important in regaining independence in completing our daily activities and returning to work. Prostate cancer survivors have been able to improve their overall physical fitness and capabilities through regular exercise training. As such, exercise is an important tool in improving independence, ability to complete daily tasks and return to work.

Where to begin?

This is a very good question! and a tough one to answer. The ideal exercises (and the safest) vary from situation to situation, depending on the stage of the cancer and overall physical capabilities after treatment. Not to mention that many people over the age of 50 are likely to have other injuries or illnesses to be considered when prescribing exercise. As such, it is important to seek advice from an expert before beginning. This is where exercise professionals, such as our expert Exercise Physiologists join the party. They are able to assess your individual needs and circumstances and provide the exercises best for you! 

In addition, we also have some previous posts that provide more detail on various exercises that can be a good starting point. I would recommend starting with “No gym? No problem! Effective ways to exercise outside the gym!“, as it provides fantastic options for exercise within the comfort of your own home.

Enjoying this Blog? Check out some of our other posts!

Keep your eyes open for more posts coming in the near future – there will be a new post every Wednesday!

Here are some related posts that may interest you:

Keep your eyes open for more posts coming in the near future – there will be a new post every Wednesday! In particular, we are working on a brand new series “How I live strong and prosper”. In this series, we’ll be chatting with Simply Stronger clients and finding out what they do to live strong and prosper!

Please leave a comment below if you have any topic ideas that you would like us to discuss!

We are here to help!

Exercise Physiologists specialise in helping people identify the type of exercise that will help them achieve their goals – not just in a gym with weights, but to include in your everyday life! If you would like some assistance in determining the best type fo exercise for you to help you achieve your goals, contact us to organise an appointment to see one of our Exercise Physiologists.

Follow us on Social Media!

References and useful resources

American Cancer Society, Prostate cancer stages and other ways to assess risk, viewed 15/09/20. https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/staging.html

Australian Government – Cancer Australia, Prostate Cancer in Australia Statistics, viewed 15/09/2020. https://www.canceraustralia.gov.au/affected-cancer/cancer-types/prostate-cancer/statistics

Baumann, F.T., Zopf, E.M. and Bloch, W., 2012. Clinical exercise interventions in prostate cancer patients—a systematic review of randomized controlled trials. Supportive Care in Cancer, 20(2), pp.221-233.

Cancer Council, Early detection of prostate cancer, viewed 15/09/2020. https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/early-detection-of-prostate-cancer

Cancer Council Victoria, Prostate Cancer, viewed 11/09/2020. https://www.cancervic.org.au/cancer-information/types-of-cancer/prostate_cancer/prostate-cancer-overview.html

Photos provided by Curtis MacNewton, Emily Morter, Marcelo Leal and National Cancer Institute via Unsplash.com

Prostate Cancer Foundation of Australia, https://www.prostate.org.au/

Segakm R.J., Reid, R.D., Courneya, K.S., Malone, S.C., Parliament, M.B., Scott, C.G., Venner, P.M., Quinney, H.A., Jones, L.W., Slovinec D’Angelo, M.E. and Wells, G.A., 2003, Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Journal of Clinical Oncology, 21(9), pp. 1653-1659.

Segal, R.J., Reid, R.D., Courneya, K.S., Sigal, R.J., Kenny, G.P., Prud’Homme, D.G., Malone, S.C., Wells, G.A., Scott, C.G. and Slovinec D’Angelo, M.E., 2009. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. Journal of clinical oncology, 27(3), pp.344-351.