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.
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:
- Screening Mammogram: checks for breast cancer when no signs or symptoms are present
- 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.
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:
- Lumpectomy (or breast conserving surgery): the removal of only part of the breast
- 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:
- Musculoskeletal dysfunction or atrophy
- Reduced bone mineral density
- 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
- Improve their:
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:
Resistance band exercises
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.
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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 women. JNCI: Journal of the National Cancer Institute, 86(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 outcomes. Journal of clinical oncology, 21(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 sport, 22(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-analysis. Cmaj, 175(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 chemotherapy. Medicine & Science in Sports & Exercise, 33(5), pp.718-723.