Breast Cancer and Exercise: Doing Good for the Body

For the healing process in breast cancer, both the physical condition of the breast cancer patient and the mental state play a very important role. While still in the hospital, patients are given tips for subsequent rehabilitation measures, the main aim of which is to help them reintegrate quickly into working and social life.

Exercise promotes recovery after breast cancer

Unfortunately, too few women still take advantage of the opportunity to participate in these advanced measures for improving overall physical and psychological well-being in breast cancer. Many patients with breast cancer are tired and feel listless as a result of therapy, or are reluctant to exercise for fear of doing something wrong. But often just going for a walk is enough to get moving. For example, light endurance training (such as hiking, walking, jogging, swimming and cycling) and effective gymnastics boost self-confidence, increase resistance to stress and reduce anxiety. The right measure plays an important role here, so that those affected by breast cancer do not overexert themselves. In any case, the attending physician should advise the patient on what she can expect of herself. Exercise should not be considered a competitive sport, but should primarily serve to improve the general well-being.

What does exercise have to do with cancer?

For a long time, people failed to recognize the actual benefits of exercise and sports in cancer treatment. While skeptical physicians still assumed 20 years ago that exercise could cause metastases, the current picture is different. In the meantime, the positive influence of exercise and sport on cancer patients has been confirmed. Today, physical activities are an important part of therapy. They serve to strengthen and restore body and soul.

Studies show influence of exercise on rehabilitation

The first experiences with exercise therapy in aftercare and rehabilitation for cancer patients were made in Germany about 25 years ago. At that time, the first cancer aftercare sports groups were also established. In a first study, scientists from the German Sport University Cologne investigated the influences of physical activities in rehabilitation in patients with breast cancer. The results were encouraging and showed that exercise had a positive effect on the physical and psychological constitution of patients with breast cancer. As a result of these and other studies, exercise therapy and rehabilitation sports have become increasingly important in the treatment of cancer. There are now about 650 special cancer sports groups in Germany. More than 90 percent of the participants are patients with breast cancer.

Goals of exercise therapy

Exercise therapy for cancer pursues the goals of positively influencing the patient’s physical, psychological, and psychosocial levels. Physical level:

Psychological level:

  • Promoting the motivation of the patient and active participation in the recovery process.
  • Stress reduction
  • Use of their own strengths
  • Distraction from the “problem
  • Promote self-confidence and self-esteem, especially after breast amputation.

Psychosocial level:

  • Appeal to personal responsibility
  • Promotion of social independence
  • Participation in social life
  • Social togetherness in a group as a supplement or alternative to the self-help group
  • Positive, communal experience of exercise and sports

Which sports are suitable for what?

Every day of a cancer patient is different. Even if the affected women feel tired and exhausted, a little exercise can do wonders. But it should not be overdone or even exercised to total exhaustion. Cancer sufferers take longer to recover than non-affected people. For a sensible exercise recommendation, three therapy phases should be distinguished.

1. acute phase

Patients should begin targeted physiotherapy (physical therapy) immediately after surgery (acute phase). Here, initial stretching and mobilization exercises are usually performed from the second day after surgery, under the guidance of a specially trained therapist. In principle, the operated side should be included in the same way as the healthy side. Small pumping movements with the hands and forearms prevent edema formation – lymph drainage can also help. The extent of movement depends on the patient’s pain and scar tension. Subsequent stool gymnastics and gait training ensure improved posture and coordination. Once the affected women feel safe, they should move as much as possible while still in the hospital, preferably on a daily basis. Climbing stairs, looking at the hospital from the outside – exercise and fresh air do good in any case. Targeted exercise therapy is also possible during chemotherapy, which can last several months. Under no circumstances should patients cower in their hospital bed. In many hospitals, exercise therapists show patients how to perform certain movements correctly. If the chosen chemotherapy has no effect on the cardiovascular system, the patient can start endurance training, e.g. on a bicycle ergometer, six hours after chemo administration. During radiation and hormone therapy, there is basically nothing to be said against exercise therapy activities. Individual sensation and side effects are the decisive factors here.

2nd rehabilitation phase

Inpatient or even outpatient follow-up rehabilitation should generally be started no later than 14 days after discharge from the acute hospital. The three-week rehabilitation phase ensures rapid reintegration into working life, society and everyday life. There, experienced therapists and doctors take care of the patients, who are slowly and gently introduced to the training. This is also where the first contact should be made with the aftercare cancer sports groups near the patient’s home. Most clinics have address lists for this purpose.

3. rehabilitation sports at home

Once at home, many patients initially feel relieved. On the other hand, this situation is not infrequently associated with uncertainty and fears that need to be overcome. In this context, exercise can help to reduce anxiety, prevent depressive moods, establish social contacts, and reduce the exhaustion syndrome (fatigue) from which many patients continue to suffer. It is important to note that only regular exercise promotes further recovery. Forms of exercise should be chosen that are fun, because this is the only way to maintain motivation for constant and regular exercise. If exercise and sports alone are boring and monotonous, the cancer aftercare sports groups are highly recommended. According to § 44 of the Social Code IX, rehabilitation sports in cancer sports groups are subsidized, and thus every patient has the right to receive these financial benefits. In a cancer aftercare sports group, patients can experience exercise under the guidance of specially trained exercise instructors. Here, the joy, social contacts and positive experience of movement play a central role. The following physical activities are recommended:

  • General endurance sports (cycling or stationary cycling).
  • Walking, Nordic walking (with low arm use).
  • Cross-country skiing (with low arm use).
  • Swimming and aqua gymnastics
  • Modified team and group games (for example, volleyball with softball).
  • Light weight training in the gym
  • Gymnastics
  • Relaxation methods (for example, according to Jacobson)

What patients should pay attention to

In acute hospital treatment, exercise should not be done on days when the patient is receiving chemotherapy drugs that trigger cardiac arrhythmias. For other chemotherapies, physical activity can be resumed after a six-hour break. There should be at least one hour between radiation or taking pills and the exercise program. Exercises that are jerky with the arms or rapid circling with the arms should be avoided to prevent “thick arm” (lymphedema). Any physical activity should be discussed with the attending physician.

Intense physical exertion should be avoided here in any case:

In the acute phase:

  • Severe pain
  • Circulatory problems, dizziness
  • Fever, temperature above 38.0 °C
  • Nausea, vomiting

In rehab sports:

  • Bone metastases
  • Diseases of the cardiovascular system
  • Advanced tumor stages

Sources: Schüle, K. (2005): Sports and exercise therapy. In: UNGER, C.; WEIS, J. (Eds. ): Oncology. Unconventional and supportive therapy strategies. Wissenschaftliche Verlagsgesellschaft mbH Stuttgart: 7-25. Schüle, K. (2001): Exercise and sport in cancer aftercare. Forum DKG, 2 (16): 39-41.

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