Exercise and Cancer Recovery

A common concern of women recovering from cancer surgery and treatment is the risks and benefits of exercise. Is it safe? Is it a good idea? For women who have their lymph nodes removed as part of their cancer surgery, an added concern is, will I be at an increased risk of lymphedema?

Here at Brown, I am fortunate to work with one of the key investigators in the area of exercise and cancer survivors. Bernadine Pinto, PhD, is a Professor of Psychiatry and Human Behavior, and has studied exercise interventions in both male and female cancer survivors extensively. She and I sat down recently to discuss the current state of the science around this topic, and some of the active research questions she is involved with. Here are a few important take home points.

The first guidelines for exercise for cancer survivors was published in July 2010 by the American College of Sports Medicine (1). A key message from the experts who reviewed the evidence is that exercise is generally safe for patients receiving treatment and contributes to recovery (improvement in physical functioning, quality of life and fatigue) in several cancer groups, after they have completed cancer treatments.

Breast cancer survivors with and at risk for lymphedema have participated safely in resistance training programs. One study published in the New England Journal of Medicine evaluated progressive weight lifting among breast cancer survivors who had stable lymphedema of the arm (2). Compared to a control group, the women who were in the weight-lifting group had no increase in the worsening of limb swelling compared to controls (11 vs. 12%, respectively) and experienced more improvements in severity of symptoms related to lymphedema and upper as well as lower-body strength, without serious adverse events.

It is now becoming clearer that being inactive during or after treatment is not necessarily helpful. Regular physical activity, of moderate-intensity (such as brisk walking) can help improve fitness, reduce fatigue and improve well-being.

There is continued interest in looking at how and what type of exercise might help cancer patients manage symptoms of fatigue, depression, poor body image and the like. Dr. Pinto's team has launched a new study in RI in partnership with the American Cancer Society’s Reach to Recovery program (3). Called the Moving Forward Together 2 study, Reach volunteers (who are breast cancer survivors themselves) are trained to offer a 12-week support and education program alone or with a telephone-based home-based exercise program. The effects of the two programs on physical activity, fatigue, quality of life and body image will be examined at 12 and 24 weeks. The goal is to help more survivors access education programs by disseminating information to Reach volunteers, who themselves will be trainers locally.

All breast cancer survivors diagnosed within the past 5 years may be eligible for this study. If you are interested in learning more, contact Jen Correia at jcorreia1@lifespan.org.

For more information:

1. KH Schmitz, et al. Roundtable Consensus Statement

American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports & Exercise 2010; 42: 1409-1426.

2. KH Schmitz, et al. Weight Lifting in Women with Breast-Cancer—Related Lymphedema. New England Journal of Medicine 2009; 361:664-673

3. Moving Forward Together 2 Breast Cancer Study. Available at: http://www.lifespan.org/services/clintrials/women/breastcancer.htm.