Breast Cancer and the Benefit of Being Fit
By Dianne Armitage
Fitness is important before, during and after after breast cancer. In late 2006 the American Cancer Society, as a part of their Prevention and Early Detection Program, introduced their Nutrition and Physical Activity Guidelines for Cancer Prevention. Here are some of their current recommendations:
Maintain a healthy weight throughout your lifespan
Adopt a physically active lifestyle
Eat a healthy diet, with an emphasis on plant sources
If you drink alcoholic beverages, limit your consumption
Women should not drink more than one alcoholic beverage per day.
The ACS cautions that being overweight or obese is clearly linked with an increased risk of developing several types of cancer. Unfortunately, breast cancer is on the list. If you are a breast cancer survivor who also happens to be overweight, it’s likely your health care provider has already cautioned you to make better choices when it comes to food and physical activity.
The dilemma for women who are not physically active, don’t eat right, and are overweight or obese is quite profound. Certainly no one would knowingly increase their risk of developing breast cancer or causing it to reoccur. Anyone who has ever struggled with the issues surrounding diet and exercise fully understands what an emotional quagmire this can be. Most women grasp what they need to do intellectually, but putting this into action and staying on track, day-in and day-out is a daunting task. This can be especially true for women who have had bad habits for years and years, or for women who are going through the physical and emotional throes of treatment. The weight gain and mood swings associated with menopause and post-menopause are also likely to be a factor.
Many women find they feel helpless when it comes to altering the course of their lives. They just can’t seem to find the solution they need to boost their physical activity, make proper food choices, and maintain a healthy weight in the long term. Since it has been suggested that exercise after breast cancer treatment may improve survival and reduce recurrence, any woman facing the ordeal of breast cancer is certainly hoping to find this elusive and all important formula!
A recent study by researchers from Harvard Medical School and the Dana Farber Cancer Institute examined whether exercising after breast cancer treatment would increase chances for survival, as well as reduce the risk of the cancer coming back. The researchers used the results of the Nurses’ Health Study (NHS) in order to select a particular group of women to observe. They ended up looking at 2,987 women who had been diagnosed with Stage I, II, or III invasive breast cancer between 1984 and 1988.
The study looked at the amount of exercise these women did each week beginning at about two years out from diagnosis. This timing allowed for the women to have recovered a bit from their treatments. The women were followed until June of 2002.
The women were asked how much time they spent each week participating in these activities:
- walking or hiking
- jogging or running
- playing tennis
- doing calisthenics, aerobics, or aerobic dance
- using a rowing machine
- playing squash or racquetball
- doing yoga, and other strenuous activities.
They were also asked to rate their usual walking pace as casual, normal, brisk, very brisk, or unable to walk. These activities were then given a MET (metabolic equivalent task) score. This score is commonly used in medicine to express metabolic rates measured during a treadmill test. Walking at an average pace has a MET score of three, while running has a MET score of 12.
Also considered were:
- the size of the woman’s cancer
- whether the cancer was found in her lymph nodes
- her hormone receptor status
- what breast cancer treatments she had received
- the length of time until the cancer came back (recurrence)
- whether breast cancer caused the woman’s death
- her menopausal status
- her age at first pregnancy
- her post-menopausal hormone use
- her oral contraceptive use
- her body mass index (BMI), and
- her diet.
Here’s some good news. Women exercising more than three MET hours a week after a breast cancer diagnosis may be able to lower their risk of recurrence and improve their chances of surviving the disease.
Think this means you’ll be walking for hours on end? Think again! If you walk at an average pace for four hours a week, you have accomplished 12 MET hours! The equivalent of walking three to five hours a week at an average pace seemed to have the most benefit. Exercising more than this didn’t provide greater protection. Women weighing more than average obtained a better benefit from exercise than women of average weight.
Walking between three to five hours a week at a moderate pace is certainly something most women can accomplish. Other than the cost of some good walking shoes, this is also a form of exercise that doesn’t put too much of a pinch on your pocketbook. These hours can be broken up in any configuration that works for you. Many women find that taking a 30 minute walk at the beginning and end of their day provides not just the physical benefits they are seeking, but mental well-being, too. It’s crucial not to be self-critical or to set goals that are unrealistic. If you have medical issues preventing you from walking, ask your doctor for safe ways in which you can become more active.
Is there a benefit to being fit? Since there is solid evidence suggesting that both diet and exercise play a role in helping women who have had breast cancer increase the likelihood of staying disease free, adhering to a healthy lifestyle is just one more way you can feel you are protecting yourself.
Research has also shown that exercise helps to boost your immune system, limits weight gain from chemotherapy, and helps to ease treatment side effects. Additionally, exercise has been found to increase self-esteem, as well as to help reduce depression, anxiety, and fatigue.
Need another good reason to embrace a healthier overall lifestyle? Just remember that being sedentary and overweight contributes to many diseases besides breast cancer. You certainly want to avoid heart disease, diabetes, and the myriad of other health problems associated with a lack of exercise and poor diet.