We all know that exercise, eating well and reducing our exposure to common oestrogen disrupting chemicals like parabens can reduce our risk of getting breast cancer. But if you are one of the unlucky 1 in 8 women in the UK who has been diagnosed with breast cancer, could you be doing more to reduce your chances of cancer coming back?
There is now overwhelming evidence to support the view that exercise can not only help symptoms of breast cancer treatment, like fatigue and depression, but can also reduce the risk of cancer returning.
On Tuesday I was privileged to be invited to speak on the medicinal benefits of exercise, at a morning for breast cancer survivors organised by the team at the Princess Alexandra Hospital’s Breast Unit. The aim of the event, chaired by lead breast cancer research sister (Breast Unit) Ruth McCrea, was to share the evidence with over 50 attendees, including breast cancer survivors and leading local professionals in the field.
When I first met with Ruth a few weeks before, I was excited by her research and endeavours. Here were NHS medical professionals working hard to get exercise onto the agenda and ultimately into the treatment package for patients.
So what is the evidence?
- A reduction of breast cancer mortality of 34%, related to physical activity was indicated in a systematic review of six studies by Ibrahim and Al-homaidh (2011).
- Exercise can reduce the risk of breast cancer recurrence (Bourke et al. 2013, Ibrahim and Al-Homaidh, 2011).
- A study by Holmes et al. (2005) concurred the most active participants had a 26-40% reduction in mortality and recurrence compared to least active women.
- The strongest evidence showing the benefits of exercise is in breast, colorectal and prostate cancers (Campbell et al. 2012, Macmillan: A Concise Evidence Review).
The important role of exercise in breast cancer treatment was discussed at the 7th Annual Royal Marsden Meeting: Hot topics in breast cancer. This backs up guidelines devised by the American College of Sports Medicine for cancer survivors of 150 minutes per week of moderate intensity exercise with strength training, with supporting evidence that exercise is safe whilst undergoing treatment and afterwards (Schmitz et al. 2010).
Of course even with this compelling evidence there are still barriers for women getting active. Work, time or family pressures all play a role but there are also unique barriers for women who have undergone treatment for breast cancer including lack of confidence or energy, depression, the risk of lymphoedema or lack of movement range post surgery. Then of course there are very practical barriers of finding the right sports bra or swimming costume.
If patients can work together with their physiotherapists and nurses, with specialists like the team at the Macmillan ‘Move More’ campaign, or with fitness professionals who understand the unique physical constraints post surgery and treatment, it is possible to find activities which not only suit the individual but enhance quality of life post treatment. Things like increasing range of movement and upper body strength, boosting dopamine and endorphines to create a happy feel good factor and gradually beginning to enjoy life again.
Exercise boosts our body’s natural defence mechanisms. Through exercise we can boost our body’s anti-oxidants and generate more mitochondria, the energy or battery cells of the body.
But regardless of optimal exercise guidelines or the science of the studies, the overwhelming message at last week’s empowering morning was one of just getting more active. It doesn’t have to be a structured exercise programme but find something you enjoy, that’s sociable and that you can stick to on a regular basis.
Of course what that thing is, is up to you. But you know Fit School has some great options for social activity included Pilates or fat loss circuits and via our partners we can recommend a range of activities in our area.
REFERENCES:
Bourke, L., Homer, K., Thaha, M., Steed, L., Rosario, D., Robb, K., Saxton, J and Taylor, S (2013) ‘Interventions for promoting habitual exercise in people living with and beyond cancer (review)’, The Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.:CD010192.
Carmichael, A. (2013) ‘Physical activity as an adjuvant treatment for breast cancer; is it time for guidelines?’ Journal of Cancer Surgery, 40, pp. 137-139.
Campbell, A., Foster, J., Stevinson, C and Cavill, N. (2012) ‘The Importance of Physical Activity for People Living with and Beyond Cancer: A Concise Evidence Review’, Macmillan Cancer Support, London.
Holmes, M., Chen, W., Feskanich, D., Kroenke, C and Colditz, G. (2005) ‘ Physical Activity and Survival After Breast Cancer Diagnosis’, The Journal of the American Medical Association (Reprinted JAMA), 293 (20), pp. 2479-2486.
Ibrahim, E and Al-Homaidh, A. (2011) ‘Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies’, Medical Oncology, 28, pp. 753-765.