Exercise after breast cancer

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Source: Fred Hutchinson Cancer Research Center – Diane Mapes.

oncologynews.com.au ovarian cancer exerciseWhy 65 percent of US survivors don’t meet recommendations for physical activity – and what to do about it.

It’s hard enough motivating yourself to go for a walk or hit the gym after a long day’s work. But what if your day consists of eight hours on the job plus an oncology appointment or blast of radiation?

A new study published in CANCER highlights an ongoing predicament among breast cancer patients. Research indicates that exercise after diagnosis is linked with prolonged survival and improved quality of life. Yet many breast cancer patients are not meeting national guidelines for physical activity.

The study, conducted at the University of North Carolina at Chapel Hill, gleaned pre- and post-diagnosis activity levels from 1,735 women aged 20 to 74 years old, all of whom had been diagnosed with invasive breast cancer between 2008 and 2011. Almost half the participants – 48 percent – were black, an unusual and data-rich sample.

Overall, about 65 percent of the women studied failed to meet national recommendations for physical activity levels six months after they were diagnosed.

The U.S. Department of Health and Human Services and the American Cancer Society recommend 2.5 hours of moderate intensity exercise (think brisk walking, vacuuming or gardening) or 1.25 hours of vigorous intensity activity (think running or heavy yard work)  each week for general health benefit s and chronic disease prevention and management.

African American women reported lower amounts of both pre-diagnosis and post-diagnosis activity, according to the study, which concluded that though “breast cancer advocates are actively promoting the message that physical activity post-diagnosis improves quality of life and survival … it’s clear that more work needs to be done to translate evidence into practice, especially among African American women.”

The case for exercise

Fred Hutch researcher Dr. Anne McTiernan, who studies the relationship between exercise, weight loss and cancer prevention, said she and her team have produced similar results, including a 2013 study that found 10 years after a diagnosis, breast cancer survivors are still not meeting national exercise recommendations.

“Women with breast cancer significantly decrease their levels of physical activity after diagnosis and as a result, few are meeting even the minimum standards set by the Surgeon General,” she said, adding that Fred Hutch and other research centers have found associations between increased levels of activity and better survival in women with breast cancer.

2011 meta-analysis of published studies regarding physical activity and survival after breast cancer found the mortality rate dropped by 34 percent for women who were very active when compared to women who weren’t. And another 2012 systematic review conducted by Fred Hutch and the National Cancer Institute found that 27 out of 45 observational studies showed consistent evidence that “physical activity is associated with reduced all-cause, breast cancer-specific and colon cancer-specific mortality.”

Barriers to exercise

Considering the data that’s available, why aren’t breast cancer survivors exercising more?

McTiernan points to a slew of reasons. For one, they may be too fatigued or in too much pain, especially if they’re still in active treatment, like the majority of women in the UNC study. And treatment – not to mention all those doctor appointments – can eat up a lot of time.

“One problem is that life-saving treatments like surgery, radiation and chemotherapy are very time-consuming,” she said. “It can require many visits to a hospital or clinic and that’s time away from a woman’s family responsibilities, her work and her potential free time. Many women need to work after their diagnosis and those with family responsibilities continue to need time for those. So the thing to go is recreation time, including time for physical activity.”

Bridgette Hempstead, a breast cancer survivor and founder of Cierra Sisters, Inc., an African-American breast cancer survivor support group, says some women don’t have the money, time or resources to exercise. “Some women may not have enough to buy a pair of proper shoes for walking or maybe there’s a community center nearby but they don’t have the funds to access it,” she said.

“In our group, we’re trying to be more proactive and encourage each other to get out and walk together, but it can be very hard if you don’t have the money and resources,” she said…read the full story.


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