By Mark William Lisky
To help combat breast cancer, new research supports the concept that living a lifestyle that includes exercising may offer protection against developing breast cancer and recurrence for those who have survived. The evidence indicating this protection, pre- or post-cancer event, states it may be on par with chemotherapy and even the newer hormonal treatments. Along with protection, a structured exercise program has been shown to improve the physical functioning of women with stages I and II breast cancer.
Quoting from an article written by Peggy Vaughn in which she interviewed Dr. Leslie Bernstein, professor of preventive medicine at the Keck School of Medicine, University of Southern California, Dr. Bernstein said. “Exercise can play as important a role in cancer prevention as the latest screening tool or chemoprevention drug.” Dr. Bernstein continued. “Epidemiological studies strongly suggest that just a few hours each week of moderate to vigorous exercise can reduce a woman’s exposure to ovarian hormones that cause breast cancer – and it’s mostly free.”
The fact that exercise is a form of preventive medicine for many disorders, including cancer, has been known for years. In an extensive study performed in 1989 that looked directly at the link between fitness and all-cause mortalities, researchers followed the exercise performance of 13,000 men and women for eight years. The results showed that even a moderate amount of exercise implicitly reduced the risk from dying of cancer and other medical conditions.
A recent study conducted at the Harvard Medical School and published in the Journal of the American Medical Association (JAMA), found that breast cancer patients who participate in an exercise program for three to five hours a week were about 50 percent less likely to die from the disease than sedentary women. The findings appeared strongest for the most common forms of breast cancer and proved valid regardless of when the cancer was diagnosed. The researchers concluded that. “Women with breast cancer have little to lose and much to gain from exercise.”
The effects that exercise may have on lowing the chances of developing or dying from breast cancer are multiple. First, being overweight or obese is a major risk factor for breast cancer. Obesity plays a role in increasing the conversion of circulating hormones and stored hormones found in body fat into estrogen. This conversion and increased estrogen production can fuel the growth of breast cancer cells. This is especially true for postmenopausal women. Research has shown that exercise lowers estrogen levels and alters ovarian hormone production. Physical activity may also prevent tumor development by lowering hormone levels in premenopausal women.
The phenomenon of physical activity and its relationship to hormonal production has been noted in young female athletes. Many young athletes have a delayed menarche (first menstruation). In one study of 1,378 elementary school girls found that 5 hours per week of physical activity delayed menarche. Exercise induced delay of menarche during adolescence can be protective in the long term, since a risk factor for breast cancer is having the first menstruation at a young age.
In a directly related project, researchers did a control study of breast cancer among women aged 40 and tracked the average hours of exercise per week in the 10 years after menarche. They noted a reduction in risk of breast cancer among women who were most physically active in the first 10 years after menarche. These results proved stronger in women who also maintained a healthy body weight.
It should be recognized that the effects of exercise on breast cancer risk in this research were restricted to women who did not have a family history of breast cancer. Experts state that family history is a very important risk factor. Studies show that the daughters of women with breast cancer may have substantially higher levels of estrogen than the daughters of women without breast cancer.
Along with altering ovarian hormone production, exercise can reduce the amount of stored nonessential body fat. There is data pointing to the fact that having high levels of body fat negatively affects breast tissue including oxidative tissue damage. One way exercise reduces body fat is by lowering and controlling levels of insulin. Insulin is a storage hormone, and body fat accumulation is under the control of insulin. The more insulin you produce, the more fat you store.
Exercise can also increase lean skeletal muscle mass. This fact helps a woman maintain a healthy bodyweight. Having more lean muscle mass increases the metabolism, which aids in decreasing body fat. Even at rest, lean muscle can burn up to as much as twenty five percent of the calories eaten or drunk. Plus, exercise improves the immune response and reduces depression. Both are important factors during breast cancer treatment and recovery.
As for an exercise prescription for prevention, the Centers for Disease Control recommend that adults “engage in moderate-intensity physical activity for at least 30 minutes on five or more days of the week,” or “engage in vigorous-intensity physical activity for at least 20 minutes on three or more days of the week.” I believe this prescription should include both a cardio-endurance program (walking, jogging or biking) and strength training (lifting weights). The training duration, frequency and intensity levels of an exercise program needs to be based on current health status, physical activity levels, time constraints, goals (make sure they’re attainable), age and motivational levels.
A woman who has been sedentary most of her life and/or is overweight and wants to give exercise a try for prevention, should start small and not be intimated. It may be uncomfortable at first, but she’ll get used to it. Be resolute and make it a weekly habit. Consistency is the key. If too, a woman who has been physically active most of her life and is used to exercising may want to increase the intensity of her chosen activity. New data shows that as the duration and frequency of exercising is increased, the greater the decrease in the risk of breast cancer.
Also, anyone who is undergoing treatment will most likely get physically worn out at some point. During these times the exercise program may need to be altered to fit the specific side effects of the treatment. From my experience as an exercise instructor training cancer patients, I feel it’s important, albeit tough, to make the effort to continue training even through the bad days. Many studies have shown that exercise boosts breast cancer patients’ sense of well-being and quality of life, so keep those benefits going.
One of the strongest advocates for exercise during breast cancer treatments is Mary Morton of Shrewsbury. Mary was first diagnosed with breast cancer in the early 1960s. She knew this was most likely to happen since her mother and three aunts all died of the same disease. After her right side mastectomy, Mary began to exercise. She has had no recurrence of breast cancer since. Unfortunately, she was diagnosed with ovarian cancer several years ago and had a hysterectomy as a result, but today is cancer-free.
Through all the treatments Mary, who’s now in her 70s, kept working out. “Getting to the gym was my salvation,” Mary said. “Exercising through all the side-effects helps you get away from the ‘poor me’ depression and keeps your mind off other bad thoughts. I cannot recommend enough to anyone who has cancer how important it is to keep your body and mind strong.” She added, “Every physician who deals with cancer patients should be a proponent for discussing with their patents about getting involved in some form of exercise.”
All this information about the benefits of exercise should be good news to women. It needs to be said that exercise does not guarantee prevention or survival of breast cancer. Nor should it be looked upon as a replacement for medical treatment or check-ups. It is, however, a proven and safe complimentary approach, one you may want to discuss with your physician. Finally, I believe that exercise allows a woman to physically, mentally and emotionally take control of an aspect of their disease outside the world of medicine.
Mark William Lisky is a fitness expert, trainer and professional speaker in Monmouth County. If you’re interested in having Mark speak to your organization about exercise or consult you on a personal exercise or nutritional program, he can be reached at (732) 933-9070 or e-mail firstname.lastname@example.org. Also check out his blog at www.grumpyfitnessguy.com.
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