Shortly after my second child was born, I asked my sister, an expert athletic trainer, what I could do to “get my body back.” She answered that I needed to lift weights and do explosive exercises. She suggested I explore nearby CrossFit “boxes” to see if I could find a trainer and a facility that suited me. Thus began my almost 20-year exercise routine. My routine includes:
Lifting weights: Olympic lifts, bench press, dumbbell, kettlebell, and barbell weight lifting,
Metabolic cardiovascular conditioning workouts such as jumping rope, lunges, step-ups,
Explosive exercises, including box jumps, Tabata routines, and core exercises
Indoor cycling using the Peloton.
Thankfully, I called Jessica at the start and invited her to join me with the irresistible invitation, “I’m going to do this, and it would suck a lot less if you did it with me.” Who could resist? Our workouts start between 6 and 630 am, three times a week. I did it because I missed the strong, firm gymnast’s body I had as a teen and in my twenties. While my exercise regime benefits me in many ways, I don’t think I’ll see that body again.
Exercise couldn’t prevent my genetic mutation from triggering a cancer episode. After all, my mother is one of the most athletic and active people I know and is a three-time cancer survivor. My sister was diagnosed three months after completing an IronMan. Exercise was good for my mind and body. It was a dedicated time during the week when I focused on myself and caught up, in person, with Jessica. Other friends have joined us, sometimes for years, and it's good to push and protect each other when we make a mistake while performing a technical lift. I didn’t expect that exercise would prove to be a secret weapon for me in my cancer journey, and I certainly didn’t anticipate that when I spoke to many other breast cancer survivors, exercise was a catalyst for fewer side effects, faster recovery, and better mental health.
I discovered exercise oncology during a conversation with another survivor, a nurse named Irit. Our discussion sparked my curiosity, and I researched academic studies on exercise and cancer patients. MD Anderson summarized the new perspective that cancer patients should exercise in their blog post: “Exercise has numerous benefits for cancer patients, both during and after treatment.” In exercise oncology, researchers find that regular physical activity can counteract the side effects of chemotherapy, expedite recovery from surgery, release endorphins and reduce cortisol (the stress hormone), improve sleep, and potentially reduce the likelihood of recurrence. Let's explore these benefits in more detail.
One of the key benefits of exercise for cancer patients is its ability to counteract the side effects of chemotherapy. Chemotherapy can often lead to fatigue, muscle weakness, and a decrease in overall physical functioning. However, studies have shown that regular exercise can help mitigate these side effects. Exercise improves cardiovascular fitness, increases muscle strength, and enhances physical endurance. Cancer patients can improve their physical functioning during treatment by incorporating exercise into their routine. I maintained my strength during treatment, although my cardiovascular endurance was less. Cardiovascular endurance is not my strong suit, but it rebounded within a month of resuming exercise after the mandatory 3-month pause following my mastectomy and DIEP flap.
In addition to counteracting the side effects of chemotherapy, exercise can also expedite recovery from surgery. Surgery is a standard treatment for many types of cancer, and it often requires a period of rest and recovery. However, research has shown that engaging in exercise after surgery can help speed up the recovery process. Exercise can improve circulation, promote healing, and prevent complications such as blood clots. It can also help restore range of motion and improve overall physical function. My exercise routine delivered unexpected benefits after my surgery.
After my mastectomy and DIEP flap, the nurses advised me to be fitted for lymphedema sleeves for when I travel to prevent myself from developing this incurable complication as a result of having multiple lymph nodes removed. The physical therapist tested my strength and range of motion during my fitting exam. At one point, she asked me to stand and raise my arms as high as possible. I put my hands straight up, elbows aligned with my ears. She was shocked and told me that she never has recent breast reconstruction patients who could do that. Then she tested if I could press my arms down laterally into a t-shape with resistance. I was able to do that easily as well. Again, she expressed shock. So I asked her if she usually treats much older women than me. Surprisingly, she told me most of her patients for lymphedema fitting were women 35-55. These were women my age and younger. The difference was that my exercise routine built strength and range of motion, which I could access quickly during my recovery.
Exercise benefits the physical aspects of cancer treatment and patients' emotional well-being. Physical activity releases endorphins, which are natural mood boosters. These endorphins can help reduce feelings of anxiety, depression, and stress that cancer patients commonly experience. Exercise can provide a sense of empowerment and control, allowing patients to focus on something positive and enjoyable during a challenging time. By incorporating exercise into their daily routine, cancer patients can experience improved mental well-being and a better overall quality of life.
Sleep is a critical component of health and is often challenging for cancer patients, especially cancer patients also facing sudden menopause as part of their journey because the hot flashes of menopause disrupt sleep, too. Exercise improves sleep. My sleep is poor when I do not exercise regularly. My sleep is deep and refreshing when I exercise, even though I exercise very early in the morning. Many cancer patients struggle with sleep disturbances, such as insomnia or disrupted sleep. However, regular exercise can help regulate sleep patterns and promote better sleep quality. Exercise increases melatonin production, a hormone that regulates sleep-wake cycles. By establishing a consistent exercise routine, cancer patients can improve their sleep patterns and feel more rested and rejuvenated.
Lastly, some oncologists believe that exercise may reduce the likelihood of cancer recurrence. Reducing recurrence may be the most compelling motivator for adopting the exercise secret weapon. While more research is needed in this area, preliminary studies have shown promising results. This NIH post reports:
“an analysis of eight studies that included 15,298 patients with breast, colorectal, and prostate cancer demonstrated that higher self-reported volumes of post-diagnosis physical activity was associated with a 45% reduction in the risk of cancer recurrence”
“among 21 studies that included 38,560 patients, higher self-reported volumes of post-diagnosis physical activity was associated with a 37% reduction in cancer mortality”
“The patients who derive the largest clinical benefits from physical activity are those individuals who were physically inactive prior to diagnosis and increase their volume of physical activity after diagnosis”
Exercise may help regulate hormone levels, reduce inflammation, and improve immune function, which can contribute to a lower risk of cancer recurrence. However, it is essential to note that exercise should be seen as a complementary approach to standard cancer treatments and discussed with your treatment team.
From counteracting the side effects of chemotherapy to expediting recovery from surgery, releasing endorphins, improving sleep, and potentially reducing the likelihood of recurrence, exercise plays a crucial role in the overall well-being of cancer patients. Cancer patients must work closely with their healthcare team to develop a safe and effective exercise program that meets their needs and capabilities. By incorporating exercise into their daily routine, cancer patients can experience improved physical and emotional well-being, leading to a better quality of life during and after treatment.
I exercised throughout my treatment and advocated to resume exercise earlier than prescribed after my surgeries. My reconstructive surgeon approved low-impact leg and cardio exercise six weeks after my mastectomies and DIEP flap. Her nurse practitioner approved the same thing two weeks after my revision surgery. Both sped my physical recovery and were instrumental in my mental health. I’ve talked to many cancer patients and am impressed that some are running 5Ks, half marathons, or competing during treatment. Exercise improved my life and was very beneficial to my happiness and resilience during my cancer treatment. And if exercise isn’t a part of your life and you find yourself facing cancer, it’s the right time to start. Walking with friends is social, supportive, and a great on-ramp to exercise, as well as its benefits to treatment and life. Get outside. Get moving. Do it for yourself today.