Breast cancer: who has can exercise?

Contrary to what many may think, physical activity is recommended for patients on breast cancer treatment. In this sense we could list at least six situations:

1) After surgical treatment: patients may return to activity as soon as their oncologist / mastologist has released it. Usually begin with activities involving the lower limbs, such as walking and cycling, and as soon as the healing of the breast and armpit are adequate the patient will be released for activities with the upper limbs

2) During chemotherapy : At this stage the practice of exercise is well-life, and is related to greater physical and psychological well-being, minimizing the side effects of chemotherapy such as fatigue, nausea, vomiting and psychological disorders resulting from treatment. Radiotherapy:

At this stage of treatment physical activity is adequate with some care, for example, one should not practice aquatic physical activity such as swimming and avoid exposure to the sun. It is common to have a little more pain in the breast and armpit area at this stage. 4) During hormone therapy:

for both tamoxifen and aromatase inhibitors the practice of physical activity is welcome. The exercises reduce the risk of thrombosis in the legs (a side effect that can occur with the use of tamoxifen), as well as reduce joint pain (a relatively frequent side effect in those using aromatase inhibitors). At this stage there is practically no restriction on the type of physical activity or its intensity. This would be a maintenance phase and the patient - with medical release - can practice the types of activity that he likes and the frequency and intensity to support, especially for those patients who performed only sentinel node biopsy and who do not have lymphedema. 5) Patients who developed lymphedema in the arm (swelling of the arm):

This is a complication. related to the removal of axillary ganglia - a procedure that is necessary in many cases of patients with breast cancer. These patients are usually approached from the preoperative and oriented on how and what to do to avoid / minimize this. When the patient has swelling of the arm already installed or risk of it occurring, one should avoid repetitive activities and limit bodybuilding activity. It is extremely important to be evaluated by the medical surgeon oncologist / mastologist and to the extent of the need also by a specialized physiotherapist. Many patients may require specific physiotherapy measures for maintenance and reestablishment of range of motion and measures to avoid and treat lymphedema. 6) Patients with metastatic disease:

more care is required here. We need to understand the extent of the disease and the sites that are potentially limited so that exercise does not disturb patients. For example, patients with bone metastasis, may have pain that worsen with exercise and activity as walking, in this scenario, rather than help could disrupt. The best types of physical activity for patients in this condition are aerobic physical exercises involving walking, small runs, cycling, dancing, among others. Other equally interesting modalities are the practice of yoga and pilates. Swimming and water aerobics are great options after the recovery phase and radiotherapy. Physical exercises produce in the body the release of substances capable of reducing chronic pain and improve the feeling of well being. They combat fatigue which is a very common effect during chemotherapy and that greatly restricts and limits the patient physically and socially. They also improve sleep, mood and sexual desire (which is reduced during the most active phase of the treatment).

There is also a direct oncological benefit of physical activity. It is known today that overweight releases in the body substances that stimulate the development / return of breast cancer, so the practice of physical activity will contribute to weight reduction which, in turn, will contribute to the reduction of risk of tumor recurrence.

Exercises to avoid

Strenuous exercises such as long runs and overweight weight training should be avoided. Also, exercises that offer a risk of injury to the arm on the side of breast and axillary surgery are not advised as climbing.

Swimming and water aerobics are not recommended during the immediate postoperative phase (until the wounds heal) as well as during the radiotherapy - at which time the skin may have several excoriations.

Care must be taken with the arm on the operated side, at the smallest signs that this arm may be swelling, this activity should be interrupted and the patient immediately return to your doctor for a new evaluation.

Necessary care

First of all, the patient should advise with his physicians to request release from them for the practice of physical activity. The type and intensity of the exercise is very individualized according to the treatment being performed and also according to the stage of the disease that the patient presents. Other previous health problems such as obesity, hypertension, diabetes, bone or joint pain, and cardiorespiratory capacity of the patient should also be taken into account. Only the responsible doctor can tell you the best time to start physical activity and what type of activity can be performed.

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