More often than not, you probably know of at least one person who has been effected by breast cancer. In 2020 alone, there were more than 2.2 million new cases of breast cancer and 684,996 deaths worldwide (1). It is the leading cause of cancer death for women, and the 5th leading cancer of cancer mortality worldwide as it effects both men and women.
So where does exercise come in? Well some of the underlying reasons that we see an increasing number of breast cancer diagnoses may be tied to our increasing number of risk factors such as excess body weight, lack of physical activity, and our abundance of processed foods(1). Mix that with a constantly stressed out economy that increases our cortisol levels if we don't find ways to focus on our own self care and decompress from our fast paced lifestyles. So how can we address it?
1) Our First Line of defense... Early Detection and Regular screening.
Early detection through regular screening has reduced the mortality among women over time. Those having regular check ups and checking for lumps usually means we are detecting the tumors when it is still localized to only the breast tissue. Not only does this increase our mortality, but it also allows for breast conserving surgery instead of a mastectomy. In total, 61% of breast cancer cases are diagnosed at a localized stage. The 5 year survival rate is 99% according to the American Cancer Society(2).
2) Physical Activity Guidelines
Studies show that physical activity/exercise clearly reduces the risk for breast cancer (3). The Women's Health Initiative (WHI), sponsored by the National Heart, Lung, and Blood Institute (NHLBI), is a long-term national health study that focuses on strategies for preventing heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women. They found that as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman's risk by 18%(3)
3) Weight Gain After Breast Cancer Diagnosis. A statistical view
Nearly 2/3 (80%) of women who receive chemotherapy gain weight (4). Chemotherapy in itself is very hard on the body, one of the most common side effects is nausea. In one study, up to 66% of patients reported eating in an effort to minimize self reported nausea. This coupled with massive fatigue from treatment may also contribute to weight gain (5). The reported range of gain is between 2 and 18 pounds. There is some evidence that pre-menopausal women who gain weight have a 1.5 fold increase of cancer recurrence (6).
On the flip side, a large new study found that women who lost weight after age 50 and kept it off had a lower risk of breast cancer over their peers whose weight remained pretty stable. This reduction in risk with weight loss was specific to women NOT using post menopausal hormones (7).
4) General Recommendations for Weight Control
By looking at the statistics above, maintaining a healthy body weight is a high priority for breast cancer patients. We aren't talking about crash diets or extreme high intensity workouts, but something is always better than nothing. Maybe our diet options aren't the best, but we can still make educated consumer decisions if we are mindful of our behaviors. Having a routine and scheduling planned events is important for any type of behavior change. Avoid skipping meals, choose foods with lower calorie content. Include fruits, veggies, and whole grains. Increase total volume of physical activity. The weekly recommendations for moderate activity is 150 minutes. Be purposeful with your days. Even if the scale doesn't go down, if the lean mass is increasing then we are still going in the right direction.
In summary,
It can feel easy to fall back into discouragement when our health feels like it is in jeopardy. A quote that has gotten myself through some rough patches in life goes like this, "Something worth doing, is worth doing poorly". And the first time I heard that I thought that was ridiculous. Why would anyone do anything if it's going to be done poorly? Then I thought about it in terms of self care. I think most people would agree that they would rather you brush your teeth "poorly", than not brush them at all. That's kind of the thought process when we are trying to change our behaviors into things that are positive to our bodies. Can only find the energy to walk 5 minutes? That's better than no minutes. Only have so much fresh fruit around the house? It's better than nothing, just add a note to buy a little more fruit next time you're at the grocery store. Every little step in the right direction is a decision to revise our habits until it is a basic routine.
In the next blog, we will dig a little deeper into Breast cancer and how different treatments have different guidelines for how to continue exercise.
Sources:
1) Hyuna Sung PhD, Jacques Ferlay MSc, ME, Rebecca L. Siegel MPH, Mathieu Laversanne MSc, Isabelle Soerjomataram MD, MSc, PhD, Ahmedin Jemal DMV, PhD, Freddie Bray BSc, MSc, PhD; Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. First published: 04 February 2021
2) The American Cancer Society medical and editorial content team, Last Medical Review: September 6, 2017 Last Revised: September 6, 2017 https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html
3) McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, Woods N, Ockene J; Women's Health Initiative Cohort Study. Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study, JAMA, Sept. 10, 2003
4) Goodwin PJ, Ennis M, Pritchard KI et al. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Onc 17:120-129. 5) Mukhopadhyay MG, Larkin S: Weight gain in cancer patients on chemotherapy. Proc Am Soc Clin Oncol 5:254, 1986 (abstr 992)
6) Camoriano JK, Loprinzi CL, Ingle JN, et al: Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol 8:1327-1334, 1990
7) Lauren R Teras, Alpa V Patel, Molin Wang, Shiaw-Shyuan Yaun, Kristin Anderson, Roderick Brathwaite, Bette J Caan, Yu Chen, Avonne E Connor, A Heather Eliassen, Susan M Gapstur, Mia M Gaudet, Jeanine M Genkinger, Graham G Giles, I-Min Lee, Roger L Milne, Kim Robien, Norie Sawada, Howard D Sesso, Meir J Stampfer, Rulla M Tamimi, Cynthia A Thomson, Shoichiro Tsugane, Kala Visvanathan, Walter C Willett, Anne Zeleniuch-Jacquotte, Stephanie A Smith-Warner. Sustained weight loss and risk of breast cancer in women ≥50 years: a pooled analysis of prospective data. JNCI: Journal of the National Cancer Institute, 2019; DOI: 10.1093/jnci/djz226pathophysiology of alcohol and breast cancer: update 2012. Alcohol Alcohol. 47(3), 204–212 (2012).
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