#NationalBreastCancerAwarenessMonth, #NationalMammographyDay #NationalPhysicalTherapyMonth
October is Breast Cancer Awareness Month, an annual campaign to raise awareness of breast cancer risks, the value of screening and early detection, and treatment options available to women and men who are diagnosed with one of the many forms of breast cancer. More than 249,000 people in the United States are diagnosed with invasive breast cancer every year, and nearly 41,000 die from the disease.
Over the years, a loop of pink ribbon has come to symbolize breast cancer awareness
Breast Cancer is one of the most common forms of cancer affecting women today. Approximately one in eight women will develop breast cancer in their lifetime. Research and treatments continue to make advancements, and today, there are many treatments available to eliminate breast cancer. However, there are many different side effects to every treatment provided. Common side effects for Cancer, and the treatments for it, can cause physical problems such as pain, numbness, swelling, weakness, fatigue, stiffness, loss of balance, and difficulty moving or walking. Physical therapists help people manage cancer-related problems, improve their health and functional abilities, and return to work and other activities.
Physical Activity and the Cancer Patient
In the past, people being treated for a chronic illness (an illness a person may live with for a long time, like cancer or diabetes) were often told by their doctor to rest and reduce their physical activity. This is good advice if movement causes pain, rapid heart rate, or shortness of breath. But newer research has shown that exercise is not only safe and possible during cancer treatment, but it can improve how well you function physically and your quality of life.
Too much rest can lead to loss of body function, muscle weakness, and reduced range of motion. So today, many cancer care teams are urging their patients to be as physically active as possible during cancer treatment. Many people are learning about the advantages of being physically active after treatment, too.
How Can a Physical Therapist Help?
Physical therapists are trained and educated to understand all of your health conditions, including a cancer diagnosis. Your physical therapist will work with you to develop a specialized treatment program to address your specific needs and goals.
The American Cancer Society recommends people undergoing cancer treatment, and cancer survivors, perform consistent physical exercise to decrease fatigue, and improve the ability to perform normal daily activities. Studies show that exercise can improve an individual’s chances of surviving cancer. Physical therapists can design individualized exercise and treatment programs to reduce or prevent many cancer-related problems.
Physical therapy can decrease these common side effects and improve the quality of life during and after cancer treatment. A physical therapist will design an individualized treatment program including specific strengthening exercises, endurance training, and stretching. Physical therapists also offer a variety of manual therapy techniques to reduce scar tissue adhesions; pains associated with scars and surgery, and improve flexibility.
Physical therapists help people diagnosed with cancer before and after surgery. Before surgery, they evaluate individuals for any of the problems listed above, and help address them. After surgery, they can help with the healing of the incision site, improve circulation, reduce pain, and minimize scarring. They evaluate individuals for any physical therapy treatment needs, and, by designing individualized treatment programs, help them recover and heal faster than they would on their own.
Research has shown that physical activity and exercise have beneficial effects on health after breast cancer treatment and during treatment. It is a safe and feasible option to improve strength, range of motion, maintain muscle, and improve cardiovascular fitness. Physical activity can even be beneficial during chemotherapy or radiation therapy; however, low intensity exercise should be performed. “While currently, it is unclear if exercise improves chemotherapy results, there is no evidence of a negative effect of exercise on response to chemotherapy.”1
Physical activity has also been shown to improve fatigue, anxiety, self-esteem, depression, cardiovascular fitness, muscle strength, and body composition. Research has also shown that individuals receiving cancer treatment who participate in an exercise program have a reduced risk of disease recurrence and improved survival rate, as well as decreased risk of osteoporosis, diabetes, and cardiovascular disease.
Your physical therapist may work with you to improve your:
Comfort and well-being. Cancer and cancer treatments can cause symptoms such as pain, burning sensations, numbness, tingling (neuropathy), cramps, spasms, and weakness. Your physical therapist may apply hands-on techniques (manual therapy) or technologies like electrical stimulation to help decrease your pain and alleviate your symptoms. The physical therapist may teach you gentle exercises or techniques to perform at home to aid your recovery. All of these options may reduce or eliminate the need for opioid pain medication.
Aerobic capacity. Cancer or cancer treatment may have decreased your ability to process oxygen (aerobic capacity), causing fatigue. Research shows that aerobic exercise, such as walking on a treadmill for at least 20 minutes 3 times per week, may help improve aerobic capacity, reduce fatigue, and optimize healing. Your physical therapist can assess your aerobic capacity and determine the best aerobic activities for you.
Bone density. Lack of activity and certain cancer treatments can cause weakening of your bones, which could lead to bone fractures. Certain types of exercise can prevent bone loss and maintain bone strength. Your physical therapist can teach you safe and effective exercises to help steadily build your bone strength.
Lymphedema and swelling. Certain cancer treatments can result in lymphedema (swelling in the arms or legs) or other types of swelling. Your physical therapist can use several methods to reduce, control, and prevent lymphedema and swelling, such as specialized gentle massage, special movements and exercises, and application of compressive garments such as arm sleeves, gloves, and leg stockings.
Surgical incisions. Your physical therapist can help you care for any surgical incisions and sutured areas, by checking for infection and assisting with dressing changes. The physical therapist also can help prevent some kinds of scarring and skin tightness as the suture line heals. Your physical therapist can use very gentle massage or certain technologies to keep the skin as soft and pliable as possible.
Body weight. By creating an exercise and physical activity program tailored just for you, your physical therapist will help you reduce body fat and maintain a healthy body weight, which can improve your energy levels.
Mood. Exercise helps elevate mood and reduce depression in everyone, including cancer patients and survivors. A diagnosis of cancer, and cancer treatment, can be stressful and cause mood changes in anyone. Proper exercise, individualized for each person by a physical therapist, can help reduce stress and improve mood.
Brain fog. Exercise helps relieve brain fog. Your physical therapist can design an individualized program of exercise that can help reduce memory loss and brain fog.
Daily activities. Your physical therapist will discuss activity goals with you and use them to design your treatment program. Cancer survivors usually increase their physical activity gradually; your treatment program will help you reach your goals in the safest, fastest, and most effective way possible.
Walking. Your physical therapist will help improve your ability to walk using techniques such as strengthening exercises, walking training, and balance activities. If you have nerve damage (neuropathy), your physical therapist may provide bracing and other techniques to make it easier or safer for you to walk. Your physical therapist also may recommend using an assistive device, such as a walker or cane.
Sports training ability. Athletes undergoing cancer treatment can continue to train for their sport to a degree, depending on the type of cancer and treatment. Physical therapists design safe, challenging, sport-specific training programs to help athletes reduce loss of fitness and strength during cancer treatment.
Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in any stiff joints. These might begin with “passive” motions that the physical therapist performs for you, and progress to active exercises and stretches that you do yourself. You can perform these motions at home to help hasten healing and pain relief.
Flexibility. Your physical therapist will determine if any muscles are tight, start helping you to stretch them, and teach you how to stretch them at home.
Strength. If your physical therapist finds any weak or injured muscles, the physical therapist will choose, and teach you, the correct exercises to steadily restore your strength and agility.
Coordination. Your physical therapist will help you improve and regain your coordination and agility, so you can perform household, community, and sports activities with greater ease.
Balance. Your physical therapist will examine your balance, and choose specific exercises that you can perform in the clinic and at home to improve your balance and prevent falls. Your physical therapist may also teach you how to use a cane or walker to help maintain your balance when walking and standing.
Home program. Your physical therapist will teach you strengthening, stretching, and pain reduction exercises to perform at home. These exercises will be designed specifically for your needs.
Some exercises that you can perform include:
- Yoga to improve flexibility
- Deep breathing exercises to improve relaxation and provide psychological benefits
- Aerobic exercise like walking, jogging, and swimming to assist with weight management and improve cardiovascular fitness
- Resistance training to improve muscle mass.
You should always consult your doctor to determine any precautions or limitations to exercising. It is important to note that all therapeutic exercise programs should be tailored to each individual and their specific needs. If you experience any increase of weakness, loss of balance, increase of pain, unusual swelling or swelling increases, headaches, dizziness, blurred vision, or new numbness/tingling you should stop your exercises and contact your doctor.
Precautions for cancer survivors who want to exercise
During and shortly after cancer treatment
Always check with your doctor before starting any exercise program. This is especially important if your treatments can affect your lungs (such as the chemo drug bleomycin or radiation to the chest), your heart (such as the chemo drugs doxorubicin or epirubicin), or if you are at risk for lung or heart disease. Be sure you understand what you can and can’t do.
If you, or someone you know, are currently undergoing or have recently received Breast Cancer treatment and wish to set up an exercise program, please contact the dedicated team at TOCA by calling 602-277-6211 today!
If you have any further questions you can look through the resources in this paper or go to the American Cancer Society web page.
For tools and calculators (In this section you’ll find interactive tools, quizzes, and videos to help you learn more about ways to lower your risk for cancer or find it early) visit: https://www.cancer.org/healthy/tools-and-calculators.html
For more information on ‘Tests to Find and Diagnose Cancer’ (Screening increases the chances of detecting certain cancers early, when they are most likely to be curable. Learn about the types of tests done to find and diagnose cancer here.) visit: https://www.cancer.org/healthy/find-cancer-early/tests-to-find-and-diagnose-cancer.html
#NationalBreastCancerAwarenessMonth, #NationalMammographyDay #NationalPhysicalTherapyMonth #MyOrthoDoc #TOCA #TOCAMD #PhysicalTherpy #Orthopedics #BreastCancer #BCA #BreastCancerAwareness #BreastCancerFighter #Cancer #FightLikeAGirl #MaleBreastCancer #Pinktober #RethinkPink #WhatGivesMeStrenth #EveryActionCounts #healthandwellness #Recovery #Results #Relief #movement #wellness #rehab #motivation #medicine #surgery #elbow #shoulder #arthroplasty
The American Physical Therapy Association (APTA) believes that consumers should have access to information that could help them make health care decisions, and also prepare them for a visit with their health care provider.
The following articles provide some of the best scientific evidence related to physical therapy treatment of cancer problems. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article titles are linked either to a PubMed* abstract of the article or to free full text, so that you can read it or print out a copy to bring with you to your health care provider.
Mohamady HM, Elsisi HF, Aneis YM. Impact of moderate intensity aerobic exercise on chemotherapy-induced anemia in elderly women with breast cancer: a randomized controlled clinical trial. J Adv Res. 2017;8(1):7-12. Free Article.
Cornette T, Vincent F, Mandigout S, et al. Effects of home-based exercise training on VO2 in breast cancer patients under adjuvant or neoadjuvant chemotherapy (SAPA): a randomized controlled trial. Eur J Phys Rehabil Med. 2016;52(2):223–232. Free Article.
Van Waart H, Stuiver MM, van Harten AW, et al. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol. 2015;33(17):1918–1927. Free Article.
Al-Majid S, Wilson LD, Rakovski C, Coburn JW. Effects of exercise on biobehavioral outcomes of fatigue during cancer treatment: results of a feasibility study. Biol Res Nurs. 2015;17(1):40–48. Free Article.
Yang TY, Chen ML, Li CC. Effects of an aerobic exercise programme on fatigue for patients with breast cancer undergoing radiotherapy. J Clin Nurs. 2015;24(1-2):202–211. Article Summary in PubMed.
Bergenthal N, Will A, Streckmann F, et al. Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev. 2014;(11):CD009075. Free Article.
Hornsby WE, Douglas PS, West MJ, et al. Safety and efficacy of aerobic training in operable breast cancer patients receiving neoadjuvant chemotherapy: a phase II randomized trial. Acta Oncol. 2014;53(1):65–74. Free Article.
Murtezani A, Ibraimi Z, Bakalli A, Krasnigi S, Disha ED, Kurtishi I. The effect of aerobic exercise on quality of life among breast cancer survivors: a randomized controlled trial. J Cancer Res Ther. 2014;10(3):658–664. Free Article.
Mishra SI, Scherer RW, Snyder C, Geigle PM, Bertanstein DR, Topaloglu O. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev. 2012;(8):CD008465. Article Summary in PubMed.
Brdareski Z, Djurovic A, Susnjar S, et al. Effects of a short-term differently dosed aerobic exercise on maximum aerobic capacity in breast cancer survivors: a pilot study. Vojnosanit Pregl. 2012;69(3):237–242. Article Summary in PubMed.
Jones LW, Douglas PS, Eves ND, et al. Rationale and design of the Exercise Intensity Trial (EXCITE): a randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer. BMC Cancer. 2010;10:531. Free Article.
Kampshoff CS, Buffart LM, Schep G, van Mechelen W, Brug J, Chinapaw MJ. Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue. BMC Cancer; 2010;10:658. Free Article.
Schwartz AL, Winters-Stone K, Gallucci B. Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum. 2007;34(3):627–633. Article Summary in PubMed.
Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 2007;25(13):1713–1721. Free Article.
*PubMed is a free online resource developed by the National Center for Biotechnology Information (NCBI). PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine’s MEDLINE database.
Authored by Andrea Avruskin, PT, DPT. Reviewed by the MoveForwardPT.com editorial board.