Breast Cancer Patients
Not Heeding Exercise Advice
Excerpt By Colette Bouchez, HealthScoutNews

Breast cancer patients are not sticking to prescribed diet and exercise routines, even though working out and controlling weight gain might help them avoid future bouts with the disease.

That's the observation of a new study by researchers from the Fred Hutchinson Cancer Center in Seattle, along with colleagues at the National Cancer Institute, the University of New Mexico and the University of Southern California. Their report appears in the April issue of Cancer.

The new research explores how even women who were diligent about working out before they were diagnosed with breast cancer appear to let their routines slide after the disease strikes.

"Most notable were the decreases in activity among women who underwent surgery as well as chemotherapy and radiation therapy, as well as the women who were obese or overweight prior to diagnosis," says study author Melinda Irwin, currently an assistant professor in the department of epidemiology and public health at Yale School of Medicine.

The findings are important, says Irwin, because previous studies show a lack of activity leads to weight gain, which then increases the risk of cancer recurrence. This is particularly true if women are overweight when they are diagnosed.

"If a woman is already overweight or obese when diagnosed with breast cancer, the chance of having a recurrence within five years is twofold over lean women, and the chance of dying from breast cancer, over a 10-year period, is 60 percent greater than lean women," Irwin says.

For breast cancer surgeon Dr. Jeanne Petrek, the study offers an interesting observation. However, its real value may not be realized until the women are followed and their cancer prognosis can be linked to activity levels, she says.

"This is an early result, and it just tells us what happened in the early months following diagnosis and treatment. But what it doesn't tell us is whether these women were able to lose the weight they gained, whether they regained physical activity in one or two years, and if they did, what would that mean to their prognosis," says Petrek, director of the surgical program at Memorial Sloan-Kettering Cancer Center in New York City.

"These are the kinds of questions that must be answered before this finding has true relevance," she adds.

The study involved 865 women diagnosed with breast cancer within the previous four to 12 months. Each woman was asked to recall how much she exercised in the year before her breast cancer diagnosis, and how much she did in the previous month, after diagnosis and treatment.

Researchers also investigated whether the level of activity could be associated with the severity of their disease, the type of treatment they received, as well as their age and their body mass index -- a measurement of total body fat.

The result: On average, each woman reported a two-hour weekly decrease in activity from what they did before diagnosis. Further, those who received the most dramatic treatments -- surgery, combined with radiation and chemotherapy -- saw the greatest decline in exercise, with 50 percent less activity than before their diagnosis. Women who had surgery alone saw only a 24 percent drop in activity after breast cancer.

The group who saw the greatest decrease in post-cancer activity -- regardless of the type of treatment they received -- were obese women, who did 41 percent less exercise. Women who were simply overweight were 36 percent less active, while lean women did 24 percent less activity.

Although many of the women cited nausea and fatigue as the reason behind their lack of exercise, Irwin says that, ironically, it is physical activity that can do the most to relieve those symptoms.

"Any exercise intervention after a cancer diagnosis shows significant improvement in fatigue and nausea and overall quality of life, including depression," Irwin says. "If a woman didn't exercise before being diagnosed, she should be counseled on the importance of starting an exercise program after treatment; if she exercised before, it's important that levels don't decrease after cancer."

More information

To learn more about the impact of exercise on cancer, visit The National Institutes of Health. You can also find information about weight and breast cancer at Cornell University's Program on Breast Cancer and Environmental Risk Factors.

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