Every year new evidence piles up that exercise has benefits in reducing breast cancer risk, recurrence, and treatment side effects. Presentations at the 2013 San Antonio Breast Symposium added new data on this topic.
But knowing something is good for you and being able to do it consistently are two different things. During my adult years, I have started any number of exercise programs, but laziness or injury always seemed to doom them to failure. The problem has been particularly bad since my cancer diagnosis.
During much of treatment I was so fatigued that walking to the shower in the morning wore me out. On the good days I did go for short walks in my neighborhood or a nearby park, but a systematic exercise program seemed out of reach.
Since finishing treatment, I've tried walking, exercise classes and gym memberships. At the classes and gyms, there were always trainers ready to help, but they never knew anything about exercising after a mastectomy with lymphedema and peripheral neuropathy. Generally, they shrugged and said, "Just use your own judgment." No matter how gradually I started my new exercise program, eventually an injury knocked me out of action.
This fall I was ready to try again, and in investigating offerings at my local YMCA, I stumbled into a Cancer Wellness Program offered in partnerships with my hospital and the Y. During this free twelve-week program, a nurse and two fitness trainers helped the members of my class learn what exercises were safe for us and how we could improve our fitness. The format consisted of two classes of strength and conditioning, and one class of Tai Chi and stress reduction each week.
For the first time, someone showed me how to modify exercises to avoid some problems I have been having in my chest related to my mastectomy. They helped me learn when to push myself to do more and when to back off. They taught me exactly what settings to use on the bikes and other intimidating gym machines and gave me some exercises to try at home. Three times a week, they praised me for my accomplishments and made gentle suggestions for improvement. Once a week the nurse took my blood pressure and discussed how I was doing medically. I got to know other people who were still in treatment or years out. It was hard to whine when people older than I still taking chemo kept peddling on that bike.
I talked to two of the leaders of the group about the benefits and challenges of participating in a cancer wellness program. Susan, the nurse who monitored us and taught the Tai Chi class, said, "One of the greatest benefits is when participants sense that they are not alone in their experience of cancer, and though each person may have individual challenges, the overall experience as a cancer survivor holds many shared feelings and challenges."
Elizabeth, the trainer mentioned a specific example, "One participant, in particular, was encouraged when she saw that her cardiovascular endurance increased quickly with consistency in her attendance. She then was motivated to set weekly goals that led her to trying different exercises & increasing her time. This motivated her to commit to her workouts a minimum of three times a week and to make this routine a part of her life moving forward. She also saw a difference in her work capacity at home; around the house and in her daily activity. She gained strength & confidence along with quite a few new friends."
I asked Susan about the high drop-out rate in our group. She said the attrition rate in exercise programs is usually about 50% and that cancer survivors have the additional burden not feeling well from treatments. She added that another problem is "Not being prepared or ready to take ownership of being a cancer survivor. There is a lot of internal 'work' that needs to take place as people navigate life as a survivor. If people don't have the support, opportunity or take the time to do that work, making long term healthy lifestyle change becomes very challenging."
When asked for recommendations for cancer patients or survivors considering an exercise program, Susan said, " I would recommend that cancer survivors consider participating in some sort of support group or individual counseling to explore how they are redefining their health and their life moving forward. Anyone with any kind of health issues who is looking at starting an exercise program start slowly, setting small, reasonable goals for themselves. I also recommend working with someone in the healthcare and/or fitness industry who has a solid understanding of issues surrounding exercise that may arise for breast cancer survivors such as strength and resistance, lymphedema, and neuropathy. One of our main objectives is to get people exercising, but keep them safe."
Throughout my twelve weeks in the Cancer Wellness Program, that emphasis on safety was paramount. I loved the Tai Chi class and have continued with a new one since the cancer program concluded. I have also been able to continue with other forms of exercise.
I've learned that many hospitals offer similar programs. If you are trying to find safe ways to get fit, ask your oncologist and local gyms about what programs might be available near you. Yes, you have some extra hurdles compared to some of your friends, but starting gradually in a supportive environment could be the key to finding fitness.
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