Many Breast Cancer Patients May Exercise Too Little

Women with breast cancer may be less likely to exercise after diagnosis than before

(RxWiki News) Exercise has been shown to help women diagnosed with breast cancer live longer and better lives. But are breast cancer patients actually getting the exercise they need?

A new study found that after a breast cancer diagnosis, women exercised less than they did before their diagnosis. African-American women with breast cancer were even less likely to be physically active than white women, the researchers found.

"Exercise on a regular basis, especially if you have breast cancer."

This study was led by Brionna Hair, a doctoral candidate in epidemiology at the University of North Carolina in Chapel Hill.

The researchers enrolled 1,735 women diagnosed with invasive breast cancer in their study between 2008 and 2011. These women came from 44 counties in North Carolina. They were aged 20 to 74, with an average age of 55.9 years. Almost half (48 percent) of the participants were African-American.

The researchers compared exercise patterns between the African-American women and the white women.

To start, the women were asked to report their usual amount of moderate-intensity exercise (such as brisk walking or vacuuming) and vigorous-intensity exercise (such as running or heavy yard work) before their diagnosis. After diagnosis, the women were asked to keep track of how much and what kind of exercise they managed per week.

The Department of Health and Human Services and American Cancer Society recommend at least 150 minutes of moderate-intensity exercise per week, or 75 minutes of vigorous activity.

About 39 percent of the women in this study failed to meet these guidelines before their breast cancer diagnosis, while 65 percent did not meet these guidelines about six months after their diagnosis.

On average, the women's amount of weekly physical activity fell by about five hours after their diagnosis.

Compared to the white women, the African Americans were about 40 percent less likely to meet the physical activity goals after diagnosis. The study's authors pointed out that African-American women are more prone to breast cancer than white women.

These authors also noted that a previous meta-analysis revealed that after a diagnosis of breast cancer, patients who reported higher levels of physical activity had a 34 percent lower death rate than those who did the least amount of physical activity.

In the current study, Hair and colleagues found that one in five women actually increased her physical activity after diagnosis. The researchers suggested that speaking to those women might help uncover how to motivate the women who did less.

The study's authors did not report asking the women why they exercised less. Interestingly, the study did find that women who were not receiving chemotherapy or radiation after diagnosis were also those least likely to exercise. The authors suggested that lack of therapy may reduce contact with health professionals who may promote and encourage exercise.

According to Graham Colditz, MD, DrPH, epidemiologist and Associate Director for Prevention and Control at the Alvin J. Siteman Cancer Center in St. Louis, Missouri, "As a population, we find it tough to exercise. Only half of us get the physical activity we should, despite study after study showing it¹s really one of the best things we can do for our health.”

Dr. Colditz was not surprised by the findings of this study. "It¹s not surprising that breast cancer survivors ­who have come through a tumultuous period of diagnosis, treatment, and readjustment to a post-cancer life ­have an even tougher time fitting activity into their day,” he told dailyRx News.

“For many reasons, African-American women overall tend to get less activity than white women,” he noted. “Add to this cancer diagnosis and treatment, and the existing barriers to exercise that many African-American women already experience can easily be compounded.”

Clinicians should reinforce the importance of exercise for cancer survivors, Dr. Colditz said. “Exercise programs can even start during treatment as long as there are no medical reasons to avoid them. For breast cancer survivors, exercise can lengthen survival, improve quality of life, and combat fatigue. It also helps lower the risk of other diseases.”

Women who have just been through diagnosis and treatment need help to identify why they aren’t exercising, locate exercise groups, and find enjoyable and safe places to exercise, he concluded.

This study was published June 9 in the journal Cancer.

Co-author Mary Beth Bell, MPH, disclosed receiving a grant from the Komen Foundation and a grant from the National Cancer Institute as a subcontract with Roswell Park Cancer Institute to fund a portion of the data collection for the current study. Co-author Sandi Hayes, PhD, received research support from the National Breast Cancer Foundation of Australia.

Review Date: 
June 5, 2014