Most Women Do Not Get Enough Exercise Post-Diagnosis
In a recent study, researchers found that most women diagnosed with breast cancer do not meet national physical activity guidelines in the 10 years after diagnosis.
Exercise has been linked to reduced mortality and improved quality of life, fatigue and body image concerns in women diagnosed with breast cancer. It can also help women cope with side effects of treatment, such as depression, pain, and weight gain.
Though researchers have reported on patterns of physical activity in women with breast cancer in several studies, few have followed participants in the long-term. The authors of the current study believe that understanding how breast cancer impacts physical fitness over time may be important in identifying fitness promotion needs to support better quality, and length, of life.
The researchers recruited women from the Health, Eating, Activity and Lifestyle (HEAL) study, for which data about the effects of lifestyle and other factors on breast cancer survival was collected beginning in 1996. HEAL investigators enrolled 1,183 women diagnosed with a first, early-stage breast cancer from Surveillance Epidemiology and End Results (SEER) registries in New Mexico, Los Angeles county, and Western Washington. Women were at least 18 years old and were diagnosed between May 1995 and March 1999.
About 6 months post-diagnosis, the HEAL group completed an interview about their recreational physical activity level (walking, jogging, hiking, bicycling, etc) before they were diagnosed. The same women completed follow-up questionnaires evaluating their fitness at 2-, 5- and 10 years after diagnosis. 631 women completed the final assessment at 10 years.
To compare the data collected, investigators classified each activity as moderate to vigorous, and then noted whether the activity was performed at a light, moderate or vigorous level. Data on changes in marital status, employment, whether a person smoked, and body-mass index (BMI) were also recorded and explored as possible reasons why a woman’s activity level changed over time.
Between 40 and 60 percent of women diagnosed with breast cancer who were surveyed reported little or no physical activity over all 10 years. Ten years after diagnosis, only about 8 percent of the women had participated in physical activity often enough to meet national fitness guidelines at every follow-up period. By comparison, two surveys of U.S. adults, the 2007 Behavioral Risk Factor Surveillance System and 2008 National Health Interview Survey, report that 60.4 percent and 39.9 percent of women over 18 met guidelines.
In addition, the study found that
- the average level of activity remained the same through the first 5 years after diagnosis, then dropped significantly between years 5 and 10.
- only 9.8 percent of women who were not active before diagnosis increased their activity to meet guidelines during the 10 year period.
- changes in BMI, smoking, marital status and employment did not impact activity level.
- women who were active before diagnosis were more likely to continue to be active after diagnosis than women who were not.
What This Means for You
These results show that women diagnosed with breast cancer exercise much less frequently than the average American woman, and that activity levels drop 5 years after diagnosis. Though researchers found that age, BMI and race and ethnicity did not affect the change in activity level, they were not able to identify whether other factors did – like treatment type, fatigue and pain.
National guidelines suggest all adults get 150 minutes of moderate-intensity exercise, or 75 minutes of vigorous-intensity exercise, per week. Regardless of whether you were active before your diagnosis, becoming active now can help you maintain your weight and keep your body strong during and after treatment.
Many cancer centers offer group exercise classes tailored to the needs of women in treatment for breast cancer. You may also find classes offered at your local community center. If you prefer to exercise alone or in small groups, activities like brisk walking, jogging and hiking are all ways you can take part in exercise everyday.
Mason, C, Alfano, CM, Wilder Smith, A, et al. Long-term physical activity trends in breast cancer survivors. Cancer Epidemiology, Biomarkers & Prevention. 2013;22(4). doi:10.1158/1055-9965. EPI-13-0141