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Exercise boosts breast cancer patients' well-being

SOURCE: The Breast Journal, January/February 2009.

Published February 25, 2009

NEW YORK (Reuters Health) - Exercise can help women going through any stage of breast cancer treatment to feel better both physically and emotionally, a new research review shows.

"It helps enhance mood and emotions during all phases of cancer treatment," lead investigator Dr. Susan R. Harris, an emeritus professor at the University of British Columbia in Vancouver, told Reuters Health. Recent studies showing that active breast cancer survivors reduce their risk of disease occurrence - and are less likely to die from the disease - make the case for exercise even more compelling, added Harris, herself a two-time breast cancer survivor.

She also noted that being active can help ward off weight gain, which is known to increase breast cancer mortality, especially for women who gain weight after undergoing treatment.

Harris and her team reviewed nine controlled trials, in which similar patients were randomly assigned to the exercise group or to a "control" group. The studies evaluated a wide range of physical activity, from aerobic exercise and resistance training to Tai Chi, dance and movement therapy, and gentle exercises done in a seated position.

Overall, the researchers say, the findings provide "strong evidence that exercise positively influences quality of life in women living with breast cancer." But it still isn't clear what type of exercise is best for a woman according to the stage of her treatment, they add.

Certain questions about safety also remain, Harris noted in an interview. For example, advanced breast cancer may spread to the bones and make them more fragile, so it's not clear that resistance exercise is safe for these patients. However, according to the researcher, aerobic exercise is "completely safe."

While some experts have raised concerns that exercise could worsen lymphedema, the swelling of the upper limb experienced by some breast cancer patients after surgery or radiation treatment, those fears have not been borne out, she added.

Breast cancer patients should understand that they don't need to exercise every single day to benefit from physical activity, Harris advised. There are times in the middle of treatment when a woman may simply feel too exhausted, she said, and on those days, it's perfectly OK to stay in bed.

Despite the clear benefits of exercise during breast cancer treatment, the researcher noted, doctors often don't give these patients recommendations on physical activity. "It's been kind of a black hole because oncologists don't know what to recommend, although they're getting better at it," Harris said.

Awareness is on the rise, she added; for example, the American College of Sports Medicine and the American Cancer Society now have a training program that certifies fitness professionals in working with cancer patients and survivors.

SOURCE: The Breast Journal, January/February 2009.

source site: click here

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Diet & Exercise Inseparable for Breast Cancer Survival Benefit
 
By Crystal Phend, Staff Writer, MedPage Today
Reviewed by
Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
June 11, 2007
SAN DIEGO, June 11 - Breast cancer survivors who eat properly & exercise may halve their mortality risk regardless of obesity, researchers here found.

In a prospective observational study, women who ate 5 or more servings of vegetables & fruits a day & got the equivalent of 30 minutes of moderate exercise 6 days a week had a significant survival advantage (hazard ratio 0.56, 95% confidence interval 0.31 to 0.98), said John P. Pierce, Ph.D., of the University of California, San Diego & colleagues.

This protective effect was seen for both obese & nonobese women, but not for women who focused on just one aspect of that healthy lifestyle, they reported in the June 10 issue of the Journal of Clinical Oncology.

Previous studies that looked at the impact of diet or physical activity on breast cancer survival had mixed results, but none of them evaluated both aspects together, the researchers said.

So, they analyzed the control group of the Women's Healthy Eating & Living Study, which is investigating a plant-based diet following breast cancer.

The 1,490 women included in the analysis had volunteered for the trial within 4 years of early-stage breast cancer diagnosis (mean 2 years). All had already completed primary therapy, although most were still on tamoxifen (Nolvadex).

Participants completed 24-hour dietary recall and physical activity questionnaires at baseline, then filled out health status questionnaires at five clinic visits over 6 years, with semiannual phone calls to report health events.

Average vegetable & fruit intake reported was 4.93 servings a day. Median physical activity was 636 metabolic equivalent task (MET)-minutes per week.

After an average of 6.7 years of follow-up, there were 236 breast cancer events & 135 total deaths, 118 from breast cancer & 10 from other cancers.

Since only 7 deaths weren't related to cancer, the mortality analyses reported by the researchers primarily referred to breast-cancer related mortality.

For the 30% of women who ate 5 or more servings of fruits & vegetables a day & accumulated at least 540 MET-minutes a week - the equivalent of 30 minutes of brisk walking 6 days a week - they found that mortality was significantly lower (hazard ratio 0.56, 95% CI 0.31 to 0.98).

Women who met these criteria for high fruit & vegetable & high physical activity had a 6% to 7% absolute 10-year mortality risk reduction compared with those who met only one criteria or neither of them (10-year survival 93% vs. 86% to 87%).

Mortality increased as adherence to the criteria decreased (P=0.01 for difference). Mortality rates were:

  • 4.8% with high diet & high exercise.
  • 10.4% with low diet & high exercise.
  • 10.7% with high diet & low exercise.
  • 11.5% with low diet & low exercise.

High fruit & vegetable consumption without high physical activity didn't significantly reduce mortality compared with poor diet & low physical activity (P=0.57).

Likewise, physical activity alone didn't significantly reduce mortality (P=0.42).

Mortality wasn't associated with energy intake (P=0.10 for trend) or fiber consumption (P=0.12 for trend).

Less than 1/3 (29%) of these breast cancer survivors were current drinkers, with 7% classified as heavy drinkers (60 drinks/mo). Alcohol consumption showed an inverse association with mortality (P<0.03)

Obese women had substantially higher mortality than nonobese women in every category except those who reported high fruit & vegetable intake & physical activity.

However, the researchers noted, fewer obese women met this pattern than their thinner counterparts (16% vs. 30%).

"Among those who adhered to this healthy lifestyle, there was no apparent effect of obesity on survival," Dr. Pierce & colleagues wrote.

The effect was stronger in women who had hormone sensitive cancers, they said.

In the univariate analysis, women who had estrogen receptor-negative, progesterone receptor-negative tumors had no significant benefit from diet & exercise (P=0.4) whereas those positive for both hormone receptors did (P=0.01).

"Given that the number of cancer survivors is increasing & breast cancer survivors make up the largest group of cancer survivors, it's important to consider the potential impact on prognosis of lifestyle changes such as diet & physical activity on women who have survived initial treatment," the researchers concluded.

Further study into the combined protective effect on breast cancer survival is warranted, they said.

source: Medpage Today

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Chemotherapy Survival Guide: Questions to Ask About Your Treatment Plan
by Judith McKay, RN, OCN, & Tamera Schacher, RN, OCN, MSN
 
 DECIDING ON THE TREATMENT PLAN

During your next visit, your doctor may recommend chemotherapy alone or in combination with radiation therapy, hormonal therapy, targeted therapy, or surgery. Your doctor will explain treatment options and why a certain one is recommended. Your doctor may be able to show you statistics (gathered over many years from all over the world) that indicate the advantage of one treatment over other available treatments, or the risk (if any) of not getting treatment.


QUESTIONS TO ASK ABOUT YOUR TREATMENT PLAN

Once all the relevant information is gathered and reviewed, you’ll probably have another appointment with your doctor and another chance to ask questions. Many people feel better prepared to ask questions at this interview than when they first met their oncologists. For instance, you’ll have had more time to learn about the kind of cancer you’re dealing with, the treatment options available, many of the relevant medical terms and abbreviations used, and the significance of tests. You may also have had the opportunity to talk to other people who’ve gone through a similar treatment. When other questions occur to you, write them down so that you don’t forget to ask about the things that concern you.

Here are some questions you may want to ask your doctor:

• What’s the expected goal of the treatment? Is it to eliminate all cancer cells and prevent their recurrence? Is the goal to slow down the spread of cancer that can’t be totally eliminated in order to achieve a remission (period of time when the cancer is inactive) for as long as possible? Is the goal to relieve the symptoms associated with the cancer (pain, shortness of breath, problems with digestion, and so on)?

• Do I need other kinds of treatments (surgery, radiation therapy, targeted therapy, hormonal treatment, and so on)? Why?

• What are the names of the chemotherapy medications I’ll get?

• How many treatments will I be getting? How often will they be given? How long does each treatment take?

• What side effects can I expect (hair loss, nausea, increased risk of infection, or fatigue)? How can these side effects be prevented? How can they be managed?

• How will the treatment affect my other medical conditions (diabetes, heart disease, lung problems, kidney problems, and so on)?

• How will this treatment affect my sexuality? Fertility? Will these effects be temporary or permanent?

• Will I be able to continue to work? Travel?

• How will I know if the treatment plan is working? What tests will I need and how often?

***


Excerpt from: THE CHEMOTHERAPY SURVIVAL GUIDE, THIRD EDITION: Everything You Need to Know to Get Through Treatment (New Harbinger Publications)

Author's Bio
Judith McKay, RN, OCN, received her degrees from California State University, Hayward, and has been an oncology nurse for more than twenty years. She works at the Alta Bates Comprehensive Cancer Center in Berkeley, CA. McKay is coauthor of When Anger Hurts: Quieting the Storm Within and contributed to the best-seller Self-Esteem.

Tamera Schacher, RN, OCN, MSN, is an oncology-certified nurse and a board-certified family nurse practitioner. For the past five years, she has worked at the Alta Bates Summit Comprehensive Cancer Center.
 
source site: www.selfgrowth.com

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Radiation and Chemotherapy Side Effects
by Remy Vixama
 
Formation of cancer cells results from mutation of normal cells that escape the normal restraint on cell division. That is, those cells function differently of other cells in a tissue. This anomie causes the development of cancer cells, which gradually multiply and possibly affect other normal tissues (metastasis). Without medical intervention, this abnormal overgrowth can cause a general degeneration of your body, and sometimes death. To stop the abnormal proliferation, your oncologist can use chemotherapy, radiation or both.

Chemotherapy - Chemotherapy is a systemic treatment of cancer consists of a combination of drugs administered at a precised interval. This can be done intravenously or orally. Those antineoplastic drugs kill “rapidly dividing cells”, which include cancer cells and, unfortunately, certain normal cells (cells in the blood, in the mouth, in the stomach and bowel, in the hair follicles, in the skin, etc.). Due to its damage on healthy cells, chemotherapy always causes side effects, which sometimes, last a lifetime.

Radiotherapy – radiation, in the other hand, is a therapeutic method involves exposing cancer cells to a controlled dose of radiation to kill them or makes them unable to multiply. Unlike chemotherapy, radiation treatment is not systematic. It is, in contrast, a locoregional treatment, which focuses its therapeutic action on the exposed body part (a tumor for instance). However, normal cells exposed to the radiation are also affected, causing side effects. Those side effects can be diverse and varied depending on the location of the irradiation.

To be more effective, radiation therapy is often associated with chemotherapy, which leads to more side effects. The damages of those therapies are enormous; it is impossible to name all of them in this article. Some adverse effects reported by individual undergoing chemotherapy and radiation include infertility, hair loss, nausea and vomiting, diarrhea, skin disorders, constipation, nail problems, hearing loss, fatigue, decreased sexual desire, irritation of the mouth, change in sleep habits, lack of appetite, and range of emotional problems. Some chemotherapy drugs may even increase your risk of heart disease and other cancer.

Side effects of chemotherapy and radiation are multiple; it is not an easy task to describe all of them in this article. On our website, we content not only to name them, but also the way to reverse them. cancer treatment can make your life miserable; there are, however, steps you can take to prevent or reverse those effects. For descriptive details on each steps, visit chemotherapyradiation.com, or click on the link in the resource box below


Author's Bio
Remy is a multi-topic writer with years of experience in nutrition and naturotherapy. He loves to share his own personal beneficial experience with natural alternative to others. For your research on health problems, beauty and personal care, please visit
chemotherapy radiation
 
source site: www.selfgrowth.com

Sleep Disorders and Breast Cancer Treatment

by PJ Hamel
Sunday, February 4th, 2007

Insomnia - the inability to fall asleep - keeps many of us awake deep into the night. Others of us fall asleep, only to awaken an hour or so later, then toss and turn the remainder of the night. My pattern during treatment was to fall asleep, then wake up 15 minutes later; after a half-hour or so of reading, I could fall asleep again, sleep maybe 30 minutes, then be wide awake.

This cycle would continue all night, for weeks on end. Looking back, I’m amazed I remained functional; living with sleeplessness - in the midst of chemotherapy - is a testament to how tough and resilient our bodies really are.

Menopause is also a huge sleep-disrupter. Our hormones thrown out of whack, neurotransmitters in our brains have trouble sending out the right sleep signals at the right time.

So, if you’re a breast cancer patient who was in the midst of menopause when diagnosed, or who’s undergone menopause due to chemotherapy, you’re facing a double whammy: cancer and menopause are a pretty good guarantee you won’t be sleeping well in the near future.

So what about the fact that even post-menopause, post-treatment, many of us still aren’t sleeping well? It may be that patterns of sleeplessness “learned” during those days have become imprinted in our brains, replacing our previous “norm” of eight hours of sleep.

Or we may simply be experiencing the effects of a well-known physical fact: as we age, we need less sleep. Whatever the reason, too many of us are wide awake at 3 a.m., staring at the ceiling as we try to will our way into comfortable slumber.

Why, oh why, with everything else going on in our lives, can sleep be so difficult?

Next time, I’ll focus on what’s actually keeping us up at night.

Sleep Disorders and Breast Cancer Treatment

by PJ Hamel
Sunday, February 4th, 2007

As I write these words, it’s 5 a.m. on a Sunday morning. I was up till 1:30 a.m. working on tax documents and college financial aid forms. Hmmm, 3 1/2 hours of sleep - sound familiar?

How can you get by on so little sleep?!”

That’s the question many of my friends pose to me, friends who

A) haven’t been through cancer,

B) haven’t been through menopause, and

C) are still in their 30s, that wonderful decade when the main thing disturbing your sleep is a hungry baby.

Me, I haven’t had a full eight hours of solid sleep in at least five years. And on the rare occasions when I sleep as long as three hours at a stretch, I awaken and think, “Ah yes, a good night’s sleep - I remember it fondly!”

While 1/4 of Americans report having sleep issues, studies show that up to 90% of cancer patients in active treatment have trouble sleeping. And for some, that sleeplessness ultimately stretches way beyond the end of treatment.

Tellingly, pharmacists at Houston’s M.D. Anderson Cancer Center report that Ambien, a popular sleep aid, is one of the most frequently prescribed non-chemotherapeutic drugs. Why are so many of us having so much trouble falling asleep, and staying asleep?

In the midst of treatment, there are multiple answers. Emotionally ravaged by what’s still a new and frightening shift in our interior landscape - living with cancer - we stay up late chasing down leads on the Internet about our particular type of illness, then fall into restless sleep only to awaken early, the challenges of the new day colliding with worries from the night before. Breast cancer drugs and radiation upset our delicate chemical balance, and sleep becomes a problem.

Chemotherapy Survival Guide: Dealing with Nausea
by Judith McKay, RN, OCN, & Tamera Schacher, RN, OCN, MSN
 
Here are some suggestions to help you get through your chemotherapy treatment. By preventing nausea you can be comfortable, stay well nourished, and feel better sooner.

BEFORE TREATMENT

It’s not necessary to have an empty stomach before getting chemotherapy. Staying well nourished and well hydrated (drinking lots of fluids) will help you feel stronger and help your body eliminate waste products more quickly. Eat and drink regularly until about two hours before your treatment. Eat foods that are easily digested (high carbohydrate, low fat). Stay away from spicy food or food that will give you a lingering aftertaste that may make you feel nauseated later (onions, garlic, and so on). Your doctor may want you to take anti-nausea medicine before coming to the clinic or hospital.

DURING TREATMENT

Do whatever you can to lower your anxiety. Bring a book, music, a CD, or a friend to occupy you while you’re waiting for treatment. Some anti-nausea medicine might make you feel sleepy, so sleeping through longer chemotherapy treatments might be possible. Wear comfortable clothes, loosen your belt or tie, and bring a sweater or ask for a blanket if you feel cold. Some chemotherapy drugs leave a metallic or unpleasant taste in your mouth, so sucking on hard candy or chewing gum might help.

AFTER TREATMENT

There are a number of things you can do to prevent nausea during the first few days after treatment. It’s important to let your doctor or nurses know if you’re experiencing unrelieved nausea or any troublesome side effects from the chemo or anti-nausea medicines, or having difficulty eating, drinking, sleeping, and so on.

+ Medications

Start by taking the medication in the dose and frequency recommended. For instance, if you’re getting a kind of chemotherapy that has very little chance of causing nausea, your doctor might recommend taking nausea-relieving medicine only if you experience that problem. Be sure to let your doctor know how often you needed it and whether it was effective.

If you’re getting chemotherapy that’s more likely to cause nausea, you may be given both nausea-blocking and nausea-rescue medications to take at specific times for the first few days after treatment. Then there may be a different combination of medicines that will relieve delayed nausea if the problem continues.

Be alert to any side effects that may occur, and notify your doctor or nurse as soon as possible if you have any problems. Remember, everyone has his own unique responses to treatment and to the anti-nausea medicines. Your doctor needs your feedback to make adjustments in the plan so that it works for you. You may need to change to a different medication. You may need to change the schedule, the dose, or the frequency of the medication, or you may need to add another medication to counteract a bothersome side effect.

+ Food and Fluids

Eat small amounts, more frequently. Avoid feeling overfull. Eat bland foods (mashed potatoes, cottage cheese, toast, sherbet, crackers).

You may be very sensitive to the way foods smell. Foods that are served cold or at room temperature have fewer aromas. Stay out of the kitchen as much as possible. Prepare dishes for yourself or the family that are quick and easy with minimal sights or odors that may upset you.

If you’re diabetic, you have to be careful that the medication you take to control your blood sugar is appropriate for how much you eat. You might need to check your blood sugar several times on the day of your treatment to make sure it doesn’t get too low or too high. Your doctor may want to adjust your insulin dose or other blood-sugar medication until you can eat normally.

Sometimes sweet juices are hard to tolerate after treatment. If that’s true for you, try lemonade, broth, club soda, or ice water. Try mixing a little juice with mineral water. You might need to try several different kinds of tastes before you discover what works best.

It’s most important to drink fluids. Don’t worry if, at first, you don’t feel like eating solid foods. Try Popsicles, tea, juices, soup, soda, watermelon, or ice. Drinking with your meal may make you feel overfull and bloated, so drink fluids before or after eating solid food. Drink small amounts of fluids frequently to avoid feeling too full. Rinse your mouth or brush your teeth before and after eating to avoid lingering tastes that may be nauseating.

+ Activities

Fresh air and mild physical activity help prevent nausea. Take a walk or sit on the porch or by an open window. Distractions may help. Go to the movies, read a book, talk to a friend, listen to music, or play cards.

+ Sleep

Some anti-nausea medications may make you sleepy. If you’re supposed to take a medication on a set schedule during the day, you may want to set the alarm clock so that you can wake up, take the medication, and then go back to sleep. If you aren’t scheduled to take anti-nausea medication in the middle of the night, then take it when you first wake up—before you get out of bed and start moving around.

+ Relaxation

If you feel anxious, relaxing may be easier said than done. There are a number of CDs and DVDs that you may find useful to help you clear your mind and relax every muscle in your body. You may find that the tension you hold in your face and jaw or in your shoulders or abdominal muscles is adding to your anxiety or feelings of queasiness. Some CDs or DVDs provide peaceful and relaxing images and music. After you practice with these aids for a period of time, you may be able to relax yourself very quickly with or without them anytime you feel tense or anxious.

+ Self –Talk

The things you say and think to yourself can either help you cope or cause you more stress. Many of these thoughts are unconscious and so automatic that you may not even be aware of them. Pay attention and try to tune in to what you may be saying to yourself that increases your stress and worries about nausea (or any other scary symptom). It may help to write these thoughts down. This makes them more conscious and more manageable. It also allows you to argue against them and replace these anxiety-provoking thoughts with thoughts that are supportive, accurate, and focused on coping.

Your anxiety-producing thoughts may sound like this:

• I can’t stand it; this is too much.

• I feel so helpless; there’s nothing I can do.

• The anti-nausea medicine isn’t working; nothing will help.

• I’ll never feel any better.

You can replace these anxious thoughts with supportive thoughts that help you cope:

• I can get through this. The discomfort will only last a few hours.

• If this medicine isn’t working to relieve my nausea, there are other medicines that I can try.

• The chemotherapy is effective, no matter how nauseated I feel.

• I’m learning how my body reacts to chemotherapy and to the anti-nausea medicines.

• I am in charge; I can take the medicine that I need in order to feel better.

• It’s okay to sleep and let the hours pass.

• The kids (or spouse or job) are taken care of for now. Right now I can pay attention to me and take care of myself.

• I know how to relax, distract myself, and feel better.

• I know that is here for me if I need him or her.

Write down your own coping thoughts. When you find your anxiety rising, tune in to what you’re silently saying to yourself and talk back, using the coping statements that help you feel better.

Excerpt from: THE CHEMOTHERAPY SURVIVAL GUIDE, THIRD EDITION: Everything You Need to Know to Get Through Treatment (New Harbinger Publications)

Author's Bio
Judith McKay, RN, OCN, received her degrees from California State University, Hayward, and has been an oncology nurse for more than twenty years. She works at the Alta Bates Comprehensive Cancer Center in Berkeley, CA. McKay is coauthor of When Anger Hurts: Quieting the Storm Within and contributed to the best-seller Self-Esteem.

Tamera Schacher, RN, OCN, MSN, is an oncology-certified nurse and a board-certified family nurse practitioner. For the past five years, she has worked at the Alta Bates Summit Comprehensive Cancer Center.

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Breast Cancer Treatment & Sleep Disorders

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