More and more research shows that regular exercise can improve physical and mental health for women with breast cancer. Now there’s new research that suggests regular exercise may improve quality of life for women living with metastatic breast cancer, the most advanced form of breast cancer.
Presented at the 2023 San Antonio Breast Cancer Symposium this week, study results suggest a supervised exercise program may help improve symptoms that often occur with metatstatic breast cancer and its treatment, such as fatigue, nausea, pain, and anxiety. The study included 357 participants with metastatic breast cancer, 178 of which took part in a nine-month exercise program. By the end of the study, participants reported more energy, less pain, and improved mental and emotional states than the 179 participants who were part of the control group.
“[During exercise sessions], patients were supervised by a physiotherapist or an exercise professional,” says study author Anne May, PhD, a professor at the Julius Center for Health Sciences and Primary Care at the University Medical Center in Utrecht, Netherlands. “Sometimes it was one-to-one supervision, but during most sessions the patients exercised in small groups.”
The research team measured participants’ physical, mental, emotional, and financial quality of life using questionnaires at enrollment, and after three, six, and nine months. To test for physical fitness, participants rode a stationary bike at increasing resistance until they had to stop.
Exercise is often recommended before and after breast cancer surgery, says Melanie Crutchfield Whitten, MD, a breast surgical oncologist at Methodist Le Bonheur Healthcare in Memphis, Tennessee, who was not involved in the study. “Exercising has also been shown to shrink some tumors before the operation,” Dr. Crutchfield Whitten says.
A study published in 2020 in Scientific Reports found that moderate to vigorous physical activity was associated with higher survival rates in people with metastatic breast cancer. Dr. May’s study, however, focused on symptom management and quality of life.
Previous studies have found positive effects of exercise on breast cancer symptoms and treatment side effects, but these have focused on less-advanced cancer types, according to May, who adds the research team is excited about these study results because they can be used to update guidelines for metastatic breast cancer treatment.
This study has not been published in a peer-reviewed journal, but its results have encouraging implications for those living with metastatic breast cancer.
6 Months of Exercise Resulted in a Higher Quality of Life and Less Pain
After six months, people in the exercise group reported a higher quality of life, measured by better social functioning, decreased pain, and improved breathing. Some people with metastatic breast cancer experience pain from the cancer itself but more often, pain shows up after surgery or during other treatments, according to Breastcancer.org. Exercise has previously been considered for cancer pain management, and with positive results, according to a meta-analysis published in 2023.
While the study authors are still investigating possible mechanisms for these effects, they have some ideas. For example, exercise may decrease symptoms of fatigue by lowering inflammation in the body, notes May, a concept reported in a study published in 2020. May also thinks higher quality of life questionnaire scores could be credited to fewer complaints of fatigue, pain, and dyspnea along with more physical activity, allowing more time and energy for family life and social activity.
People in the Exercise Group Had More Physical Strength
Many people with breast cancer report fatigue and weakness during their illness and while undergoing treatment, according to Breastcancer.org. But after only six months, study participants in the exercise group found that on the stationary bike, they could reach a 13 percent higher resistance level than those in the nonexercise group.
Exercise also increases endurance, according to the American Heart Association. “In addition, exercise can help with fatigue that so many people experience while going through chemotherapy,” says Crutchfield Whitten.
Everyone has different thresholds for physical activity, and Crutchfield Whitten recommends speaking with your medical team to decide on an exercise plan. “For my patients who are not actively undergoing treatment, the American Cancer Society recommends 150 minutes of exercise a week, with at least 30 minutes of that being a strength-related exercise. That comes out to about 30 minutes a day, five days a week,” says Crutchfield Whitten.
The nine-month program may have helped people make exercise part of their everyday routine, said May in a press release. Many of the study participants kept up their exercise programs after they completed the study.
More Research Is Needed
Based on the study results, May recommends healthcare providers should offer supervised exercise to their patients with metastatic breast cancer and that policymakers and insurance companies need to ensure these treatments are covered under health plans. This study has opened the door to this possibility and future research may prompt a change in metastatic breast cancer care guidelines.
Exercise guidelines have been lacking in metastatic breast cancer due to a lack of studies like this one, says May. Some patients may even worry that exercise will worsen their symptoms, she says, but this study shows it can improve them.
