Getting Strong with Exercise After Breast Cancer

by: Naomi Aaronson MA OTR/L CHT

Add html Getting Strong With Exercise After Breast Cancer By Naomi Aaronson MA, OTR/L, CHT We are bombarded daily with conflicting messages regarding exercise and diet. If you have had breast cancer, it is even more confusing. Should you exercise after surgery? When should exercise begin? What kind of exercises should you do? Should you use weights if you are at risk for developing lymphedema? What if you feel pain when you exercise? The information that follows can help you to begin an exercise program to increase flexibility and strength in the affected arm and develop better posture after undergoing breast cancer surgery. This information can help to facilitate your recovery and reduce lymphedema risk. It is not intended to be a substitute for medical advice, and a physician’s clearance should be obtained before you begin this or any exercise program. Exercise After Surgery Most women are able to begin light exercise to the shoulder, arm, back, and hand after the surgical drains are removed. Before you begin, you should talk with your doctor about the exercises that you intend to do. It is important to strengthen your arm after surgery. This will help you to perform daily activities, such as lifting children or groceries, more easily. Strengthening the arm also will help to prevent musculoskeletal problems due to muscle imbalances and weakness. Young women who are put into premature menopause early due to chemotherapy and women who use an aromatase inhibitor as their hormonal therapy are at increased risk of osteoporosis. For these women, exercises that strengthen the back, hips, and wrists are a necessity to reduce the risk of fractures. Lymphedema Lymphedema is a chronic condition characterized by the swelling of a body part. It occurs when lymphatic fluid builds up because it cannot drain properly due to malfunctioning of the lymphatic system. Lymphedema is estimated to effect up to 40 percent of women whose breast cancer treatment included lymph node dissection and/ or radiation. If you are at risk of developing lymphedema, you must proceed slowly with an exercise program. Before you begin any of these exercises, you should consult an occupational therapist or physical therapist who can teach you what exercises to do and can help you learn the right way to do them. Your physical therapist or occupational therapist will probably suggest that you perform exercises that will strengthen the muscles around the shoulder and shoulder girdle, as this can facilitate alternative lymphatic pathways and help reduce the risk of developing lymphedema. Exercises that can strengthen this area work on the anterior deltoid, middle deltoid, triceps, and rotator cuff. Exercises that strengthen the lower back and abdominals are important as well. It is necessary that you learn how to do these strengthening exercises properly. Doing the exercises the wrong way may lead to injury and won’t build the muscles that you are trying to focus on. Your physical therapist or occupational therapist may recommend that you wear a sleeve on the affected arm. A sleeve is a type of compression garment. Sleeves provide gentle pressure that helps to return lymphatic fluid back to the heart, they also support the muscle as it contracts. You may need to wear the sleeve while you go about your daily activities as well as when you exercise. Check Your Posture It is important to have good posture while you are exercising. It is quite common to find postural changes after surgery. As you are exercising check and see: Is your head forward? Are your shoulders slumped forward? Is your back hunched? Look into a mirror and try to correct yourself by planting your feet under you shoulders and keeping your knees unlocked. The chest should be lifted with the shoulder blades back. Line up your ears over your shoulders. There should be a gentle curve in your neck and lower back. Warm Up: Neck and Shoulder Rolls Neck rolls and shoulder rolls are a good warm-up that can be done right before you start a formal exercise program or begin your daily activities. Use a deep breathing technique that can assist with pain management and the return of lymphatic fluid to the heart. As you inhale, feel your abdominals and chest expand; as you exhale feel them flatten. Take 5 counts to inhale and 5 counts to exhale. It is natural to feel some pain, as you just went through major surgery. But you should not feel a lot of pain. Keep going if you have some discomfort. If you have a lot of pain, stop. Slowly and gradually, while using the deep breathing technique, try to do more rolls each time you exercise. If you find that you need assistance performing the exercises described below ( such as the shoulder lift) or that you are experiencing a lot of pain, ask your physician for a referral to an occupational therapist or physical therapist who is skilled in this area. Increase Range of Motion: Stretching One of your goals should be to improve your range of motion. Performing stretching exercises that focus on the armpit and the chest area can do this. These should be done daily for up to two years after surgery to promote flexibility. These exercises can help stretch scar tissue, which can severely limit range of motion, and which continues to form for up to two years after surgery. It is better to do several repetitions of a few exercises over the course of the day rather than perform all of your stretching exercises at once. When you begin, you should do each stretch five times. Your goal is to hold each stretch at the furthest point you can achieve for ten seconds. Gradually increase the time allotted to 15-20 seconds. Then gradually increase the number of repetitions until you are doing each stretch 10 times. If you are at risk for developing lymphedema, you will want to speak with your physical therapist or occupational therapist about how to monitor your arm. This is typically done by using a tape measure to measure the circumference of your arm in five different places. You should measure before you begin any exercise program. These measurements will be your baseline. Future measurements will be compared against these initial measurements, to allow you to see if any changes have occurred. Balls, towels, and ropes are tools you can use while stretching to help you regain your range of motion. All these tools allow you to use your strong arm to support the arm affected by the surgery. You may want to begin with the shoulder lift. To perform this exercise, you position yourself on your back with both knees bent. Hold the ball with both hands and slowly raise it to your face and as far overhead as you can. Keep both elbows straight. Work on gradually stretching the affected arm as high as the other. Exhale as you slowly lift the ball overhead. Gravity will assist you in getting it higher each time. Work for slow gradual changes. Variations include lifting the ball to both the right and left sides (once you are able to get it further overhead) or kneeling and stretching the ball from side to side. Another good stretch as you get stronger is the triceps stretch which stretches the axillary (armpit) region where lymph nodes were removed. Although it is tempting to avoid using the arm, try to do your daily activities, such as making the bed, folding laundry, or drying the dishes. This will increase your range of motion and strength. Keeping your arm elevated, with the elbow above the heart with pillows, especially at night, can also help to reduce swelling and promote lymphatic flow back to the heart. Strength Training Strength training to the affected arm should only begin after full mobility has been achieved in the arm. While waiting for this to occur, you can still do strength-training exercises for the back, legs, hips, and unaffected arm, unless you have received reconstructive surgery. In that case, you must wait until you have your doctor’s approval to begin an exercise program. You should warm-up, check your posture, and stretch, before you begin your strength-training exercises. When you begin, you should start with light weights that are no more than 1 lb. for the affected arm. (Even if you used to work out a lot and lift heavy weights, you still need to start with 1 lb. Going back to lifting heavy weights right away may increase your risk of developing lymphedema.) For strength training to be beneficial, it should be performed two to three times per week to each muscle group. You can gradually increase the weight once you see how your arm and body responds. Perform one set (12 repetitions is one set) for each muscle group. Rest after each set or change arms. Stay at the same weight for three weeks and then gradually increase the number of sets. You will slowly increase both weight and sets, but you should not increase both at the same time. Be sure to breathe deeply and to exhale as you lift the weight and inhale as you lower it. 1 set=12 repetitions Example: Deltoid Raises Week 1 Week 2 Week 3 Week 4 1 lb., 1 sets 1 lb., 2 sets 1lbs., 3sets increase weight to 2 lbs., 2 sets Monitor your arm for swelling. If swelling increases, the weight or number of sets was too much and you need to go back to what you were doing previously. Be alert to the signs and symptoms of lymphedema. This includes a feeling of heaviness or fullness in the arm, aching in the limb, rings that don’t fit, or a pins and needle sensation in the limb. If any of these problems develop consult your physician immediately. If your breast cancer treatment did not include lymph node dissection and/ or radiation, you are not at risk for lymphedema and can proceed more quickly. In this instance, you can increase the weight once you see how your arm and body responds. Below is a guide for how to increase weights and repetitions. This is just a guide. Different muscles get stronger faster so, for example, it is often possible to increase weight for leg exercises sooner than you can for shoulder exercises. 1 set=12 repetitions Example: Deltoid Raises Week 1 Week 2 Week 3 Week 4 1 lb., 2 sets 1 lb., 3 sets 2lbs., 3sets 2 lbs., 3 sets Aerobic Conditioning Aerobic conditioning can help improve cardiovascular endurance. This is your ability to sustain heart-pumping activity for increasing periods of time. Aerobic activities are those that use the large muscles in the legs, along with the arms, to bring the heart rate up for a continuous period of time. Dancing, swimming, running, and walking are all examples of aerobic activities. While you are undergoing treatment, you will want to do an activity that is easy and safe, such as walking or riding a stationary bicycle. Start with five minutes of walking and then gradually increase the duration of time you walk or bike to 20-30 minutes. Try to do an aerobic exercise three to five times per week. Once treatment is over and you are less fatigued and less prone to infections or treatment-related side effects, you can increase the intensity of the exercise (how hard you work) as well as the duration (the amount of time you exercise). You can also add more variety to your workout regimen by taking part in other types of aerobic activities. By following a slow, gradual approach to exercise you will have the best chance of optimizing your participation in the leisure and daily activities that you enjoy. You may even find that, before long, you are even stronger than you were before. Naomi Aaronson is an occupational therapist and fitness professional who specializes in breast cancer recovery. Naomi believes that exercise after surgery is instrumental in healing mind and body. She is the author of the Breast Cancer Recovery Exercise Manual, which is used to educate fitness instructors on breast cancer rehabilitation. You can visit Naomi’s web site at http://www.recovercisesforwellness.com/ The pictures in this article are from Naomi’s CD Recovercises: Exercise For Breast Cancer Survivors, which can be purchased through her web site. You can contact Naomi at recovercises@aol.com. References: Burt, J White, B Lymphedema (1999) Hunter House Publications Courneya ,K Mackey, J and Mckenzie, D Exercise for Breast Cancer Survivors Research Evidence and Clinical Guidelines The Physician and Sports Medicine Vol. 30 # 8 August 2002 Harris, S Hugi,M Olivotto, I and Levine,M Clinical Practice Guidelines for the care and treatment of breast cancer : 11. Lymphedema Canadian Medical Association Journal January 23,2001; 164 Lasinski, Bonnie B. Exercise, Lymphedema, and The Limb at Risk www.lymphedema-therapy.com/Exercise.htm Miller, L Exercise in Breast Cancer Related Lymphedema” Innovations in Cancer Care 3 (4) 101-106 September 1998 Stumm, D Recovery from Breast Surgery (1995) Hunter House Publications back to top <<

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Cancer and Exercise

CT Fox, Certified Cancer Exercise Specialist

EXERCISE AND CANCER by CT Fox, Certified Cancer Exercise Specialist

“You have cancer.” These words rip through your entire being with the horrendous force of an atomic blast. Suddenly, everything is inside-out, upside-down. Your mind tries to wrap itself around this new and frightening reality. The somber-faced doctor looking at you from across his desk surely must have you mistaken for somebody else. How can this be? Are you kidding me? Will I die? Once having worked through the myriad of denials, when the acceptance of the news finally settles in, it does so with gut-wrenching agony.

You have entered a new and foreign world. Life is now no longer just about getting the kids ready for school, walking the dog, dropping off the laundry, planning dinner for the family, cleaning the house, meeting deadlines, spending time with friends, or the minutia of daily living. Life is now also about survival.

The speed at which things begin to happen can be terrifying. You quickly have to make some decisions regarding treatment that will move your life in a direction you never anticipated. Your life may seem like it is spinning completely out of control. “Overwhelmed” is an inadequate word for the experience.

There is nothing that can totally remove the fear and the shock of discovering that you have cancer. You can, however, do something significant that will help you regain the feeling of being in control of your life, your body, and your destiny EXERCISE!

You might be tired, depressed, frustrated, drained, worn-out, and have limited strength and functional capacity. Activities of daily living might become an unimaginable challenge. Good news; moderate physical exercise has been proven to help fight the possible physical and emotional side effects of cancer and associated treatment. It can be part of your personal recipe
for living stronger.

EXERCISE, your weapon, can help you make significant improvement in the following areas; stamina, functional capacity, strength, range of motion and flexibility, treatment tolerance, self-esteem, self-confidence, increased ability to perform activities of daily living.. Exercise can also help decrease pain, decrease depression and total mood disturbances, reduce sleep problems, anxiety, nausea, and cancer related fatigue. Quite simply, it can help you get your life back.

It has long been thought that staying active can lower the risk of getting cancer, but new findings
show that it can also be a valuable prescription for recovery.

A recent study, released March 2004, done by Brigham and Women’s Hospital in Boston,
found that women who exercised after breast cancer reduced their chance of dying from the disease by one-quarter to one-half, depending on their level of activity.

Although there are many expert theories, it is biologically unclear as to how exercise
accomplishes this feat. Researchers do agree that moderate activity is an unquestionably
safe recommendation and that it can have a myriad of benefits.

For breast cancer survivors, getting back normal range of motion in the affected arm can be challenging, at best. The surgical arm can feel extremely tight. Simple tasks, such as reaching
a high kitchen cabinet can prove to be difficult.
Presumably, after surgery for breast cancer, the surgeon will refer the patient to a Cancer Exercise Specialist (or a physical therapist trained to work with breast cancer patients) for initial
assessment of range of motion, lymphedema precaution instructions, and exercise education.
If the surgeon has not offered that as a viable option to you, ask about it.

A Cancer Exercise Specialist can put together an exercise program that is tailored to your individual needs and limitations. A regimen of progressive milestones will undoubtedly provide you with a sense of accomplishment and confidence, as well as bolster your self-esteem.

The goals of your exercise program should include; increasing your energy levels; improve your posture by stretching tight muscles and strengthening muscles that are weak; increase your range of motion through stretching and movement exercises that emphasize your upper body, and
improving your quality of life by enhancing your physical and mental condition.

When you begin an exercise program, do not be discouraged if you find that you tire easily. Fighting and surviving cancer, takes emotional, spiritual, physical, and mental energy.
You might also find that certain movements cause you discomfort. Working through slight
discomfort is acceptable, but you should never try and work through any kind of pain.

Being consistent with your program will assist you in getting past these issues. It will also provide you with benefits you may not have even imagined possible when you were first diagnosed with cancer.


“Keeping up with a regular exercise program is great for my mental health.” It gives me something to look forward to, breaks up the monotony of my house-bound days, and gives me more energy. It helps me maintain a better self-image to see the positive changes in my body.
I feel strong and in control.

I believe that keeping physically active and keeping myself strong are going to help me fight and beat this not unconquerable enemy. Somebody has to beat the odds. There is absolutely no reason why it won’t be me.”

CJB – Stage IV uterine cancer


Hold close to your heart the fact that while cancer may have invaded your body, it does not have to invade your spirit.

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Passive Smokers Can Get Breast Cancer

by: Jasdeep Singh

US scientists have claimed that secondhand smokers are at higher risk of Breast Cancer. Earlier, their research also led to them to the conclusion that young women smokers are more likely to get addicted to smoking than young men.

Breast Cancer is the number one cancer among women and the count of its victim are rising very rapidly. This is for the first time that passive smoking has been directly linked with some sort of cancer. World Health Organization links smoking with 25 Cancers: Some of these cancers are : uterine, kidneys, cervix, pancreas, head and neck... The study firmly proves that smoking is not only injurious to your health but also to the company you are with. Wake Up!

Smoking doesn't stop here with its side-effects. For women, smoking also increases the risk of strokes and heart diseases. And to add fuel to the fire, chances for heart related diseases gets ten-fold if they are taking birth-control pills side by side.

Besides this, smoking is also responsible for :

. Bad breath and stained teeth

. Risk of stomach ulcers and acid reflux.

. Charm on the face vanishes. Wrinkles develop soon.

. Setting up wrong examples for your children.

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Breast Cancer Causes and Treatment

by: Michal

About Breast Cancer:
Breast cancer is a type of uncontrolled growth of abnormal cells that can develop in one of several areas of the breast, including the ducts that carry milk to the nipple, the small sacs that produce milk (lobules) and the nonglandular tissue.Breast Cancer is estimated that 192,200 women and 1,500 men in the United States will be diagnosed with Breast cancer in 2001. Though rare in men, Breast cancer accounts for 31% of all cancer diagnosed in women. Breast cancer is a disease in which cancer cells are found in Breast tissue. There are numerous types of Breast cancer. For example, ductile cancer, found in the cells of the ducts, is the most common type of Breast cancer. Cancer that begins in the lobes or lobules is called lobular cancer. Treatment will depend on the type of Breast cancer and stage of the disease. There are also many non-cancerous (benign) Breast diseases as well.
Symptoms of Breast Cancer:
1.A lump or thickening in the breast or under the arm.
2.A clear or bloody discharge from the nipple.
3.Crusting or scaling of the nipple.
4.Nipples that don't stick out (inverted).
5.Redness or swelling of the breast.
6.Dimpling on the breast skin resembling the texture of an orange.
7.A change in the contours of the breast, such as one being higher than the other.
8.A sore or ulcer on the skin of the breast that does not heal.
Causes of Breast Cancer:
The exact cause of cancer remains a mystery. Over twenty percent of those who have cancer never know why. The primary parts that are involved are the natural parts of food, tobacco, occupational hazards, genetic composition and food additives. Other agents that have been linked with cancer are ionizing radiation, chemicals in the air and diet, vitamin deficiency, high-fat diet, stress and environmental conditions.
Diagnosis:
Biopsy: Used to diagnose tumors, a biopsy tests cells removed surgically or through aspiration for microscopic examination.
Cytology test: A test that shows the shedding of abnormal cells. A good example of a cytology test is pap smear.
Imaging techniques: low dose x-rays such as those used in a mammogram can detect early Breast cancer. Ultrasound scanners can also produce images of organs.
Chemical testing: Detect the presence of blood in the feces or elevated levels of enzyme acid phosphates in the blood.
Ultrasound: A new ultrasound technique used after a mammogram can help reduce uncertainty about whether a Breast mass is cancerous or not.
Home Care Suggestions:
-Avoid tobacco in all forms, synthetic hormones, particularly estrogen, excessive alcohol, caffeine.
-To minimize hair loss apply cold packs to the scalp while taking radiation or therapy.
-Engage in mild exercise such as walking and make it part of your daily ritual.
-If you ever receive a serious diagnosis of any kind, one of the most important things you can do is to free your mind of daily concerns.
More Detail About Breast Cancer

Author By Michal John

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Vitamins and Cancer Prevention

by: Tim Whiston

Much has been studied about the role of certain vitamins, minerals and herbs
in cancer prevention. Some of the most promising cancer prevention
properties come from those vitamins that are known as antioxidants.

Antioxidants are substances that protect the body's cells from damage caused
by dangerous free radicals, which can potentially cause cancer. There are
many different sources of antioxidants, including herbs, vitamins, and
foods. Here are some of the most widely recommended supplements thought to
help prevent cancer by fighting free radicals:

Beta Carotene: Beta carotene is thought to reduce the risk of cancer,
especially lung cancer. Beta carotene is naturally occurring in red and
orange foods such as pumpkin, squash, carrots, and red peppers. Beta
carotene can also be found in dark leafy greens like spinach and kale.

Lutein: Lutein can help prevent colon cancer and encourage good eye health.
Find lutein in dark green vegetables like collard greens, kale and spinach.

Lycopene: Lycopene has been studied for it's prostate cancer preventing
properties. Tomato products are the best sources of lycopene. Studies have
shown that processed tomato products like canned tomatoes, soups and juices
are higher in lycopene than fresh tomatoes.

Vitamin A:Vitamin A, whose most common form is retinol, is a powerful
antioxidant with cancer preventing properties that is found in such foods as
liver, carrots, milk, egg yolk and sweet potatoes.

Vitamin C: Getting enough Vitamin C can help prevent cancers of the mouth,
throat, esophagus, lung and colon. Vitamin C is found in citrus fruits,
berries, broccoli, and even lean poultry, beef and types of fish.

Vitamin E: Vitamin E is thought to prevent certain types of cancer such as
prostate cancer and can be found in foods like green, leafy vegetables,
fortified cereals, wheat germ oil and almonds.

Green Tea: Green tea is a powerful source of free-radical fighting
antioxidants. Drink green tea in it's natural form or try a supplement if
you can't stand the taste.

It's a good idea to eat a balanced diet rich in fruits, vegetables, lean
protein and healthy fat like the omegas found in wild salmon. You can add
vitamin supplements to your diet as well. Try a multivitamin that contains
a specialized blend of all the vitamins required for total-body health.

Before adding nutritional supplements to your diet, talk to your doctor or
nutritionist to be sure you take the right dosage and tell them what
medications you are taking to avoid possibly dangerous interactions.

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First Time Intercourse

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Kegel Exercises

by: Amy Otis, BSN, RN

Kegel Exercises

A kegel is the name of a pelvic floor exercise, named after Dr. Kegel who discovered the exercise in 1948. I call them “the invisible exercise”, since you can do them when no one else can tell. Kegels are a series of exercises which can help tighten up the pubococcygeal muscles (PC muscles). These originate from your pubic bone, go under your genitals and attach to your tailbone. Both men and women have them.

After pelvic surgery, pregnancy, or even as we age, these muscles lose their tone. This can result in a loss of bladder control, also called incontinence, a loose vagina, (especially after having a child), an inability to control ejaculation in guys, and a reduction of sexual pleasure for both men and women.

There are several ways to do kegel exercises. One method requires you to have a full bladder, sit on the toilet and start to urinate, then suddenly clamp down and stop the flow. Start and stop several times in a row. If you can’t cut off the flow of urine, but dribble on, you need to start kegel exercises for sure. From now on, every time you urinate start and stop all the way. This is often called “the faucet” and is a good indicator of your progress.

You can also do kegels right at your desk, even right now. Tighten your PC muscles and hold for a count of eight, then slowly release and repeat eight times. Yes, you can do these sitting at the computer or at your desk at work or school. (But don’t let that distract you from your teacher or boss). If you can’t make it to eight or ten in the beginning, use a lower number and do those until you build up to ten.

Another good time to do kegels, is when you are the passenger in a car. Every time you stop at a red light, do some, who will know but you.

Not only does this improve bladder control, but doing kegels regularly will improve your sex life. After doing kegel exercises, a woman will be able to clamp down and grip her partner’s penis increasing both their sexual pleasures. You men should notice an improvement in the 'intensity' of your erections and ejaculations. These exercises are also recommended for guys who experience premature ejaculation. While the penis is not a muscle, the increased muscle tone will improve blood supply resulting in firmer erections and also help a man to delay ejaculation. Kegels can also help prevent leaking urine when you sneeze or cough!

Like any other muscle group, you either “use it or lose it”. For honest answer about your sexual health see:

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