“During my chemotherapy treatment, I went to yoga every week. Every day I walked with my sister as much as I could, four, five or even six kilometres. I came home physically exhausted, but I rested mentally and felt much better.” Cristina T., a 36-year-old from Zaragoza, is one of the many breast cancer patients who turned to sport as a “lifeline” in one of the worst moments of their lives. But her case is not unique… There are many more cancer patients who have followed her example.
That physical exercise is a very effective tool for preventing and managing many of the consequences of cancer is not only perceived by patients themselves, but is also scientific evidence. In recent years, there have been more and more scientific publications on oncology that include studies that defend, with great rigor, how physical exercise improves cancer parameters , from prevention to the phase of preparing the patient for treatment.
“It has been seen that practicing physical exercise helps reduce the risk of suffering from cancer by up to 30% (breast, colon, bladder, endometrium and stomach) and reduces the risk of specific mortality by 20%,” says Julio Lambea, oncologist at the Hospital Clínico de Zaragoza and president of the Spanish Association Against Cancer in the Aragonese capital.
It has been known for years that physical exercise is a very effective tool for preventing and managing many of the consequences of cancer itself. In this regard, Dr. Elena Aguirre, director of the Quirónsalud Oncology Institute in Zaragoza, recommends a series of guidelines that can help reduce the risk of breast cancer.
“Clinical guidelines, as well as the World Health Organization (WHO), recommend a type of exercise combined with 150 minutes of cardiovascular activity per week , such as walking, running or swimming, and two sessions per week of strength training of about 30 minutes each. At the same time, it is advisable to follow a Mediterranean diet, rich in fruits and vegetables, limiting fats and avoiding alcohol,” she points out.
Once the diagnosis is in hand, it has also been proven that starting to do physical exercise before starting with the treatments can have numerous benefits for subsequent recovery. ” This is included within the concept of prehabilitation, an approach from various disciplines, of which we have a pioneering unit in Zaragoza,” explains Pablo Gargallo, physiotherapist, teacher and researcher at the San Jorge University, and member of the Physiotherapy Guidance Service of the Spanish Association Against Cancer of Zaragoza, a service that is the result of the collaboration between both entities.
In the case of pain, physical exercise can contribute to a significant improvement, although this will require the involvement of a multidisciplinary team so that “at each stage of the disease, the appropriate measures are taken. In addition to the oncologist, this team must include a rehabilitation physician, nutritionists, and other medical professionals,” says Julio Lambea, an oncologist at the Hospital Clínico de Zaragoza.
Patients diagnosed with cancer also find exercise to be a great companion on their journey to mitigate the side effects. In the case of breast cancer, it has been found that between 16 and 43% of those affected suffer functional limitation in the shoulder, and also inflammation, pain or reduced strength and flexibility in the upper limb one year after the operation.
In addition, they witness strong episodes of fatigue, depression or lymphedema, in some cases. “One of the main problems is asthenia , an intense fatigue that affects the majority of women undergoing oncological treatments ,” explains Elena Aguirre, who assures that sport helps to combat this exhaustion, improving their quality of life and becoming an essential element for their physical and emotional well-being.
Another aspect that is improved with physical exercise is bone health, which in the oncological process is usually altered by some treatments, such as hormonal ones. “In this case, it is necessary to do exercise with a sufficient and adequate load stimulus to produce improvements.
Even in those people with bone metastasis, something unfortunately common in advanced stages of breast cancer, physical exercise is a safe and effective option when it is properly prescribed. Perhaps not so much to improve the state of the bones, but to improve the capacity for movement and even to reduce pain,” says Pablo Gargallo, physiotherapist and teacher.
When it comes to choosing the most appropriate type of exercise, all the physical activity and exercise guides from the main health entities recommend including aerobic exercise and strength training, although most also recommend other types of exercise such as flexibility, balance or coordination.
There are many reasons why it is recommended to include these two main types of exercise: they improve cardiorespiratory fitness, help prevent and/or manage many side effects, have beneficial effects on the immune system, and are even believed to improve tolerance to some cancer treatments.
“Furthermore, it is becoming clear that a higher percentage of muscle mass and muscle strength not only has repercussions on movement or the risk of falls, but the muscle also acts as an important regulatory organ in the body,” confirms Pablo Gargallo.
And while it is true that exercise is good for cancer patients before, during and after treatment, other studies claim that ” higher levels of physical activity are associated with a lower risk of recurrence. But not only that, it also reduces the risk of suffering from other health problems that are very prevalent in people with cancer, such as cardiovascular problems, and even the risk of mortality from cancer or other diseases,” concludes Gargallo.
