Study Finds That Cardio and Strength Training Can Bring Benefits for Stage IV Breast Cancer Patients

A new study suggests that women undergoing treatment for metastatic breast cancer might find respite from fatigue and an overall enhancement of life quality through exercise.

Previous studies have demonstrated that exercise can be both practical and beneficial for individuals receiving treatment for early-stage breast cancer.

However, "there's a significant gap in research when it comes to advanced breast cancer", says Dr. Jennifer Ligibel, head of the Zakim Center for Integrated Therapies at Boston's Dana-Farber Cancer Institute.

Concerns have been raised in some studies over whether individuals with metastatic cancer, given the advanced stage and distribution of their cancer, would be capable of exercise.

But "this study validates that patients with metastatic cancer can indeed exercise", explains Dr. Neil Iyengar, a breast cancer and exercise oncologist at Memorial Sloan Kettering Cancer Center, in his discussion with Health.

Next, the article explores how exercise may enhance life quality for breast cancer patients, and details some exercises doctors recommend these patients try.

Treatment for stage IV—metastatic—breast cancer is usually more enduring than treatment for earlier-stage breast cancer, making life quality improvement during treatment crucial for these patients, says Dr. Anne May, who is steering this new research.

If an individual's metastatic breast cancer is hormone-sensitive, hormone therapy, often combined with a targeted cancer drug, forms the main treatment strategy.

For non-hormone-sensitive types, treatment usually involves chemotherapy, often a drug combination.

The fresh study aimed to establish whether a structured exercise program could alleviate some typical side effects of these treatments, such as fatigue, nausea, pain, and breathing difficulties.

May, also a professor at the Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, in the Netherlands, disclosed the preliminary results of the ongoing trial at the San Antonio Breast Cancer Symposium held early in December.

So far, nearly 360 individuals with metastatic breast cancer participate in the Europe-based clinical trial. About half of them have joined in a structured twice-weekly exercise program, which mixes aerobic and strength training.

All sessions were supervised by a physical therapist or another exercise professional, typically held in group settings, though occasionally the settings were one-on-one.

Ligibel highlights that the study's strength lies in that the women were on various treatment regimens, including both hormone therapy and chemotherapy.

At three, six, and nine months, everyone completed questionnaires to assess their physical, mental, emotional, and financial life quality, as well as their daily fatigue levels.

The team also evaluated the physical fitness of these individuals, requesting participants to pedal on a stationary bike with progressive resistance until they needed to stop.

Participants who exercised reported decreased fatigue and a better overall perception of life quality, including mitigated pain, compared to those who didn't take part in the program.

The strength of the exercise group also saw a marked improvement.

After six months, the fitness enthusiasts could ride a stationary bike with an improved resistance of 13% compared to the control group. Many supportees pressed on with their regimen even after nine months.

The findings still require peer-reviewed journal publication, and further studies are necessary to pinpoint how exercise exactly eases cancer treatment side effects, Iyengar admits. But the results certainly align with those of earlier trials investigating exercise benefits in individuals with less advanced breast cancer stages.

Exercise can mitigate fatigue by enhancing cardiopulmonary fitness—stamina of both the cardiovascular and respiratory systems.

“Exercise certainly offers a mental boost as well," Iyengar comments. "It can enhance mood, memory, and cognitive function."

May advises individuals receiving therapy for metastatic breast cancer to consult their doctors before embarking on an exercise routine.

Exercise should be customised per an individual's physical fitness and side effect profile. A trusted healthcare provider's supervision is optimal for accomplishing this.

“Any kind of physical activity is better than none," May adds, but agrees that higher intensity exercise typically comes with greater benefits.

Strength training could be especially crucial since muscle mass loss is common among those receiving cancer treatment, Ligibel notes.

“Strength training can take a lot of different forms; you don’t need weights,” she explained. “Doing core exercise and using your own body weight is exercise meant to strengthen your muscles.”

In addition to strength training, cardio can provide benefits to cancer patients, like relieving fatigue, Iyengar said.

If fatigue increases after exercising regularly, people should speak with their physician about ways they can adjust their workouts, May added.

Movements, whether cardio or strength training, can be tailored to accommodate cancer side effects such as the loss of movement in a limb, issues with balance, or neuropathy, Iyengar said.

Again, any new movement strategy should be discussed with a medical professional.

“A lot of people will have bone metastasis, and evidence has shown that exercise is safe for these people, but there are considerations such as where the metastatic lesions are and where you are putting weight,” Ligibel said. “That warrants a talk with someone in the medical setting.”