Weight Gain

Scientific research shows that two-thirds of all breast cancer survivors gain approximately three pounds, plus a 2% increase in body fat, between the time of their diagnosis and two years later. The main causes of weight gain are medical treatment, higher disease stages and physical inactivity. Because weight gain and obesity are associated with a prognosis of recurrence risk or poor survival, some researchers are looking closely at the potential of physical activity to help cancer survivors maintain or lose weight.

Melinda Irwin, Ph.D., M.P.H., assistant professor in the Department of Epidemiology and Public Health at the Yale University School of Medicine, has been immersed in a number of studies assessing various aspects of physical activity among breast cancer survivors. A trained exercise physiologist, Dr. Irwin is convinced of the value of physical activity not only in helping to control weight, but also in helping patients feel better.

"Many women think that if they exercise, they are going to feel more tired,” she says. “In fact, the opposite is true. There are lots of small studies that show that exercise during treatment is associated with improved quality of life—including decreased fatigue and nausea.

"The women in our current studies all report feeling better when they come back from a walk than they did before,” she says. "Many studies show, too, that women who exercise during and after treatment have decreased depression and an overall higher quality of life.”

According to Dr. Irwin, the level of physical activity proposed for the general population is moderate intensity exercise, such as walking, for 30 minutes a day, five days a week. These recommendations come from both the Centers for Disease Control and Prevention and the American College of Sports Medicine. In the Health, Eating, Activity and Lifestyle (HEAL) study published in the September 2004 issue of Medicine, Science, Sports & Exercise and in the February 1, 2005 issue of the Journal of Clinical Oncology, Dr. Irwin and her colleagues assessed the physical activity levels of 806 breast cancer survivors. They found that only 32% of these women participated in the recommended levels of exercise. She and her colleagues also found that being active is associated with less weight gain.

In current studies aimed at further understanding how physical activity changes risk factors for breast cancer, and what kinds of exercise women like most, Dr. Irwin is working with newly diagnosed breast cancer survivors as well as those who have recently completed treatment.

Both groups of women were asked what form of physical activity program they most preferred. Dr. Irwin says all women wanted a home-based program with a weekly phone call from an exercise trainer or physiologist—along with access to a gym close to home where they could work out with a free membership. Most women didn’t want to meet a personal trainer at a gym at a pre-arranged time. They preferred the flexibility to work out at a convenient time for them.

Because most newly diagnosed patients may not feel like going to a gym and working out there, the women in the study followed the book Active Living Every Day: 20 Weeks to Lifelong Vitality, by Steven N. Blair et al., which is broken into weekly chapters. This book is filled with lots motivational tips, such as the following:

• Because social support is important, find a friend or family member to exercise with you.

• Plan ahead and schedule your walk or other activity.

• Plan ahead for bad weather. If it is raining, for example, walk at the mall instead of around your neighborhood.
  

One problem with any illness, and particularly with a serious illness such as breast cancer, is that patients may feel upset and saddened that their life is out of control. Embarking on a planned exercise program, however, is something very positive that every woman can do for herself.

Dr. Irwin especially encourages women to walk. "Walking for even five minutes during your treatment is better than nothing—whether it is walking at the mall or in your neighborhood," she says. "And after treatment, try to meet the current cardiovascular goal of 30 minutes, five days a week, of moderate intensity exercise. This may be sufficient to improve your prognosis."

This article first appeared in the Spring 2005 issue of Lifeline.

Think your experience is uncommon? Want to speak with someone who has gone through a similar one? Call the Y-ME Hotline at 800-221-2141 and speak with a trained peer counselor who is a breast cancer survivor.

November 2007