Being physically active is one of the most important things you can do for your health. It can help you control your weight, lower your risk of heart disease, and maintain healthy bones. It may even lower the risk of breast cancer recurrence (breast cancer coming back in the breast or in other parts of the body).
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Research shows that young adults with breast cancer often exercise less and gain weight during treatment. There may be good reasons for this: you may be tired, depressed, or not feeling well. But studies tell us it’s important to keep up an exercise routine, particularly young adults with breast cancer, because they are more likely to gain weight than older adults with breast cancer. Chemotherapy treatment and early menopause also can cause weight gain.
Read a Dana-Farber tip sheet about weight management. Other important reasons for adults with breast cancer to get regular physical activity are to:
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For all of these reasons, cancer experts agree that physical activity is one of the keys to good health, both now and in the future. They offer three main recommendations for young adults with breast cancer:
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Frequently Asked Questions about Physical Activity
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Is physical activity safe for me?
When first diagnosed with breast cancer, many young adults wonder if physical activity is safe for them. The answer is yes! In general, if you were in good health before you were diagnosed, it should be safe for you to exercise now.
The American College of Sports Medicine (ACSM), the world's largest organization of sports medicine and exercise science experts, has developed exercise guidelines for people undergoing cancer treatment and for cancer survivors. Walking is a safe type of exercise for almost all people with cancer. Before starting upper-body exercises, talk with your doctor or an exercise professional familiar with the needs of people going through breast cancer treatment. This person can help you prevent arm injuries or lymphedema by being careful about upper-body exercises, including some yoga poses. Most people with breast cancer don't need a professional fitness evaluation to start exercising at a moderate level of intensity (like brisk walking). However, it's always a good idea to talk with your doctor before you begin any new exercise program. During any kind of activity, be sure to drink plenty of water and listen to your body if it asks you to slow down or stop. Possible side effects of treatment, such as diarrhea or vomiting, may contribute to dehydration. |
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What kind of exercise should I be doing?
There is no single right answer for everybody. Physical activity after surgery can ease sore, stiff muscles and reduce pain and swelling. The American Cancer Society recommends that people do not exercise until the third day after surgery, and that they exercise gently until the end of the first week. During this time, use the arm affected by surgery for day-to-day activities (brushing your teeth, eating, getting dressed) as usual. Discuss with your surgeon what activity plan might be best for you.
For more information about exercising and breast cancer, visit: American Cancer Society: Exercises after breast surgery. If your doctor says exercise is OK, you should get a good amount of moderate, aerobic (cardio) activity during and after your treatment for breast cancer. Aerobic activity is any exercise that makes you breathe a little heavier and get a little bit sweaty. Heavier breathing makes your body work harder, which is good for your heart and lungs. Other important types of physical activity include weight-bearing exercises and strength training exercises. As a young adult with breast cancer, you should also be aware of a condition called lymphedema. This extreme swelling in areas where you've had breast cancer treatments can be painful and make it hard to exercise. |
Aerobic activity
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Aerobic activity can be either moderate or vigorous. Experts recommend that all people (with or without breast cancer) get at least:
One easy way to reach 150 minutes of exercise a week is to briskly walk at least 10,000 steps a day. Walking is good, because you can do it anywhere and you don’t need any special equipment. All you need is a sturdy pair of shoes and a little motivation. To help you reach your walking goals, try:
The great news is that moderate and vigorous activity are both linked with a longer, healthier life. Basically, that means brisk walking is just as good for you as running. |
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Moderate intensity activity
During moderate activity, you will notice that your heart rate and breathing will get faster and you may sweat a bit. If you are not used to being active, you may be slightly sore for a day or two afterwards. How do you know if you’re working at moderate intensity?
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Examples of moderate activities include:
- Walking quickly
- Golfing, pulling or carrying clubs
- Swimming or treading water
- Rollerblading
- Bicycling at 5 to 9 mph
- Canoeing or kayaking
- Zumba and other types of dancing
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Vigorous activity
Vigorous activity requires more effort than moderate activity. During vigorous activity, you will notice that your heart rate and breathing will get much faster, you will be very sweaty, and you may not be able to talk easily. Some examples of vigorous activity are:
Interval training: To add some variety into your workouts, try aerobic interval training. This is when you add short bursts, just a minute or a little longer, of very vigorous activity into your exercise plan. Then you slow down and recover and do it again. For example, you can sprint for a minute or two then walk for a few minutes then sprint again when you feel ready. Keep alternating between bursts of vigorous activity and lower intensity activity until you have reached 20 or 30 minutes. |
Dr. Jennifer Ligibel - Director, Leonard P. Zakim Center for Integrative Therapies and Healthy Living
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Weight-bearing workouts
Weight-bearing exercise means that you're working against gravity. This is important for your body, because it strengthens your bones. Walking is one weight-bearing exercise. Others include jogging or running, climbing stairs, and dancing. Non-weight-bearing exercises include swimming, water aerobics, and biking. Strength training Strength training, or lifting weights, helps build strong muscles, bones, and joints. It also seems to boost metabolism (the way your body turns food into energy). It's good to include strength training in your exercise routine. However, as a young adult with breast cancer, you should be aware that some people may develop lymphedema when they lift heavy weights. Read a Dana-Farber teaching sheet on exercise and cancer. |
Exercise and Lymphedema
Lymphedema is when fluid builds up in the tissues of a particular part of the body and causes painful swelling. After breast cancer surgery or radiation, you may develop or be at risk for developing this condition. If so, it will most likely affect your arm or breast/chest area on the side of your body where you received treatment.
Research has changed our understanding of lymphedema in recent years. Moderate upper-body strength training does not seem to increase a person's risk of developing this kind of severe swelling. In fact, moderate upper-body strength training may actually decrease symptoms for people who have lymphedema. Some experts recommend that individuals wear a lymphedema sleeve whenever they do upper-body exercises. By compressing (squeezing) your arm, these sleeves can lessen or prevent lymphedema and reduce pain.
If you choose to try upper-body exercises, be sure to consult with an exercise professional who specializes in working with adults who have breast cancer. Your upper body may be weak from treatments. It is important to listen to your body and not push yourself too hard. Your instructor can help you build (or rebuild) a strength training routine where you use very light weights. Then start very slowly, take it easy, and listen to your body.
To find an instructor, visit the website of the American College of Sports Medicine (ACSM). You can also check your local YMCA for Livestrong program classes.
Read a Dana-Farber teaching sheet about lymphedema.
Lymphedema is when fluid builds up in the tissues of a particular part of the body and causes painful swelling. After breast cancer surgery or radiation, you may develop or be at risk for developing this condition. If so, it will most likely affect your arm or breast/chest area on the side of your body where you received treatment.
Research has changed our understanding of lymphedema in recent years. Moderate upper-body strength training does not seem to increase a person's risk of developing this kind of severe swelling. In fact, moderate upper-body strength training may actually decrease symptoms for people who have lymphedema. Some experts recommend that individuals wear a lymphedema sleeve whenever they do upper-body exercises. By compressing (squeezing) your arm, these sleeves can lessen or prevent lymphedema and reduce pain.
If you choose to try upper-body exercises, be sure to consult with an exercise professional who specializes in working with adults who have breast cancer. Your upper body may be weak from treatments. It is important to listen to your body and not push yourself too hard. Your instructor can help you build (or rebuild) a strength training routine where you use very light weights. Then start very slowly, take it easy, and listen to your body.
To find an instructor, visit the website of the American College of Sports Medicine (ACSM). You can also check your local YMCA for Livestrong program classes.
Read a Dana-Farber teaching sheet about lymphedema.
Strategies for success
It can be hard to make health changes and stick with them. Change rarely happens by chance, and the people who stick with it for good find that it really helps to make a plan. As you work on your plan to get (or keep) moving, we offer some strategies and tips.
It can be hard to make health changes and stick with them. Change rarely happens by chance, and the people who stick with it for good find that it really helps to make a plan. As you work on your plan to get (or keep) moving, we offer some strategies and tips.
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Make a motivation list
Physical activity can reduce depression, elevate mood, and increase self-esteem. Whether you're a seasoned exerciser, just getting started, or somewhere in between, take a moment to think about what motivates you. Make a list of the reasons why physical activity is good for you, and why it’s especially important to your health now. People who aren't physically active—or who stop exercising—often ignore these benefits. They also may not believe they can overcome the things that stop them from exercising. As you create your list, think about which benefits and reasons are most important to you personally. For example, you may want to improve your stamina, so you can be more active with your kids. You may want to lose weight, so your clothes fit better. Be sure to put your list in a place where you will see it regularly. |
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Pick a goal
Whether you're a beginner or upping your intensity level, picking a goal that's right for you is an important first step. Remember, the recommended goal is 150 minutes or more of moderate physical activity (or 75 minutes or more of vigorous activity) per week. To reach that goal, you should exercise for a short time every day or for a longer time a few days a week. Do what works best for your lifestyle. Just remember that your exercise should last for at least 10 minutes at a time, before it counts toward your goal. A goal should be specific (says exactly what you will do) and realistic (something you really can do). For example, saying "I want to exercise more" is not specific. You won't know if you are actually meeting this goal. Instead, think of a goal like "I will walk at least 30 minutes, five days each week." This is specific and realistic; in short, it’s a great goal. When thinking about your physical activity goals, remember FIT:
After a while, rethink your goal. Is it too easy? If so, you might want to make your walks longer or add some vigorous activity to your routine. A good way to do this is to jog for a bit during a walk. |
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Take it slow
If you're just beginning to exercise, or starting up again after a break, be realistic; don't try to ramp up all at once. If you get more physical activity than you are used to at one time, you may overdo it. Taking on too much may also make you feel discouraged and frustrated. So, make these changes gradually and start with a small, reachable goal. For example, a great long-term goal is to walk for 30 minutes or more per day (or until you reach 10,000 steps in a day). However, it might be unrealistic to meet that goal right from the beginning, and that's OK. If you are new to this, start with a goal of walking 20 minutes a day (or until you reach 5,000 steps a day). After you meet this goal for two weeks, add some more minutes (or steps) to your goal. Gradually continue to add time or steps each day, until you eventually reach your long-term goal. |
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Stay safe
As you get ready to walk more, follow these tips:
Follow these tips for a safe walk:
Stretching is a good way to prevent injury. It also helps make you more flexible and can increase joint movement. But it is important to get your muscles warmed up before stretching. Walk, jog, or run, and then consider doing some stretches. Check out 6 yoga stretches for breast cancer patients. |
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Track your progress
Whether you're new to exercise or not, keeping a record or log of your progress can help you move toward your physical activity goal (or maintain it). For example, you can track the total distance, number of steps, or minutes you walk each day. A tracking log clearly shows your progress, as it's happening. It also lets you follow how you're doing from one day to the next and how close you are to reaching your overall goal. In addition to tracking your progress, you may want to keep track of barriers—things that get in the way or make it hard for you to meet your goals. Try to think of ways to overcome them. For a list of some common barriers and suggested solutions, see the Overcoming Challenges section of this page. If you are trying to change other health habits, consider tracking them, too. For example, you might want to increase the number of fruits and vegetables you eat. Start by writing down the number of servings you eat now, and decide how many more you want to add to your diet. There are many free apps available for you to log this information on your phone. Count your steps: Want to know how many steps you walk each day? If you have a smartphone, you may be able to download an app that will count or track your steps. There are also devices, such as a Fitbit, that you can wear on your wrist. The goal is to briskly walk 10,000 steps a day. 10,000 steps or more is good for your health. This may sound like a lot, but you can work up to it over time. Also, you don't need to walk all the steps at once, you can spread them throughout your day. To get more steps:
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Be patient
People often get tired when they start to exercise more, and breast cancer treatment can be particularly draining. If you already exercise, your treatment schedule may make it hard to find time for physical activity, but keep at it! Because your treatments may leave you with less energy than you're used to, you may want to rethink your workouts. You might need to switch to a new kind of activity or stop exercising completely for a short time. Even so, try not to get discouraged. Most people who try to exercise are successful. Listen to your body and be patient. In general, you should try to fit 30 or more minutes of moderate activity into your day. If necessary, you can break your workouts into several 10-minute chunks or do 15 minutes in the morning and 15 in the evening. If you're not up to being physically active, give yourself permission to take a day off or to do a little less than usual. Instead of walking for 30 minutes, go for 15. Even a short walk can help you feel better physically and raise your spirits. |
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Celebrate!
In any case, be proud of yourself for trying. Pat yourself on the back for starting—or continuing—an exercise program while you're in treatment. Focus on positive thoughts and celebrate your successes. After meeting your goal for a week or more, do something nice for yourself. You could go to the movies, go shopping, or go out with a friend. Do whatever feels like a reward to you! |
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Buddy up!
Choose an exercise buddy to support you. This person can be a friend, family member, coworker, neighbor, or anyone else you think can help. The most important thing is that you feel comfortable telling this person that you have breast cancer. Knowing about your treatments and their possible side effects will give your buddy a chance to offer extra support when you need it most. Explain what your exercise goal is and be specific. Also, think about what kind of help you need. If you want your buddy to exercise with you, plan ahead and schedule times to exercise together. If you want your buddy to take care of your kids while you exercise, figure out some specific dates and times in advance. If you want your buddy to check on your progress, think about how often, and ask your buddy to stick with that plan. (We recommend checking in at least once a week, in person or over the phone.) Ask your buddy to encourage you and acknowledge your hard work. There will be days when you may be discouraged or tired from your treatment. Those are the days when you'll really appreciate an extra boost. Make sure your buddy knows that. Explain that if you hit a stumbling block, nagging won't help but encouraging words will. |
Overcoming Challenges
There are many common challenges to physical activity during breast cancer treatment. There are also many strategies for turning them around or moving past them.
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Fatigue: Your treatment may make you tired. But moderate exercise (like walking briskly or riding a bike) makes your blood circulate better and brings more oxygen to your brain. This can make you feel more energized and ready for even more activity.
Read a Dana-Farber teaching sheet about fatigue. |
Sleep: It is important to get good, sound sleep. If you exercise, you will probably sleep better and feel more rested the next day. You may also find that you need to take naps, even if you've never been a regular napper in the past. If you get tired during the day, take a 5- to 10-minute nap. Allow yourself that down time. Afterwards, move ahead with your day, take a walk around the block, or go up and down a few flights of stairs at work.
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Lower energy or less strength: If you are used to exercising, you may find that you can't do as much as you're used to, but there's no need to push it. Your body needs time to heal. Slowly work your way back up to where you'd like to be. If you usually walk for 30 minutes at a time, walk for 10 minutes instead. Over time, you can work back up to your full 30 minutes or more. Once you get to that point, think about whether you're ready to take on more.
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Depression: It's OK to feel depressed or angry that you have breast cancer. The time it takes to work through these emotions is different for everybody. However, one great tool for combating them is physical activity. Try to get some physical activity on most days of the week. Even 10 minutes of exercise is good for your physical and mental health.
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In the short term, moving and being active can improve your mood and make you feel better. In the long-term, studies show that physical activity is particularly good for young adults living with breast cancer.
If you feel down, try taking a walk. Even a short one may make you feel better. Invite a friend to walk with you and talk about how you're feeling. Walking and talking may help to raise your spirits more quickly.
On days when you're depressed or angry about your diagnosis, or you're just worn out, it's OK to take a break. Allow yourself to skip a day or do less than you would like. If you can't shake your depression or anger over time, be sure to ask your doctor for resources and referrals. It can be very helpful to talk with someone about how you're feeling.
On days when you're depressed or angry about your diagnosis, or you're just worn out, it's OK to take a break. Allow yourself to skip a day or do less than you would like. If you can't shake your depression or anger over time, be sure to ask your doctor for resources and referrals. It can be very helpful to talk with someone about how you're feeling.
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Finding the right exercise space: Exercising publicly can pose unique challenges for young adults experiencing physical changes due to their breast cancer treatment. For example, wearing a wig or breast prostheses may make you feel self-conscious. It's important to find a place to exercise where you feel comfortable. Many people have gone through this, and they have found places that might also work for you.
Workout comfort: Many people remain or become active after a diagnosis. Whether or not you are a seasoned athlete, new to exercise, or somewhere in the middle, you may have questions about some of the practical aspects of exercise during and after breast cancer treatment, such as: Where can I buy a sports bra or swimsuit that will meet my needs? Can I exercise in a wig? |
Wearing the right athletic clothing can increase your comfort and your confidence when you exercise. Many stores and online merchants offer clothing and athletic gear developed specifically for people with breast cancer—for example, bathing suits, sports bras, and sun protective clothing. Look for this clothing online, in some specialty intimate apparel stores, or in boutiques at cancer centers.
Deciding what is best to wear, or not wear, on your head should be based on whatever helps you feel most comfortable. Options include wigs, headwraps, scarves, hats, or nothing. Some adults purchase a wig specifically for exercising to keep their day-to-day wig sweat-free. Or you may want to wear a net underneath your regular wig and wash it every 7-14 days.
If you exercise outdoors and your head is exposed, protect yourself with a broad-brimmed hat and sunblock with at least SPF 15.
Deciding what is best to wear, or not wear, on your head should be based on whatever helps you feel most comfortable. Options include wigs, headwraps, scarves, hats, or nothing. Some adults purchase a wig specifically for exercising to keep their day-to-day wig sweat-free. Or you may want to wear a net underneath your regular wig and wash it every 7-14 days.
If you exercise outdoors and your head is exposed, protect yourself with a broad-brimmed hat and sunblock with at least SPF 15.
Staying Active All Year Round
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The American Society of Clinical Oncology website provides useful information, including podcasts, for tackling the extremes of weather in the summer and winter:
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