One forward-thinking oncologist is a pioneer in exercise for breast cancer patients and survivors. More than 20 years ago, one of the organizers of the 1995 Danskin Women’s Triathlon Series approached Dr. Julie Gralow, a Seattle oncologist, and asked her to put together a team of breast cancer survivors to participate in the event. Intrigued by the idea, she asked her patients if they were interested. With a little encouragement from her, Gralow recruited many volunteers, who became engaged and physically active.
The experience had a profound effect on Gralow, who in addition to her clinical work, has become a strong advocate for breast cancer survivors in the United States and abroad. In fact, her accomplishments were recently recognized by the American Society of Clinical Onology (ASCO), which gave her its 2018 Humanitarian Award.
During that first event, Gralow saw how empowering exercise was for women who had been through surgery, radiation, and chemotherapy. “Women lost weight and felt better about themselves and how they look,” Gralow said. It also turned out to be a support group, where women meet other women, find an exercise partner, or get help training for an event.”
This initial experience led to the formation of Team Survivor Northwest, which supports women as they strive to make healthy lifestyle choices following cancer treatment. “I’m a firm believer in realistic goal setting,” added Gralow. “Setting a goal that forces someone to stretch a bit but is not out of reach can make a tremendous difference in a woman’s life.”
Following this advice is especially important for women with estrogen-receptor positive breast cancer—which affects about 75 to 80 percent of this population. These women are typically prescribed adjuvant endocrine therapy, also called hormonal therapy, to prevent a recurrence. But endocrine therapy, while lifesaving, also has a down side: It depletes estrogen supplies from the body, which can contribute to bone loss.
Premenopausal women are typically prescribed tamoxifen, which can contribute to bone loss. For postmenopausal women, however, the medicine of choice is a class of drugs called aromatase inhibitors. Research has shown that these drugs wreak havoc on the bones, potentially leading to osteopenia and osteoporosis. Both conditions result in weakened bones and even fractures.
Exercise is one way to counter these effects. Weight-bearing exercises, such as squats, lunges, and stair-climbing, have been shown to be particularly helpful. That said, any kind of exercise can help improve balance, reduce fractures and minimize falls. For example, swimming and yoga can help improve muscle strength and coordination. Nonetheless, more research is needed to identify which types of exercise work best for breast cancer survivors.
But don’t wait until science catches up with what anecdotal information has already shown to be true. A good workout among fellow survivors can go a long way toward building healthy bones and an enduring supportive community.
About Our Author
Marilyn Fenichel is a science writer based in Silver Spring, Maryland. She writes often about cancer for CURE and Cancer Today magazines, the American Society for Clinical Oncology, and other organizations.