A Harvard University study in the Journal of the American Medical Association found that regular exercise can improve the survival of patients with breast cancer. What does that mean in practical terms?
I have discussed these findings with Dr. Christopher Peters of the Dunmore-based Northeast Radiation Oncology Centers, who says he regularly counsels his patients about the value of exercise in the recovery from breast cancer. As found in the study, he recommends aerobic exercise, such as walking and biking, and mild resistance exercise. He also encourages patients to enroll in a formal rehabilitation program, especially to prevent a frozen shoulder if invasive surgery was performed.
Previous studies also have shown many benefits of exercise for breast cancer patients, including improving immune functioning and controlling depression. A study conducted at Vanderbilt University found that women who had high activity levels throughout life were less likely to develop endometrial cancer. At the Hutchinson Cancer Research Center in Seattle, researchers found that exercise with moderate intensity can reduce serum markers of inflammation (C-reactive protein), which, when elevated, are associated with chronic disease and poor cancer survival.
But the newer research, presented at an American Association for Cancer Research meeting, was the first to conclude that physical exercise may improve survival in breast cancer patients. The Harvard researchers compared survival rates in women with breast cancer, measuring exercise levels in terms of metabolic equivalent hours per week. While women with high activity levels of exercise had the best outcomes, even women with moderate exercise benefited.
The benefits of exercise in women with breast cancer include: possibly increased survival; less risk of endometrial cancer; improved C-reactive protein levels; improved autoimmune function; control of depression; psychosocial value (builds confidence, fosters control, develops new skills); and promotes healthy mind, body and spirit.
General guidelines
Medical clearance: Talk to your physician to get clearance for exercise. Remember, each patient must be individually evaluated by a physician to determine the extent of their problem and the appropriateness of exercise. Once medically cleared, seek the advice of a physical therapist to assess your needs and design a program for you.
Aerobic exercise: three to five days per week, moderate intensity, 20 to 60 minutes.
Strength training: two to three days per week, light to moderate weight; wear a compression sleeve during exercise if you have lymphedema (swelling in the affected arm).
Flexibility exercise
Flexibility exercises involve moving the arms, legs and trunk through a comfortable range of motion to give you more mobility, making it easier for you to perform daily activities such as tucking in a shirt, tying shoes or fastening a bra. These are best performed after strength exercises because the muscles and joints will be warm and limber. Always perform slowly with a slight stretch sensation and no pain. No bouncing or overstretching.
Examples of flexibility exercises for the upper body, to be performed slowly while sitting in a chair with a backrest; five repetitions, three to five times per week.
• Shoulder raise: Clasp hands together, raise arms up to forehead, then above head, as high as comfortably possible.
• Hands behind head: Raise arms behind head by first touching ears, then back of head.
• Hands behind back: Bring arms behind back by first touching the side pocket, then back pocket and toward the small of the back as comfortably possible.
Examples of flexibility exercises for the lower body, to be performed while lying on back in bed:
• Knees to chest: Bring knee toward chest using hands; right leg five times, left leg five times, both legs five times.
• Leg spread: Spread legs apart by sliding heels on bed.
• Leg cross: Bring legs together to touch by sliding heels on bed.
• Gas pedals: Pump ankles up and down like using a gas pedal.
Balance exercise
Balance exercises involve strengthening muscles that keep the body upright and stable in standing, improving your ability to perform daily activities without falling. According to the National Institutes of Health, 300,000 U.S. hospital admissions for broken hips occur each year due to falls. Check with your physician if you have a history of dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Always use a countertop or back of a chair to hold onto for support.
Examples of balance exercises:
• Sitting squat: Squat up and down in a chair; first use both arms to assist, then one arm.
• Standing march: March legs up and down while holding onto countertop.
• Standing scissors: Bring one leg out and cross over the other like a scissors, one leg at a time.
• Standing squat: Squat down by bending at hips, with knees bent 20-30 degrees, while holding onto countertop.
• Dance: Slow dancing with a partner is great fun and a very helpful exercise to improve balance.
Endurance exercise
Endurance exercises involve any activity, such as walking, swimming, biking or raking leaves, that elevates your heart rate and breathing for an extended period of time. Check with your physician if you have a history of heart problems or dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Start off slowly for only five minutes and add a minute or two each week. Wear good, comfortable shoes; no heels.
While not all of these endurance exercises may be appropriate for you, one or two may offer a good starting point:
• Walk around the house: Start walking around the house for one to two minutes nonstop, every one to two hours; add a minute or two every week.
• Static marching: Hold onto a countertop or back of a chair and march in place for 30 seconds; rest for a minute or two and repeat; do five cycles; add five to 10 seconds every week.
• Climb the steps: If you can do so safely, use the steps for exercise once or twice per day, adding repetitions as you advance.
• Walk the mall/treadmill: If you are able to get out of the house and can tolerate more extensive endurance exercises, walk a mall or use a treadmill.
• Recumbent bike: If balance is a problem but you can tolerate more extensive endurance exercise, use a recumbent bike (a bike with a backrest).
Paul J. Mackarey, P.T., D.H.Sc., is a doctor in health sciences specializing in orthopedic and sports physical therapy. He is in private practice in Scranton and Clarks Summit and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. Email: mackareypt@gmail.com.
Originally Published: October 26, 2025 at 12:00 AM EDT