DEAR MAYO CLINIC: I've always been active, but after being diagnosed with breast cancer and starting my treatment, I'm a little worried about getting back into my routine. Is it OK to exercise during cancer treatment?

ANSWER: Exercise decreases the risk of developing cancer. Studies have shown there is a 30%- 35% reduction in the risk of breast cancer among the most physically active women compared with those who are least active. Exercise also plays a protective role in many other cancers, including lung, endometrial, colon, kidney, bladder and esophageal.

However, exercise can also be helpful during and after cancer treatment. According to the American Cancer Society, research shows that exercise during cancer treatment can improve physical functioning and quality of life.

Moderate exercise can:

• Increase strength and endurance.
• Strengthen the cardiovascular system.
• Reduce depression.
• Decrease anxiety.
• Diminish fatigue.
• Improve mood.
• Raise self-esteem.
• Lessen pain.
• Improve sleep.

Of course, there may be certain issues that prevent or affect a person's ability to exercise due to disease or type of treatment, including:

• Anemia — having a low number of red blood cells or quantity of hemoglobin or protein.
• Weak immune system.
• Some forms of radiation treatment.
• Some surgeries limit certain exercises.

Some people should use extra care to reduce the risk of injury, including older people and those with bone disease, arthritis, or nerve damage, also called peripheral neuropathy.

Exciting studies show that regular physical activity is linked to increased life expectancy after a cancer diagnosis. In many cases, it also decreases the risk of cancer recurrence. Multiple studies in cancer survivors, with the strongest evidence in breast and colon cancer survivors, have suggested that physically active cancer survivors have a lower risk of cancer recurrence and improved survival compared with those who are inactive.

The American Cancer Society, the American Institute for Cancer Research, the American College of Sports Medicine, and the U.S. Department of Health and Human Services all advocate physical activity for cancer patients and survivors.

The American Cancer Society recommends cancer survivors take these actions:

• Participate in regular physical activity.
• Avoid inactivity and return to normal daily activities as soon as possible after diagnosis.
• Exercise at least 150 minutes per week.
• Include strength training exercises at least two days per week.

Not everyone is ready to head to the gym during or after cancer therapy. However, reconnecting with an activity you like to do can increase your enjoyment and ability to stick with an exercise program. Exercise may include a bike ride with friends or chasing your dog around the park.

Walking is a great activity for almost everyone, and swimming can be a wonderful alternative for those with joint issues. Yoga is fantastic for strengthening, flexibility and balance concerns.

Kaye Sturz, D.N.P., Hematology/Oncology, Mayo Clinic Health System, Eau Claire, Wisconsin

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