Physical therapy can be a key factor in recovery following breast cancer

Breast cancer survivors and patients can become stronger and healthier — mentally and physically — with physical therapy, according to healthcare experts who say the treatment can often be a crucial piece of the recovery process.

Experts agree that getting quick referrals to physical therapy can halt pain and loss of mobility, especially in breast cancer patients’ arms and upper body resulting from breast or lymph node surgery.

Maria Jaramillo, a 57-year-old mother of two and grandmother of four who lives in Berwyn, is a breast-cancer survivor who got timely physical therapy and in the process became a vigorous exercise enthusiast.

Jaramillo had surgery and chemotherapy nearly a decade ago and now works out at least twice a week by walking and using exercise machines at the Loyola Fitness Center — a regimen she said lets her battle fatigue, chronic shoulder pain and cancer-related swelling near her armpit.

“I have more energy,” she said.

When Jaramillo goes to the fitness center in the mornings, she walks for 35 to 45 minutes and then exercises for 20 minutes on an “arm bike,” also known as an upper-body ergometer, in which you pedal the machine with your arms. The arm bike improves arm muscles.

She walks for another 45 minutes in the afternoons in her neighborhood.

October is Breast Cancer Awareness Month — the perfect reminder to get a mammogram. . Experts say that hospitals and treatment centers have COVID-19 safety measures in place to encourage appointments; and it’s vitally important to detect breast cancer as early as possible through regular screenings.

Leslie J. Waltke, a doctor of physical therapy who is an oncology physical therapy specialist and cancer rehab coordinator for Advocate Aurora Health, designed four stretches (see diagram below) for breast cancer patients to combat muscle tissue shortening, connective tissue shortening or thickening and layers of tissue sticking together — all which can cause muscle aches. (No one should attempt the exercises without first consulting their own physician.)

Leslie J. Waltke

Eric Hughes, a doctor of physical therapy and physical therapy facility manager at SHIFT/Athletico, a private concierge wellness center at 750 N. Orleans, said people who’ve had breast cancer surgery can suffer from restricted mobility because of what’s known as cording — Axillary Web Syndrome — when tissue under the arm scars.

The situation can be offset in many cases by getting immediate physical therapy, which could include lymph massage, gentle stretching, myofascial release, soft-tissue manipulation and physical therapist-guided massage, he said.

Long-term, experts say it’s important that breast cancer patients boost their health by going beyond stretching into regular cardio and weight-resistance exercises.

“Lifting weights is good,” Waltke said. “It decreases the risk of muscle and bone loss and makes people stronger and healthier. The more you use the arm, the less pain, the less chance for long-term side effects.

“We recommend every patient get a physical therapist. We don’t want people to assume, ‘I’m supposed to be weak and not use that arm again,’ ” she said.

Doctors say they work with patients to access some type of healthcare insurance coverage and ensure that the uninsured and underinsured get access to physical and other therapies.

Waltke set up and leads the Waltke Cancer Rehabilitation Academy based in Milwaukee, which trains doctors, hospitals and other care centers in building rehab programs for all types of cancer.

Dr. Shelly Lo, an oncologist at Loyola University Medical Center who specializes in breast cancer, refers patients to Loyola’s Center for Fitness, adjacent to the Maywood medical center, to help them regain strength and mobility.

The fitness center’s Next Steps Fitness Programs starts with a personalized assessment, then takes into account patients’ goals and makes sure they exercise with a trainer’s guidance. The goal is to motivate the breast cancer survivors to keep up their own exercise routines.

Anthony Vazquez/Sun-Times

Lo, also a professor of medicine at Loyola’s Stritch School of Medicine, said she sees to it that patients who develop lymphedema — arm or breast swelling due to breast cancer treatment — get referred to physical therapists with expertise in complete decongestive therapy.

“The sooner treatment is started, the more successful it can be,” she said.

Another little-talked-about after-effect of breast cancer treatment is weight gain — as much as 20 pounds — which can cause joint pain and mental distress. That’s a concern because obesity is a risk factor for breast cancer.

So Patricia Sheean a registered dietitian and assistant professor of nutrition at Loyola University Chicago’s Parkinson School of Health Sciences and Public Health, said she urges breast cancer patients, like anyone else, to get at least 150 minutes a week of moderate to vigorous physical activity and eat a healthy, plant-focused diet. That’s the recommendation of the American Cancer Society and the American Institute for Cancer Research once doctors clear patients for exercise.

Sheean was one of 19 co-investigators, along with principal investigator Dr. Melinda Stolley, who conducted a breast-cancer survivor study among African-American women. Studies show Black women have lower breast cancer survival rates than their white counterparts partly because their cancer tends to be detected at later stages.

In the study, the women regularly exercised and made important dietary changes to lose 3 percent of their body weight, resulting in improvements in body fat and muscle mass. The study may have implications for inflammation, blood pressure and cardiovascular disease — indicators of breast cancer recurrence and chronic disease risk, Sheean said. The study, funded by the National Cancer Institute, was published in the Journal of Clinical Oncology.

Even women with Stage 4 breast cancer — the most advanced — showed tremendous improvement in quality of life, particularly combating fatigue and boosting physical functioning, after following a strict exercise regimen and plant-based eating, Sheean said of a more recent study undergoing peer review.

“This supports that lifestyle behaviors are critical to feeling better and reducing symptoms caused by breast cancer or breast-cancer treatments,” she said.

NOTE: Please consult with your doctor or other health care provider before attempting any exercises depicted in this article.

Sandra Guy is a freelance writer.