Exercise after breast and ovarian cancer

Cancer treatment leaves life-long side-effects. You lack sleep, have low energy, mood swings, physical degeneration, bowel and bladder incontinence where stool and urine come out without control, unexplained tiredness, swollen hands and feet, and joint and muscle pain.

But you can rehabilitate your body after cancer or during treatment.

Bhavan Bhavsar, a physical specialist at MP Shah Hospital, says rehabilitation is important in cancer care as it eases pain and anxiety, improves body image, increases sexuality and energy, and it helps maintain bone health.

Sometimes taking painkillers or hormonal drugs changes nothing.

One of the ways to improve the quality of life after cancer is exercise. For those with breast cancer, start exercising the first week after surgery, Mr Bhavsar says.

“Basic exercises will help in the flexibility of the arms but do them carefully so that you don't injure the wound,” he says.

Start with lifting shoulders, folding arms onto shoulder, putting hands akimbo, putting arms backward across the head while lying flat, or touching neck, arms folded.

“Repeat the exercises twice daily for 15-20 minutes. But if you have removable stitches or a drain, wait until they have been removed,” the specialist says.

After the second week, advance to exercises like stretching the chest and shoulder muscles. Start by lifting one bent knee while holding onto a chair or do wall presses. Also, lift your heels, one hand holding the wall.

“Six weeks after mastectomy [removal of the breast] or radiotherapy or chemotherapy. You can add strength exercises. Do half press-ups, hand pull-ups, or use dumbbells.” When using dumbbells, hold them slightly wider, pull them up, allowing your elbows to jut out.

Another challenge after breast cancer surgery is lymphedema, where the hand swells. “About 80 percent of cancer patients get lymphatic problems," says Mr Bhavsar, who specialises in cancer, neuro, stroke pain rehabilitation.

Exercises can improve the flow of the lymphatic fluid to prevent swelling. Lie on your back with knees folded and rotate the stretched arms clockwise or place hands on the wall at an angle and lifting the palm.

"Patients usually experience tightness in the chest and armpit after surgery. The tightness decreases after exercises. Do them five to seven times twice a day until you get back your normal flexibility. Some women experience tingling or numbness or soreness at the back of the arm or chest wall. Take deep breathes when exercising.

There is also the option of manually draining the fluid by massage. But do not go to a masseuse. Look for a specialist. You can also wear compression sleeves or buy a compression machine at Sh50,000 to Sh100,000.

For ovarian cancer, most women will have surgery to remove the ovaries and fallopian tubes and the womb, including the cervix.

After surgery, patients may have vaginal bleeding, bowel and bladder problems where urine and stool leaks and swelling of the legs due to removal of lymph nodes.

After chemotherapy, many experience fatigue, nausea, hair loss, joint and muscle pain, and numbness or tingling on the hands and feet, a condition called neuropathy.

“Some chemo drugs have more side effects than others, so it is important to know the drugs you're being given and possible side-effects,” Mr Bhavsar says.

To strengthen the bladder, do not pass urine unintentionally, do pelvic floor exercises that involve contracting and relaxing of muscles around the vagina and bottom. The pelvic floor supports the bladder and bowel and the muscles help in controlling urine and sexual function.

Some of the exercises are lying on the back, bending the knees, putting a ball between legs, and contracting the buttocks and pelvic floor as you lift the buttocks several inches off the ground and press the ball.