Exercise to survive

Physical activity reduces the risk of breast cancer recurrence and mortality, says breast cancer surgeon Carolyn M. Kaelin, MD, MPH.

Stretching can improve range of motion, flexibility and posture; strength training can fight osteoporosis and sarcopenia (i.e., muscle deterioration) that result from chemotherapy and aerobic therapy helps limit the weight gain that often occurs during chemotherapy.

"Both chemotherapy and surgery have profound impacts on the body," says Kaelin. Since treatments and their effects vary, each patient should receive a customized program for health and fitness.

For instance, "after breast reconstruction following a mastectomy, certain motions may be challenging or impossible to perform, so stretching and strength training need to be personalized to reflect how the body has changed," explains Kaelin.

For those who have not previously exercised or are fatigued by treatment, Kaelin prescribes a three-part program, including walking with a pedometer to count daily accumulated steps, stretching to regain shoulder range-of-motion and comfortable upright posture and light strength training to avoid muscle deterioration.

Breast cancer survivors who exercise together are often more successful in maintaining their program long term, she notes.

"The exercise objective is to improve your overall health--reducing breast cancer recurrence, maintaining a healthy weight, keeping the heart fit--so you are stronger from the day of your diagnosis forward," explains Kaelin.

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Keep moving to slow aging

People who are physically active seem to be biologically younger than their sedentary peers, according to a report in the Jan. 28 issue of Archives of Internal Medicine. The researchers studied 2,400 twins with different lifestyles and activity levels. From blood samples, researchers were able to examine the length of the participants' telomeres--pieces of DNA in white blood cells that shorten over time and are thought to be a marker of biological age. Findings showed that women and men who were less physically active had shorter telomeres than those who were more active. The authors suggest that oxidative stress--cell damage caused by exposure to oxygen--and inflammation are likely mechanisms by which sedentary lifestyles shorten telomeres. They also note that physical activity may reduce psychological stress, thereby limiting its effect on telomeres and the aging process.

"The study makes sense to me," says Lisa D. Ravdin, PhD, director of the Cornell Neuropsychology Service at Weill Cornell Medical College. "And we know there's so much literature documenting the benefits of exercise even if you don't investigate at the cellular level. The evidence is hard to resist."

Live longer--and better

Individuals who exercise regularly have better cognitive function and lower rates of heart disease, type 2 diabetes, cancer, high blood pressure, obesity, and osteoporosis. They also are less likely to smoke and more likely to maintain a desirable weight, says Dr. Ravdin. "All these benefits are associated not only with a longer life, but also a healthier life," she says.

The importance of staying active can't be overstated, she continues. "Think about chronic pain, arthritis, anxiety, depression, hospitalizations. All tend to increase with age, and exercise is associated with lower risk." Women are especially vulnerable to falling, which is "the biggest risk that comes with aging, because it can mean loss of independence or death, even in healthy adults trying to do everything right. Regular exercise goes a long way toward lowering the risk. If you're in better shape, you're less vulnerable," Dr. Ravdin stresses.

Active lifestyle is key

There are many things you can do besides going to the gym to maintain an active lifestyle. "Walk everywhere--keep on the move. Make walking your main form of transportation," Dr. Ravdin says. "Get off the bus a few stops early. Park the car as far away as possible. Use the stairs. Stretch while watching TV. You don't have to work up a big sweat to get a big benefit."

If you want to look and feel younger, "You also need to have a young attitude, and being physically fit can help you feel fit mentally and emotionally," she says. "If you've been active all your life, so much the better. But you can start at any age and still benefit. It's like quitting smoking--no matter when you do it, it's still a good thing."

So get moving now, and forget about excuses. "Many people complain they don't have time to exercise. But we know that being physically active can lead to a longer life. So, find the time if you want more time," Dr. Ravdin says.

WHAT YOU CAN DO

Make regular physical activity part of your day by choosing activities that enhance endurance, strength, flexibility, and balance.

* Endurance: Walk briskly, do water aerobics, play tennis, do housework or gardening, dance, play with your children or grandchildren, climb stairs, swim.

* Strength: Lift weights, carry groceries, do household or gardening tasks that make you lift or dig, push a lawn mower.

* Flexibility: Stretch or do yoga or Pilates.

* Balance: Stand on one foot, stand up from a chair and sit down again without using your hands, take a tai chi class.
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