Get back to your SENSEsational Self after Breast Cancer

 

October is recognized as Breast Cancer Awareness Month worldwide and serves to increase support and attention for early detection and treatment. As one breast cancer survivor puts it, “October is a yearly reminder of how grateful I am to be here.”

There are more than 3 million women in the United States who have been diagnosed with breast cancer and it doesn’t stop with women. Recent publicity by Beyonce’s father is helping to raise awareness of a lesser known fact - men make up approximately 10% of all breast cancer diagnoses.

anatomy trains
 
 

Let this month serves as a reminder to us all, both men and women, to take a step back from our hectic lives, get in tune with our own bodies and be aware of any subtle changes. Early diagnosis and treatment are key to improving your chances of survival. In addition, the American Society of Clinical Oncology recommends maintaining a healthy weight, limiting alcohol intake, and completing 30 to 60 minutes of moderate to high-intensity physical activity a day to help lower your risk of breast cancer.

Unique Needs Require Unique Treatments

As survival rates improve, there is a growing population with unique physical and emotional needs. Often, breast cancer, as well as other cancer treatments, lead to a vast number of side effects including cancer related fatigue, neuropathy, lymphedema, altered motor control and changes in balance to name a few. During chemotherapy or following a surgery, movement is important for protecting the body’s natural movement systems and preserving a positive mind-body relationship.

Regardless of the number of years past since a breast cancer diagnosis, regular exercise is suggested to help mitigate long-term side effects of treatments and reduce rate of recurrence. A movement professional can be a helpful advisor to address common areas of concern for breast cancer survivors such as the area around the shoulder blades (scapulothoracic joint), postural dysfunction, and pain as well as lymphedema risk reduction and management.  

In addition to remaining physically active, maintaining a healthy weight through aerobic exercise and a healthy diet are essential to control body mass index (BMI). A high BMI is a risk factor for recurrence. 

Cancer Impact on Body Awareness

To gain a first-hand perspective on the challenges that patients with breast cancer face and how movement plays a critical role in a healthy recovery, we spoke with Dr. MaryLou Galantino, PT, MS, PhD, MSCE, FNAP, FAPTA. Dr. Galantino is a professor at Stockton University, author of numerous articles relating to breast cancer, and a breast cancer survivor herself. As a movement specialist, Dr. Galantino stresses the importance of regular movement following cancer treatments.

With cancer and cancer treatments, it’s important to engage in activities that help restore cognitive function, mind-body connection, and safe return to daily activities in order to maintain a healthy and meaningful life. Dr. Galantino notes that cancer related fatigue responds positively to aerobic exercise, an approach supported by current literature.

She also draws attention to other changes that occurs post cancer treatment including neuropathy. Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent side effect that presents in sensory deficits, but also motor and autonomic dysfunction which develops in stocking and glove distributions, meaning that it significantly affects the feet and hands. The effects of CIPN alter proprioception, balance, walking speed and can lead to increased fall risks and physical disability.

Exercise After Breast Cancer

Dr. Galantino mentioned that there are numerous targeted exercises that can be incorporated into an exercise program for breast cancer patients. Many cancer treatments such as chemotherapy, radiation, and surgery impact range of motion, strength, and neuromuscular control and leave behind scar tissue that can further restrict motion. 

One particular exercise she feels can benefit every breast cancer patient involves supine scapular stabilization. Dr. Galantino notes that this exercise is great for improving proprioceptive input into the scapulothoracic joint and creating a stable foundation for upper extremity motion.

The WAV amplifies the sensations breast cancer patients are often lacking.

This exercise can be performed with simple body weight or with the WAV as Dr. Galantino now does. “I love using the WAV to help patients feel the subtlety of the movement”, she noted.  She went on to further highlight the benefit of this exercise with the WAV, particularly for patients who are affected by neuropathy, “the WAV amplifies the sensations that they are lacking.”

Going beyond this exercise, Dr. Galantino notes that the WAV can provide a valuable overall benefit. “It helps to address chemo brain. You can’t use the WAV without being focused on what exercise you are doing, creating a mind-body connection with the breath”.

Sensory Scapular Stabilization

Initially, this sensory scapular stabilization exercise should be performed in the supine position as highlighted. When appropriate this movement pattern can be amplified by performing in a sitting and eventually standing position for additional challenge and core stabilization.  

 
 

Step  1

  1. Begin laying on your back with knees bent and feet grounded into the earth.

  2. Find a neutral spine and neutral pelvis.

  3. Hold the WAV with an overhand grip equidistant from the center logo. Extend the elbows to make a single line through the shoulders, elbows and wrists.

Receive sensory input via the ground and the WAV into the scapula to improve stability.

Receive sensory input via the ground and the WAV into the scapula to improve stability.

Step 2

breast-cancer-exercise-for-upper-body.jpg
  1. Keep the shoulder blades tucked beneath your body and maintain space between the top of the shoulders and the bottom of the ears.

  2. Stabilize your gaze on the fluid as you work to centrate the shoulders and find strength through the scapula.

  3. Hold position for 20-30 seconds then rest.

  4. Repeat 3-5 times

  • What am I doing?

Providing sensory input via the ground and the WAV into the scapula to improve stability.

Channeling the connection between the core, scapula, and upper extremities.

Improving mind-body connection and drawing cognitive attention to the scapulothoracic joint.

  • What am I mindful of?

Am I maintaining a neutral spine?

Are my shoulders in a neutral position with space between the ears and the shoulders?

Am I able to breathe throughout the motion?

Are my shoulders active throughout and reactive to any changes in the fluid to help maintain stability?


Footnotes
Dr. Marylou Galantino is an accomplished therapist, researcher and professor that has dedicated more than 30 years to improving the lives of cancer patients and survivors. She helped establish oncology rehabilitation programs at the University of Pennsylvania Hospital and Bacharach. We extend a very special thank you to her for sharing her time and expertise with breast cancer related treatments. Learn more about Dr. Galantino and some of her work:

  1. Galantino, M. L., Tiger, R., Brooks, J., Jang, S., & Wilson, K. (2019). Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors.
  2. Galantino, M. L., Desai, K., Greene, L., DeMichele, A., Stricker, C. T., & Mao, J. J. (2012). Impact of Yoga on Functional Outcomes in Breast Cancer Survivors With Aromatase Inhibitor–Associated Arthralgias. Integrative Cancer Therapies, 313–320.
  3. Integrative Health: Increasing Vitality through Mind-Body Awareness (2016)
  4. Learn more about Dr. Galantino's personal story. Featured MassKicker, Mary Lou Galantino PT, PhD & Mary Lou Galantino to Study the Effects of Yoga on Cancer Patients in 2018.

Some other helpful links to learn more about how a healthy and active lifestyle impacts a patient diagnosed with breast cancer

  1. Courneya KS, Mackey JR, Jones LW. Coping with Cancer: Can Exercise Help? The Physician and Sportsmedicine (28)5, 2000
  2. Kirshbaum MN et al: A review of the benefits of whole body exercise during and after treatment for breast cancer. Journal of Clinical Nursing, 2007
  3. Bearskens CH et al: The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study. August 2007 volume 7: 166
  4. Male breast cancer awareness: Why Beyonce's father, Mathew Knowles, urges men to get tested

Dr. Lindsay Schuele is part of the movement team for WAV training. As a top athlete and Doctor of Physcial Therapy she integrates the brain-body approach with her passion to help athletes avoid injury and achieve top performance.

Want to know more about using the WAV for athletic taining and sports rehabilitation? Contact us for more information about our sensory-based training approach.