wowowow - excellent post ladies! I just did a research paper on the effects of exercise while undergoing treatment for cancer patients. so far (although there is not a lot of research done. more needs to be done) it appears that exercising during treatment can improve your levels of fatigue as well as help reduce nausea. They’ve also shown in a couple of studies an odd correlation between patients who exercise completing chemo at higher rates than those who don’t. but that needs more study as well!

What a wonderful idea for women in need. A BIG KUDOS!

Yes, low-intensity has been the “word” for several decades now, but really this article sounds like another ad. There is a great body of research (check pubmed) on exercise during and after cancer, and breastcancer - would women not be the target for anything to bring them in to a “group?” For most of “us” activity helps the total being, including the mind, so without replicated research, and professional studies to document physiological changes we must be careful about how we view those who exercise during and after anything. For the majority of the populace, exercise raises endorphins, which do reduce pain perception (exhibited by the gate-control theory, but so does temperature, pressure, and tactile stimulation). Realistically, no one needs to be certain anything “works” or doesn’t if help is being derived - period - but same may not be applied across the board to others. Please look into the NIH research on exercise for those with breastcancer. It was critically important that no excessive exercise be performed, because it depletes cysteine (which is an amino acid that protects DNA); hence, it prevents the breakdown of DNA, which is the ultimate cause of cancer. Supplementing with NAC (cysteine) may be helpful, but may not be taken prior to exercise of at any level, and has prevented a high number of those with HIV from going into active AIDS. Additionally, at the NIN center for alternative medicine, after and during exercise they gave women large amounts of shredded raw vegetables (those wondrous antioxidants), which helped protect their immune system. We now know, though, that we can get too many antioxidants (Google that). Thus, “Moderation in all things, including moderation (Dr. R. L. Bruno).” One caveat, an arthritis foundation approved aquatic exercise program (meaning higher temperature water than for swimming laps, the joint being moved is under water, and no stomping on the pool floor, and no aerobics that are “jarring” to the joints, with full range of motion as tolerated), is a thorough and safe means of exercising. The physiological changes such a program brings within 3 weeks of 3X/week 40-minute sessions to diabetics, those with severe arthritis, post mastecomy, joint-replacment patients, hypertensives, etc is nothing short of amazing - I taught them (and the cert. programs for other instructors) as a “busman’s holiday” for over 15 years, and benefited myself, of course. The term “Aerobics” went out in the late 1980s due to the damage such routines were causing to the joints, and ligaments - two people I know have had ligament transplants from their aerobics - if you think knee pain is difficult try needing knee-joint ligament transplant If women were placed in aquatic exercise programs prior to mastectomy, they would not have the degree of lymphedema they do - increasing circulation increases the number of capillaries, and assists with fluid transport. It is so easy to “target” cancer survivors and those in treatment, but it is also easy to posit an approach as being beneficial when there are no controlled, replicated studies to prove them as appropriate, much less productive. There is plenty of documented research on the benefits of movement, walking in fact, and other exercise regimens. For someone with breastcancer, it really is only fair to help them focus on coping, obtaining 2nd.and 3rd. opinions, and using NIH/NCI as a source for those 2nd and 3rd opinions, including those for pathology reports, always. As a breast cancer survivor (and having had 2 other cancers), now an advocate, and having worked on two breastcancer publications in national periodicals, I am protective of these “new” fads that come along, which further snare those who have enough on their plates - in fact, most of the time peace and rest is far more healing - such often takes months for an individual to achieve such levels especially if they are accepting the steroids that are given with the chemotherapy to so many women (most are unaware they are getting it, much less have the option to refuse it). I recommend Pema Chodon’s writings, and nutrition, first). Let’s get to a point of homeostasis, first. Some people apparently do better when they remain active, or increase activity, however, they must keep their eye on the donut not the hole, or at least on the whole! Treatments may render some people unable to maintain their level of fitness, indeed, merely get through the treatments, so there is a time to rest, and a time to move forward, always taking 1-day-at-a-time. I’ve worked with many, many women where we had to begin with a few steps forward, and equal number back, each day, little by little, and that’s fine - their doctors knew their condition, and the teams agreed.

I am not usually motivated to respond to posts that are about my own work but after reading Carol J’s comment it seemed important to share more about the development of Moving ON Aerobics. First of all, while we have done pilot studies, we recognize the need for replicable research, indeed MOA was awarded a superior status for a research project to be funded by the Komen foundation but it was a year they did not have enough money so the project was given alternate status. Various conditions changed and the research did not get to happen. We’d love the opportunity for that funding in the near future. In regards to Aerobics and it’s deleterious impact on joints: we agree, that is why MOA is a gentle aerobic program - it low impact. It was designed carefully for women already post-surgery to include no jumps gives each women the choice of using more or less force in her lower body weight shifts. Some women are well past treatment and have no joint issues and like the opportunity to put a little bounce in their steps. Most choose to stay more subtle. The video is one of our more upbeat groups. We also have versions of the class that use quieter music and go at a slower pace, as well as some additional dances that are for athletic and basically healthy survivors. This brings us to a key element of our class. The major theme of every class is to become more conscious of bodily sensation - pains as well as pleasures, and to respond sensitively. So while the aerobic aspect of class is emphasized BECAUSE of the numerous studies that have shown positive effects from Aerobic Training, we do not “push it.” Indeed a greater proportion of our time is used to relax through integrated breathing, support lymphatic drainage, and move gently to music. It is this combined program that keeps women coming back. It has been a point of discussion in our training program whether to continue using the name aerobics in the title but because the research has been so positive vis a vis aerobic exercises (see articles listed on the Moving On Aerobics website) that we felt it important not to throw the baby out with the bath water and to move the need for aerobic activity from fad to fact of life. I would also add that the tips listed only focus on the social aspect of the class. As you point out, being in a group while doing something you enjoy, has its own potency. Your points about exercise and nutrition are important and should be heeded. Links to the various research studies you cite could be useful. Here is what I found. And yes to rest and walking. Actually we find that many women dont know how to rest deeply after the trials of cancer. We are able to exchange information about how to recuperate from the days stresses through relaxing different body parts, as well as how to engage in quiet but freeing movement (as close to water exercise as you can get). At one of our sites - Gilda’s Club in NYC - women will choose to lounge on the big coaches in the room during parts of the class or for the entire class as needed. It would be great if more fitness studios had such accommodating furniture! Finally as you learn more about how we began you will find out that our intention was not to “target” but rather from the ground up as a group of survivors combined with other experts in movement and music to build a community that served the needs of cancer survivors. It is this process that I am sure explains why participants keep coming back. Notes: “Exercise enthusiasts and researchers have become interested in recent years to identify any means to help minimize the detrimental effects of oxidative stress that are commonly associated with intense and unaccustomed exercise. It is possible that a decrease in the amount of oxidative stress a cell is exposed to could increase health and performance.” http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2129149 “In summary, it is the position of the International Society of Sport Nutrition that exercising individuals ingest protein ranging from 1.4 to 2.0 g/kg/day. Individuals engaging in endurance exercise should ingest levels at the lower end of this range, individuals engaging in intermittent activities should ingest levels in the middle of this range, and those engaging in strength/power exercise should ingest levels at the upper end of this range.” http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2117006 This article explains some about the type of supplements that are be tested on marathon and sprint athletes Page 1. 31 Molecular and Cellular Biochemistry 196: 31–42, 1999. © 1999 “Abstract: Glutathione plays a central role in the maintenance of tissue antioxidant defenses and in the regulation of redox sensitive signal transduction. In muscle cells, the level and redox status of GSH regulates activity of the redox sensitive transcription factor NF-kappaB. Physical exercise may cause oxidation of GSH in tissues such as the blood, skeletal muscle and liver. Endurance training strengthened GSH dependent tissue antioxidant defenses in most studies. Although studies investigating the effect of sprint training are few, current results show that sprint training may also have a beneficial effect on tissue GSH homeostasis. Skeletal muscle GSH level appears to be tightly regulated by the state of physical activity. Regular exercise enhances and chronic inactivity decreases the level of GSH in this tissue. N-acetyl-L-cysteine (NAC) and agr-lipoic acid (LA) are two antioxidant dietary supplements that are able to enhance cellular GSH levels. Because LA can be recycled to its potent dithiol form, dihydrolipoate, by enzymes present in the human cell it has a clear advantage over NAC. Recently an improved form of LA, a positively charged analogue (LA-Plus), has been discovered. LA-Plus has more potent immuno-modulatory activity compared to LA. Both LA and NAC have been shown to have beneficial effects in protecting tissue GSH homeostasis against exercise induced oxidative stress.” http://www.springerlink.com/content/g212057163n5wq18/ Other studies available on line through google are about cellular environments and studies of mice. I also found: Among the more active women 65 and younger, however, those who slept for fewer than seven hours a night saw much of that benefit negated. Their cancer risk was greater than those who exercised but slept more — but still lower than those who exercised the least. http://www.cnn.com/2008/HEALTH/conditions/11/18/healthmag.exercise.sleep… - unfortunately they dont list the citation for the original research But based on reading the article,I guess its time to go to bed! Martha Eddy, CMA, RSMT, Doctor of Education in Movement Science