I remember meeting this patient, years and years ago, who lived way out in the country.  It was a four hour drive to go and see her.  I know it was a long time ago because I was driving my 1994 Celica GTS at the time.  I loved that car!  Ms. G was referred to me from her insurance company just for an assessment, so I wasn’t able to provide treatment.  But I certainly made some recommendations.  

When we first started talking she explained to me about this tightness she has.  I was thinking to myself, of course there’s tightness, you’ve had breast cancer surgery.  But this was far beyond that. 

It wasn’t just the shoulder.  Yes, that was tight and lacked a fair amount of movement, but there was more involved.  As I moved from testing range of motion to palpating (fancy word for feeling) the muscles around the shoulder, I couldn’t believe how tight everything was.  There was no give, no change in pressure.  Her muscles were like a rock! 

This is how I first discovered what radiation can do to the body.  You see, Ms. G. underwent radiation treatment after her breast cancer surgery and the effects could be seen with her movement and felt in the muscles.

Background

External beam radiation therapy is a targeted beam of high dose radiation used to damage cancer cells to the point that they cannot divide and therefore die.  Radiation can be used for a number of reasons.

• to shrink tumours
• treat pain
• slow tumour growth
• prevent cancer from returning

Radiation can be given before or after surgery depending on things such as the size and type of your tumour. 

Radiation Side Effects

In order for the radiation to reach the cancer cells that may be deep in the chest area, it has to travel through the tissue in its way.  This is how some of the side effects occur. 

Radiation can also cause:

•  lymphedema
• movement difficulties
•  heart damage
• hair loss
• skin changes
• fatigue

The fatigue and lymphedema symptoms may have caught you off guard.  People generally think of these symptoms as side effects from from chemo.

In addition to fatigue, function can be affected with extremely tight muscles and tight skin surrounding the areas that have been affected by radiation.  There can be blistering and skin issues that can also affect movement. 

So…what about Exercise?

As a Cancer Exercise Professional, I have two great sources of information.

• One source is my patients. 
• And the other is the research articles I review.

Both sources confirm that exercise is a positive therapy for patients who received radiation after surgery. 

In fact, a number of radiation side effects can benefit from exercise.  In patients who have finished treatment, I find that mobility work is an essential area of exercise.  Because of the changes in tissue, the tightness in the muscles, and the difficulty with movement, a program that works to progressively improve mobility is really helpful in three ways. 

1. The joints and surrounding soft tissue get the work they need to improve movement
2. Patients can better maintain their activities
3. Both treatment and maintaining function can help with mood

Sometimes there’s the need for more concentrated therapy when decreased movement and muscle tightness from surgery isn’t restored before the side effects of radiation start to take hold.  Some ‘hands on’ treatment with a Professional skilled in working with cancer patients may be the most helpful place to start with mobility. 

For Cancer Exercise Professionals working with breast cancer patients, or patients receiving radiation in the chest region, it’s important to know that radiation can affect the heart, bones, and tissues in this area.  Precautions need to be taken with proper screening before exercise.

Moving Forward

Everybody needs to move.  When there is injury, disease, or treatment that effects the muscles, the tissues, and sometimes the whole body, exercise can help alleviate or minimize the side effects.

1. Try to maintain your current program, or slowly start an exercise program, as soon as it’s possible.
2. Not just the areas affected by cancer and treatment, but the whole body.  It will do you good.
3. When you can, add a cardiovascular component to your exercise routine. Again, start slowly.  I have a blog post that teaches you how to stay in a safe exercise zone with a FREE DOWNLOAD to help you out.  Here’s the link.

Are You Pushing Yourself Too Hard?

If you have any questions on mobility for cancer patients, please send me an email or DM me from my Facebook page.