Past research has concluded that exercise is both feasible and beneficial for people undergoing treatment for earlier-stage breast cancer.

Some studies have proven reason for concern over whether people with metastatic cancer would be able to exercise because of the advanced stage and spread of their cancer.

Here’s how exercise may improve the lives of breast cancer patients, as well as doctor-recommended exercises these patients can try.

Stage IV Cancer Patients Saw Increased Quality of Life With Exercise

If the type of metastatic breast cancer a person has is hormone-responsive, the first line of treatment is hormone therapy, which may be combined with a targeted cancer drug.

For types that are not hormone-responsive, chemotherapy, usually a combination of multiple drugs, is used. 

The new study set out to determine whether a prescribed exercise regime could relieve some common side effects of these treatments, including fatigue, nausea, pain, and shortness of breath.

So far, the clinical trial, which is based in Europe, includes nearly 360 people with metastatic breast cancer. About 180 of these patients took part in a planned twice-a-week exercise program that included a mix of aerobic and strength training.

All sessions were supervised by a physiotherapist or other exercise expert, and most workouts occurred in group settings, though occasionally people were guided during one-on-one sessions. 

After three, six, and nine months, both groups filled out questionnaires that gauged their physical, mental, emotional, and financial quality of life, as well as how fatigued they felt on a day-to-day basis.

Compared to those who did not participate in the exercise program, participants who did reported less fatigue. They also reported having a higher perception of their overall quality of life, as well as improved pain.

This group’s strength improved, too.

After six months, participants in the exercise group could ride a stationary bike with a 13% higher resistance level than those in the control group. Many of these patients continued with their routine after the nine months were up.

By improving cardiopulmonary fitness—both cardiovascular and respiratory stamina—exercise can improve fatigue.

“There is also certainly a cognitive component,” Iyengar said. “We know exercise improves mood, memory, and cognitive functioning.”

Doctor-Recommended Exercises For Stage IV Breast Cancer

May recommends people undergoing treatment for metastatic breast cancer to talk with their doctors before starting an exercise routine.

Movement should be individualized, based on a person’s physical fitness as well as their side effect—this is best done with the supervision of a trusted healthcare provider.

“Any physical activity is better than none,” May said, though in general, intense exercise usually yields more benefits.

According to Ligibel, strength training can be particularly important since it’s common for people to lose some muscle mass while undergoing cancer therapy.

“Strength training can take a lot of different forms; you don’t need weights,” she explained. “Doing core exercise and using your own body weight is exercise meant to strengthen your muscles.”

In addition to strength training, cardio can provide benefits to cancer patients, like relieving fatigue, Iyengar said.

If fatigue increases after exercising regularly, people should speak with their physician about ways they can adjust their workouts, May added.

Movements, whether cardio or strength training, can be tailored to accommodate cancer side effects such as the loss of movement in a limb, issues with balance, or neuropathy, Iyengar said.

Again, any new movement strategy should be discussed with a medical professional.

“A lot of people will have bone metastasis, and evidence has shown that exercise is safe for these people, but there are considerations such as where the metastatic lesions are and where you are putting weight,” Ligibel said. “That warrants a talk with someone in the medical setting.”