Pilates Clínico: um apoio à recuperação do câncer de mama

Helen O'Leary, Physiotherapist and Clinical Pilates Expert, Complete Pilates, London, UK says that most cancer survivors are not meeting the NHS guidelines for physical activity.

A Pinc & Steel certified cancer rehabilitation physiotherapist, O'Leary explains that cancer rehabilitation - supported by Pilates - can contribute to overall wellbeing and potentially play a role in cancer recovery.

How does breast cancer impact the body?

The impact of cancer extends beyond the specific area of the body where it is detected. Both treatment and surgery can have widespread effects on your entire body.

"Survival is the beginning," says O'Leary. "We then need to ensure that your quality of life is also returned."

O'Leary says these side effects may be managed and improved with the help of physiotherapy, exercise and clinical Pilates.

How can exercise help breast cancer?

Exercise has a significant impact on the body, particularly for cancer prevention, treatment, and recovery.

"If we could take exercise as a pill it would be the most commonly prescribed pill in the world," says O'Leary. "There are many ways in which exercise affects the body physically and psychologically."

The exercise guidelines are the same for breast cancer as for the general population. This is 150 minutes per week of moderate exercise - including 2-3 sessions of strength exercises.

O'Leary advises that an extra half an hour - around 180 minutes - per week of higher-intensity exercise may be more beneficial for people undergoing breast cancer treatment.

Exercise can boost the effectiveness of cancer treatment

Maintaining a healthy level of exercise during cancer treatment may limit its toxic effects and potentially enhance its outcomes.

O'Leary explains how some research suggests that exercise can contribute to improved blood flow which could assist in the delivery of treatments such as chemotherapy. Research also says exercise could help support your immune system which might help the body's natural defences against cancer cells.

Exercise eases treatment side effects

Cancer treatment can lead to side effects such as fatigue, bone loss, muscle weakness, pain, and cognitive changes.

O'Leary explains that exercise could help ease pain, and maintain muscle and bone mass.

"Research shows that physical exercise can significantly reduce cancer treatment-related fatigue," she says. "This effect was seen both post-operatively and during chemotherapy."

She adds that exercise can help improve brain function - even during cancer treatment. It can also help protect the heart from the damaging effects of endocrine therapy - a common treatment for breast cancer.

Exercise aids cancer recovery

Regular moderate exercise can improve breast cancer survival rates.

O'Leary explains this is because exercise also encourages other positive lifestyle changes.

"Studies have found that regular physical exercise can reduce the likelihood of death from breast cancer by up to 40%," she says. "This is one of the most effective lifestyle changes you can make to help prevent the return of breast cancer."

How can clinical Pilates help breast cancer?

Clinical Pilates applies the principles of the Pilates method to support medical patients in their recovery and rehabilitation.

According to O'Leary, Pilates is a great form of exercise that can help breast cancer survivors. Breast cancer surgeries - such as mastectomy and reconstruction - can cause limitations in shoulder mobility, spinal flexibility, posture, and core strength.

"Pilates looks at the body as a whole, not just the one area that may be affected by the disease," says O'Leary. "It can be used at all stages of care including preventative, during treatment, post-operatively and throughout your recovery."

O'Leary suggests combining Pilates equipment-based exercises with home-based mat work, and one-to-one personalised guidance from your instructor.

Exercise following breast cancer reconstructive surgery

When guiding someone through exercise after breast cancer reconstructive surgery, it should be with a qualified instructor who understands the complexities of cancer recovery and has specialised training in this area.

O'Leary says: "It is important to understand any medicines and potential side effects that you are still on, including any other surgeries you may have had. This will lead to not only effective exercise choices but also modifications so that you are set up for success."

She advises that the Pilates exercises should be adapted to be more supportive, using assistive equipment - such as springs - to improve your range of movement.

"This should happen within any surgical restrictions," says O'Leary. "If you are undergoing further interventions - such as chemotherapy - you can also adjust the timing of your sessions, including how long they last."