Phone: (03) 9813 2189

Breast Cancer Case Study

Background
  • 38 year old Locally advanced, grade 3 breast cancer. No co-morbidities.
  • Otherwise healthy & fit.
Treatment
  • Double mastectomy & 5 lymph nodes removed
  • Chemotherapy: Doxorubicin & cyclophosphamide x4. Paclitaxel x 12. 6 months.
  • 6 weeks of daily radiation treatment
  • Herceptin every 21 days for 1 year.
Side effects/
considerations/
Precautions
  • Port.
  • Potential for lymphedema.
  • Increase risk of cardio-myopathies.
  • Arm ROM.
  • Lung scarring from radiation.
  • Skin sensitivities.
  • Blood counts
  • Side Effects:
  • Peripheral Neuropathy, hands & feet but can still do up buttons.
  • Mild fatigue
  • Mild pain in joints – fingers, knees & ankles
Pre-cancer activity Gym every 3-4 days, mod-high intensity
Pre EP exercise
  • Daily walks for around 30 mins, low intensity
  • Exercised throughout chemotherapy. At least a 5 min walk.
  • Work: built up from 2 days to 4 days per week.
Goals
  • Learn how hard she can push herself
  • Maintain/improve cardiovascular fitness
  • Improve dynamic balance
  • Improve upper body strength
Outcome Measures Weight, RBP, RHR, arm circumferences, functional strength, sit to stand, grip, bench height push ups, shoulder ROM, balance, sub max VO2.
Exercise Prescription
  • Light weights to start with. Progress gradually.
  • ROM for arm.
  • Monitor arm circumference.
  • Spikey ball massage
  • Progress walking intensity
  • Return to gym for strength, cardio & dynamic functional balance ex.
  • Closely monitor cardiac symptoms.

Outcomes

After 6 months of supervised EP sessions
  • Now going to gym 5 – 7 days per week. 10 – 30 mins cardio HR max 160.
  • Has made excellent gains in CV fitness & balance – during treatment. Need to work on strength. Now progressing to plyometric exercises for legs and continuing to gradually challenge the arms.