|
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.
|
|
|
|
