International Journal of Medicine Research 

International Journal of Medicine Research

ISSN: 2455-7404; Impact Factor: RJIF 5.42
www.medicinesjournal.com
Volume 1; Issue 2; May 2016; Page No. 124-128

The role of physiotherapy for the management of breast cancer and enhancing lifestyle for breast
cancer survivors through physical activity and exercises
1
Davinder Kumar, 2 Virender Kumar, *3 Savarna
1, 2
College of Pharmacy, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India
3
Department of orthopedics, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India

Abstract
The roles of physical exercise techniques in the cancer journey are very important. The physical techniques, improve patients
psychologically as well as physically who are suffering life threatening illness disease like cardiovascular disease, respiratory
disease, diabetes and cancer. Physiotherapy respiratory techniques, pain control techniques, neurological rehabilitation education
and lymphedema management very significant in different kind of illness. Breast cancer is associated with hormonal imbalances.
The treatment of breast cancer includes multiple modalities like Surgery, radiation therapy, hormonal therapy, chemotherapy, and
biologic as well as physical therapy that can all be used in many different combinations based on a patient’s specific disease.
Exercise may prevent weight gain during cancer treatment and also cause reduction in fatigue. Few physical techniques like, lying
down exercises, sitting up exercises, standing exercises after surgery maximize recovery and provide information is prevent
forthcoming complications. This mini review suggested that exercise can contribute to improved mood, reduced anxiety and
depression undergoing breast cancer treatment.

Keywords: Physiotherapy techniques, American Cancer Society, Breast cancer

Introduction breast cancer screening including recommendations from the

Cancer is physiologically condition where affected cells in a American Cancer Society and the US Preventative Services
body parts grow and reproduce uncontrollably growth. The Task Force [7, 8]. All recommend combination modalities of
cancerous cells can assault and wipe out surrounding healthy screening because no one test is considered conclusive. Breast
tissue, including organs [1, 2]. Tumor metastases word became cancer can be prevented in patients who are considered at high
like an umbrella which illustrate more than 50 different kinds of risk of developing breast cancer. Both surgical, non-surgical
cancer diseases with the similar characteristic of uncontrolled (post-operative) and anticancer drugs (Pharmacological therapy)
malignant cell growth. Tumor metastases to distant sites are available. Prophylactic mastectomies can be successfully
generally have a greater effect than the primary tumor on the completed; however, they do not provide a 100% guarantee of
frequency of complications and the patient’s quality of life and the prevention of breast cancer [9, 3, 4]. Pharmacologic therapies
mortality. Each year, the American Cancer Society (ACS) have been approved for the prevention of breast cancer including
publishes an estimate for the number of new cases and number tamoxifen and raloxifene. Two large studies in high risk women
of cancer-related deaths. Breast cancer is the most common demonstrated decreased incidences in breast cancer in those
malignancy in American women and is second to lung cancer in women who received tamoxifen or raloxifene for 5 years. Non-
mortality rates [3, 4]. Breast cancer arises from the breast tissues, surgical (post-operative), physiotherapists (Physical therapists)
the ducts (tubes that carry milk to the nipple) and lobules (glands are experts to improve fitness by exercise techniques, who give
that make milk). In 2010, it was estimated that 209,060 women strengthen to those people who are optimize their physical
would be diagnosed with breast cancer and approximately ability [10, 11]. Their exercise techniques can help in preventing
40,230 were expected to die from their disease. Approximately and treating the four major, life threatening and non-
1,970 cases were estimated to be diagnosed in men, indicating it communicable diseases in the world, as identified by the United
is not a disease solely of women. The incidence rates of breast Nations: cardiovascular disease, respiratory disease, diabetes
cancer have continued to decline from 1999 through 2004 due and cancer. Physical therapists set down exercise as part, safe
to the decreased use of hormone-replacement therapy. This and effective programme for physically and mentally challenged
[11, 12]
decline follows the results of the Women’s Health Initiative .
study, which demonstrated increased risk of breast cancer in
those receiving hormone-replacement therapies. One in eight Risk Factors for Developing Breast Cancer [13, 14].
women are expected to develop the disease over the course of Known Risk Factors
their lifetime [5,6]. However, this frequently quoted statistic 1. Gender: Female > male
may overestimate the risk of breast cancer because it is derived 2. Personal history of breast cancer
from women who live to be 110 years of age. If breast cancer is 3. Family history of breast cancer (first-degree relatives)
diagnosed early, it is curable. The likelihood of diagnosing 4. Benign breast “cancer” (i.e., atypical hyperplasia)
breast cancer is increased by the use of standardized screening 5. Early menarche (<12 years of age), late menopause (>55
methods. Currently, many different guidelines are available for years of age)

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6. Late first pregnancy (≥ 30 years) or no pregnancy Stages of breast Cancer [15].

7. Advancing age The information collected on tumor size and how it has spread
8. Long-term use of hormone-replacement therapy (estrogen) around within breast and organs (T), lymph node involvement
9. Previous chest wall irradiation (N), and the presence or absence of distant metastases (M) by
using TNM staging system. Once the T, N, and M are
Possible Risk Factors determined, a stage of 0, I, II, III, or IV is assigned [Figure 1],
1. Alcohol with stage 0 being in situ, stage I being early stage invasive
2. Obesity cancer, and stage IV being the most advanced. The commonly
3. High-fat diet used system in clinical trials is TNM [Figure 2].

Fig 1

Fig 2: Stages of breast Cancer

Role of Physiotherapy in breast cancer and their techniques divided into three categories which include physical therapy like
Physiotherapy or physical therapy is part of rehabilitation back massage therapy, spray and stretch technique, therapeutic
to the times of Hippocrates, who acknowledged that blood exercise, physical activity and yoga [16, 17]. Electrotherapy
circulation of body parts by the physical exercise to be methods are like TENS (Transcutaneous Electrical Nerve
encouraged for a patient's recovery from any kind of illness. The Stimulation), MENS (Micro Current Electrical Nerve
recognition of physiotherapy and its outcomes were well-known Stimulation, Electro acupuncture ,Short Wave Diathermy,
during the polio outbreak in the 1950's when it became main Micro Wave Diathermy, Ultra Violet Radiation, Infra Radiation,
rehabilitation technique in prevention the disabling effects Ultra sound therapy, Lasers, Iontophoresis and thermal
diseases. Treatment modalities by physiotherapy can be broadly modalities like hot packs, paraffin wax's, ice packs, ice massage,
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cold spray are also recommended [18]. 1.2 Elbow winging

Physiotherapy or physical therapy is part of rehabilitation during This exercise helps increase the movement in the front of chest
the hospital period, particularly in the postoperative phase in and shoulder this exercise takes 6 to 7 weeks of regular exercise
breast cancer. Patients are instructed how to protect it against before your elbows get close to the bed or floor. (Figure 4)
acute infection factors and the risk of lymphedema in breast
cancer. Along with the improved survival rates, the quality of
life in patients who have been cured of their cancer has become
an important issue. ACMS (American College of Sports
Medicine) recommended programmes and physical activities for
breast cancer patients’ that they immediate go for post-surgical
physiotherapy [19, 20]. According to physio-experts
recommendations strengthen exercise should be 50% of one
repetition maximum (1RM) carried out 5-7 days per week. The
long-term goal of rehabilitation is to return the person to work,
domestic activities and social interaction with as few physical
deficits as possible. To achieve this, intervention should occur
as soon as the like hood of disability is anticipated [23, 24]. From
the first follow-up for rehabilitation the impaired shoulder
movements in relation to post-operative incidence show an Fig 4
increase in range of motion that vary from 10% to as high as
45%. Factors related to impaired shoulder movements are older 2. Sitting up techniques (exercises)
age, nonparticipation in physical exercise programmes, and 2.1 Shoulder blade Exercises
subcutaneous fibrosis. But Physiotherapy or physical therapy is This exercise helps increase your shoulder blade movement.
part of rehabilitation improve shoulder movements breast cancer Figure 5
patients by number of different physical techniques [25, 27].
The physical techniques, improve patients psychologically as
well as physically health whose are suffering life threatening
illness. The following type of techniques are Suggested for
breast cancer patients [28, 31].

1. lying down techniques (exercises)

1.1 Wand exercise
1.2 Elbow winging

2. Sitting up techniques (exercises)

2.1 Shoulder blade
2.2 Shoulder blade squeeze
2.3 Side bending
Fig 5
3. Standing techniques (exercises)
3.1 Chest wall stretch 2.2 Shoulder blade squeeze
3.2 Shoulder stretch This helps increase shoulder blade movement. Figure 6

1. Lying down techniques (exercises)

These exercises can be done on a bed or the floor. Lie on your
back with your knees and hips bent and your feet flat.

1.1 Wand exercise

This exercise helps increase the forward motion of patient
shoulders. The exercise needed broom handle, yardstick, or
other stick-like object to use as the wand. (Figure 3)

Fig 6

2.3 Side bending

This technique helps increase movement of your trunk and body.
Figure 7.
Fig 3
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gain during cancer treatment and cause reduction in fatigue; it

may also be useful in alleviating menopausal symptoms in breast
cancer survivors who experience early menopause. Physical
techniques may also reduce the risk of other chronic disease
among survivors. The review showed that it is safe for breast
cancer patients to exercise, but what type of exercise is the most
effective for individuals with specific problems.

Acknowledgements
I would like to express my deepest gratitude to Dr. Jasbir Singh,
Assistant Professor, College of Pharmacy, PGIMS Rohtak, for
his excellent guidance to complete the review.
Fig 7
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