Personal Story: Running marathons with metastatic breast cancer? Yes!

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Runner’s World Magazine featured Sarah Smith, a metastatic breast cancer patient who runs marathons and ultra-marathons. By telling her story, Sarah wants to encourage people to stay active, despite the challenges that life may bring. (10/13/19)


At a glance Guidelines                       
What is known about exercise for MBC Questions to ask your doctor             
Clinical trials Resources and references


This article is about:

The personal story of a metastatic breast cancer patient and how running marathons has improved her quality of life.

Sarah’s story

Since 2012 Sarah has run over 40 marathons (26.2 miles) and ultramarathons (any race longer than 26.2 miles). However, her ability to continue long-distance running came into question this July when she was diagnosed with metastic breast cancer. 

Sarah asked her oncologist if she could still run long distances. Because her breast cancer had spread to her bones, Sarah was worried that extreme running might put her at risk for a fracture.  Even in healthy long distance runners, stress fractures are not uncommon. Sarah’s oncologist reassured her that running can strengthen her bones. Her oncologist encouraged her to continue participating in the sport that made her happy, but advised her to listen to her body.

Benefits of exercise for breast cancer patients

Over 100 exercise intervention trials have shown that physical activity for women with early-stage breast cancer helps manage cancer-related symptoms, improves quality of life and can even lower the risk of recurrence and breast cancer related death. These studies have shown that exercise is safe and can provide health benefits to these patients both during and after treatment. 

Yet, less is known about whether exercise is safe or beneficial for women with advanced breast cancer. In fact, they are often excluded from exercise intervention studies.

What do we know about exercise for metastatic breast cancer patients?

One small study from September 2019 looked at the benefits of exercise in 14 women with metastatic breast cancer.

Researchers randomized the women to either a control group or an exercise group. The exercise group followed an 8-week home-based physical activity program, which included twice-weekly supervised resistance training and unsupervised walking.

When the exercise group was compared to the control group, the exercise group had less chronic fatigue, better ability to use oxygen, and performed better on a six-minute walk test.

An earlier study from April 2016 randomized 101 women with metastatic breast cancer to a 16-week moderate exercise intervention or a control group. About 40 percent of participants were undergoing chemotherapy at the time of enrollment. 

This earlier study found that participants in the exercise group increased (although not significantly) their minutes of weekly exercise and improved their treadmill test scores and physical function (as measured by a survey designed to access an individual’s ability to complete daily living activities and more strenuous tasks).

Although both of these studies were small, they suggest that an exercise program for women with metastatic breast cancer may safely lead to better physical capacity and help them to live well with their disease. Much more work is needed to determine if an exercise intervention could help women with advanced disease live more fully with fewer symptoms from their disease and treatment.

Sarah’s latest marathon

Last September, Sarah ran the Columbus Marathon. She and her husband wore shirts with “Living with Metastatic Breast Cancer,” on the front, and the phrase “Bound and Determined” on the back. A few days before she was feeling extreme fatigue. The morning of the race while waiting at the start line, she felt terrible until the song “Thunderstruck” by ACDC came on. It was then that she realized how much joy running brought to her life. Running had helped her deal with both the emotional and physical impact of her advanced disease.

Sarah is now more determined than ever to keep running.  She’s encouraging people to stay active no matter what circumstances life throws at them. She wants to let metastatic breast cancer patients know that they should keep doing the things they love, whether it’s a 5K or 100 mile race.  As Sarah said, “Just put a smile on your face and enjoy the heck out of it.”

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Expert Guidelines

The National Comprehensive Cancer Network has recommendations on physical activity for people diagnosed with cancer. 

  • Physical activity and exercise recommendations should be tailored to the individual’s abilities and preferences
  • Physical activity for cancers survivors:
    • Overall volume of weekly activity sould be at least 150-300 minutes of moderate-intensity activity or 75 minutes of vigorous activity or equivalent combination spread out over the course of the week
    • Two to three sessions per week of strength/resistance training that include major muscle groups
    • Stretch major muscle groups at least two days per week
  • Engage in general physical activity daily (eg. Taking the stairs, parking in the back of parking lot)
    • physical activity includes exercise, daily routine activities, and recreational activities
  • Avoid prolonged sedentary behavior (eg. Sitting for long periods).

These recommendations were not developed specifically for people with metastatic cancer. Patients in treatment should speak with their providers about their exercise programs. 

Questions To Ask Your Health Care Provider

  • Would an exercise program help me better manage my disease symptoms and treatment?
  • If I exercise during treatment, what is the best frequency, length and intensity of my workouts. 
  • Are there any exercises that I should avoid? 
  • If I exercise during my treatment, what are some warning signs that may indicate a need to reduce my exercise program?
  • Can you refer me to a personal trainer? 

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