Almost twenty years ago the threat of breast cancer related lymphedema was a very serious concern to all breast cancer patients and influenced decisions regarding lifestyle. At that time, the recommendations for physical activity were quite limiting and restricted all forms of vigorous exercise for fear of causing lymphedema. The pathophysiology of this condition was not known and the restrictions did not pass the test of common sense. The first Abreast in A Boat team was formed to defy the myth that exercise would cause lymphedema and we remain indebted to the original 24 women who tested that hypothesis in their first season. The success of that year and the accomplishments of Abreast in A Boat since are legend and in my opinion they have played a significant role in changing the way society thinks of breast cancer and chronic disease.
In 1995 a search of the literature on breast cancer and exercise yielded very few useful recommendations, ones that were supported by good science. Indeed, it was data from the first year team that was published and raised the notion that perhaps some of these patient recommendations were incorrect and should merit more research. As the number of breast cancer dragon boat teams increased, initially in BC and Ontario, the media was attracted to this story as the idea of challenging breast cancer with exercise was noteworthy and unique enough that it received a lot of attention. It was about this time, partially due to this media attention generated by Abreast in A Boat, that the medical profession slowly began to recognize that there was a link between physical activity and health, and that exercise had merit as a form of treatment as well as prevention. This has continued and there are currently “Exercise is Medicine” programs in USA and Canada. Ironically, this program is not new- I have an Exercise is Medicine t-shirt and poster circa 1985- it has just taken this long for traditional medicine to take exercise seriously.
A review of the literature in 2014 reveals an exponential growth in articles on breast cancer and exercise. Many of the myths have been dismissed by publications in the top journals in medicine and cancer. The ‘cancer gym’, which some of you will know very well, continues to do research and now every woman with breast cancer who is cared for at the BCCA is referred to the gym. We consider physical activity ‘standard of care’ and need to make ‘a cancer gym’ available to every patient, not just those in Vancouver.
The gym continues to provide a rich environment to study the interaction between breast cancer and physical activity. It is clear that modest levels of regular exercise can change the course of the disease. That’s right; fewer cases of lymphedema, less morbidity, less mortality and protection from other diseases- all from ~3 hours of physical activity each week. Research needs to address the mechanism responsible for this important observation.
It has been a long ride from the day the original team cautiously slipped into a dragon boat in 1996 and silenced the critics that felt that this was a dangerous course to take. Who could imagine that this would start a movement that now involves thousands of women (and a few men) on four continents? It is changing the way the world views breast cancer; you lead by example and all members of Abreast in a Boat can be proud of the role that they are playing. There is still some distance to paddle in this race against breast cancer so dig deep, don’t slow down- paddling is medicine.