A Strong Case

Could exercise help heal the pain for breast cancer survivors?

Vertex Fitness owner Dwayne Wimmer with client Alexis Limberakis of Fort Washington.Last year, rowing machines, leg presses and a healthy dose of sweat were de rigueur for Grace Cannon. It only took about six half-hour sessions at Bryn Mawr’s Vertex Fitness for the spry 61-year-old to start seeing the benefits.

And while her story may not sound that unusual, Cannon’s workouts had nothing to do with bikini season. “I wasn’t there for the body beautiful,” she confesses. “I was there for a different reason than most.”

Cannon was one of 14 women who participated in a pilot study conducted by doctors at Lankenau Hospital in partnership with fitness experts at Vertex. The focus was on exercise as a possible treatment option for aromatase inhibitor-induced arthralgia. A 15-year breast cancer survivor, Cannon knows all about the ups and downs of remission. And the physical and emotional liberation from the disease can be accompanied by a painful sensation that’s often felt throughout the body.

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Many postmenopausal women taking aromatase inhibitors to treat breast cancer experience mild to severe joint pain as a side effect. For women who are Cannon’s age, this can be particularly distressing. So, rather than adding yet another drug to her medicine cabinet, she followed doctor’s orders and hit the gym.

“Certain medications are necessary to treat early-stage breast cancer in post-menopausal women—in the form of hormonal therapy to prevent recurrence,” says Dr. Paul Gilman, medical director of the Lankenau Cancer Center, who spearheaded the study. “But the problem is often joint pain.”

Gilman estimates that up to 40 percent of women experience some type of arthralgia as a side effect of the aromatase inhibitors.

“It seemed sad that a lot of these women have to be on the medication and have a poor quality of life,” says Dr. Jessica Katz, a fellow at Lankenau during the study. “Exercise looked like a great way to make their remission more tolerable. Also, it’s been shown in other studies that women who don’t gain weight—or have a low-fat diet—after having breast cancer have a better chance of survival.”

Gilman had been a member of Vertex Fitness a year or so prior to the Lankenau study. Motivated by his conversations with Vertex owner Dwayne Wimmer and his own experience with aches and pains, he hit on what he hoped would be a source of relief for Cannon and countless others.

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“We thought there must be a way to do some type of research looking at the effects of a controlled, repeated workout for this condition,” says Wimmer, who helped Gilman through his own back and hip pain.

In September of 2007, the two began to formulate the parameters of the pilot study. And by 2009, the participants were ready to go. Two to three times a week for two months, Cannon and the others moved from machine to machine under the watchful eyes of Wimmer and other Vertex employees. “We didn’t treat them any differently than we would our other clients,” says Wimmer. “We worked them hard and didn’t baby them. The purpose was to see how they’d perform under typical circumstances.”

Each session began with a five-minute warm-up on a stationary bike, treadmill or elliptical machine. From there, participants completed a circuit of strength-training exercises that worked the muscles surrounding the hips, torso, legs, arms and back, followed by a 20-minute cardiovascular workout.

“When I’d leave there, I had more energy and no pain,” Cannon says. “I was sleeping better, and everything else just started to feel better. I did it in the morning, and I found that I had a lot of energy for the whole day.”

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Participants were asked to fill out questionnaires at the beginning, middle and end of the study. The 33 questions examined the timing and duration of joint symptoms, weight gain, mood changes, sleep habits and hot flashes, among other topics. After eight weeks, about 75 percent of the participants reported an overall improvement in joint pain and quality of life. (Two women didn’t complete the study due to scheduling conflicts or other non-study-related factors.) The statistician working with Gilman and his team reported a positive correlation between exercise and joint pain alleviation.

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The results have been presented at a number of venues, including the American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium. The idea is to build clinical momentum and support for a larger study.

“What we’re looking at right now is a pilot study that’s promising, feasible and safe—and we want to expand it,” Gilman says. “Do we do a similar study, but with larger numbers? Or a comparative study of different groups of patients exercising different ways? We’ve seen the results. We just want to take it bigger.”

Until then, Cannon is enjoying the fruits of her labor—and each day as it comes. “What people sometimes forget is that cancer is only one aspect of us,” she says. “We’re out in the world and working, and doing a lot in our communities. Don’t cut us out of the picture—we’re still vital.”

Breast Cancer Awareness Month: Local Happenings

Oct. 2: Living Beyond Breast Cancer’s Butterfly Ball 2010
Where: Loews Philadelphia Hotel, 1200 Market St., Philadelphia.
Contact: Lauren Ainsworth at (610) 645-4567, ext. 113, or lauren@lbbc.org.

Oct. 3: Fourth Annual Bowling for Boobs
Where: Playdrome Devon Lanes, 300 Lancaster Ave., Devon.
Contact: (610) 399-3246 or support.breastcancer.org.

Oct. 10: 2010 Making Strides Against Breast Cancer Philadelphia
Where: Philadelphia Museum of Art, 26th Street and the Benjamin Franklin Parkway, Philadelphia.
Contact: (215) 985-5401 or makingstrides.acsevents.org.

Oct. 15: Young Survival Coalition’s “In Living Pink” Event
Where: Kildare’s Irish Pub, 826 W. Dekalb Pike, King of Prussia.
Contact: (267) 898-2233 or yscphila@youngsurvival.org.

Oct. 15-17: Susan G. Komen 3-Day for the Cure Philadelphia
Where: Willow Grove Park Mall, 2500 Moreland Ave., Willow Grove.
Contact: the3day.org.

Oct. 30: 10th Anniversary Rock the Ribbon Celebration with Harry Connick, Jr.
Where: Academy of Music, Broad and Locust streets, Philadelphia.
Contact: academyofmusic.org.

Combating Arthralgia

While its symptoms are similar to those of arthritis, arthralgia is a general term for joint pain that can be caused by any number of factors. Taking an aromatase inhibitor doesn’t directly cause the joint-damaging disease arthritis, but the consistent pain experienced by those who undergo the treatment is often comparable. Last year’s joint study between Lankenau Hospital and Vertex Fitness implemented the following exercises:

• Hip flexion
• Abdominal pulldown
• Rotary torso
• Hip adduction and abduction
• Knee extension and flexion
• Leg press
• Row
• Decline chest press
• Lat pulldown
• Overhead shoulder press

Our Best of the Main Line & Western Suburbs Party is July 25!