This article appears in Paint it Pink 2017.

Exercise helps keep a body healthy and lowers risk of some diseases. For women with cancer, physical activity can do many things, including control weight, improve mood, boost energy, increase sleep, and be fun and social — as long as exercise is done safely.

It is well-documented that physical activity benefits patients with cancer, both during and after treatment. Exercise helps patients combat physical and psychological impacts of cancer treatment, giving them a sense of well-being, control, stress reduction and empowerment.

So why aren’t more oncologists discussing exercise with their patients? A focus group study from Gundersen Health System in Wisconsin found that 95 percent of patients surveyed felt they benefited from exercise during treatment, but only three of the 20 patients recalled being instructed to exercise.

The investigators interviewed nine practitioners plus 20 patients 45 and older with two kinds of cancer: non-metastatic cancer after adjuvant therapy and metastatic disease undergoing palliative treatment, both across multiple tumor types. While the sample size is small, the study provides an understanding of how the group as a whole has the potential to influence the practice of physical activity recommendations.

The results indicated that exercise is perceived as important to patients with cancer, but physicians are reluctant to consistently include recommendations for physical activity in patient discussions, said Dr. Agnes Smaradottir, medical oncologist and lead investigator of the focus group study, which was published in the Journal of the National Comprehensive Cancer Network in May. A key finding was that physicians expressed concerns about asking patients to be more physically active while undergoing arduous cancer treatments.

“Regular exercise has been a part of the breast cancer treatment plan for years,” Smaradottir said. “Exercise regularly from the day you are diagnosed and beyond and have exercise be an important part of your life. Carve out time for exercise at least every other day. It is that important.”

For breast cancer patients, Smaradottir’s recommendations for exercise are:

— 150 minutes a week (30 minutes a day, five days a week) of moderate exercise or 75 minutes of vigorous activity.

— In addition, two to three sessions per week of strength training that includes major muscle groups and stretching.

— For women who have never exercised, start slower, working up to the goal of 150 minutes a week.

— For women already exercising, continue the exercise plan with adjustments during chemotherapy and radiation.

Before starting an exercise regime, talk to your doctor about weight loss, weight management and what types of exercise are safe for you to do. Walking is probably the simplest, easiest and the most inexpensive way to remain fit. Studies presented at the American Society of Clinical Oncology conference reported that just 25 minutes of brisk walking every day not only cuts the risk of cancer but also helps people battling the disease.

For moderate exercise, try walking briskly at a pace where you are able to talk but not sing, Smaradottir said.