The management of breast cancer has improved significantly in recent years. Cancer is being found in earlier, more treatable stages and there are more treatment options for women to choose from. Where once it was shrouded in silence, the topic of breast cancer is now discussed openly and without shame.
But even successful breast cancer surgery can be followed by aftereffects. Frozen shoulder, back problems and lymphedema are all common problems for breast cancer survivors, and can seriously compromise quality of life.
Medical exercise specialist and breast cancer survivor Annie Toglia believes that more must be done to prevent such problems. Previous to her diagnosis, Toglia worked as a trainer, specializing in sports medicine and designing individualized strength and conditioning programs for athletes. After undergoing treatment for her breast cancer, she created a different kind of conditioning program, this time for herself.
Together with her physician and medical team, she created a comprehensive exercise program that addressed the rehabilitative needs of breast cancer survivors, which culminated in her book, Staying Abreast: Rehabilitation Exercises for Breast Cancer Surgery.
Below she talks about common problems facing women after breast cancer treatment, and why it is so critical to get up and get moving after breast cancer surgery.
What led you to specialize in breast cancer rehabilitation? I was diagnosed with breast cancer in April 1996. In the years that followed, I underwent a number of treatments and procedures — mastectomy, reconstruction, chemotherapy, radiation, stem cell transplant — so I've been down a very long road.
Were you surprised by how hard it was to recover from the various treatments? I went into the first surgery very strong because I was a trainer, and I was surprised to find how difficult it was to recover. It was then I learned how ill-informed and unsupported many women are in their physical recovery, and I became interested in addressing these problems, using my skill as a trainer and dancer.
What sort of recovery support or advice is traditionally offered to women following treatment for breast cancer? I would say that even now, there are not very many options offered. It usually requires a very savvy team of medical experts to actually think about the physical recovery plan in advance. In some hospitals an occupational therapist or a physical therapist may visit a patient in a hospital right after their surgery and show them one or two exercises. There are not very many comprehensive programs.
Can you describe some of the common problems that women face following various surgeries for breast cancer? Frozen shoulder is very common. The connective tissue in the shoulder area actually becomes so tight that you lose the range of the motion in your arm. It becomes difficult even to lift your arm. A lot of people mistake frozen shoulder for a natural weakness in the arm and shoulder that follows surgery. What they're not aware of is that that weakness is starting to occur not only from the trauma of the surgery, but because of the immediate and rapid development of scar tissue after the incisions are made. A lot of the tightness and pain is the result of scar tissue.