Exercise – Liz O’Riordan explains why it should be the fourth treatment for breast cancer

We recently caught up with former consultant breast surgeon, breast cancer survivor and author Liz O’Riordan to discuss the positive impact that exercise has had during and after her cancer experience.

In our interview, Liz revealed why she found it so helpful to exercise during her treatment, shared her recommendations for staying active post-diagnosis and explained how exercise can be so beneficial in preventing breast cancer recurrence.

LOR: There is so much evidence now to show that exercise should be the fourth treatment of anybody with cancer. It can reduce the side effects of treatments such as chemotherapy, surgery, radiotherapy. It is the one thing that can help fatigue, although it’s the last thing you want to do.

It can also help with mindfulness and the mental side effects, such as anxiety and depression. It can reduce the risk of recurrence by up to 50% in breast cancer patients and gets people out of hospital quicker after surgery. It really is the miracle drug – and it’s free.

Everybody should be doing three sessions of aerobic exercise where you get your heart rate up and you’re sweaty. But most importantly, two resistance sessions a week will help alongside. The two have to go together.

LOR: I only got into exercise in my late 30s when I met my husband. He started cycling and I thought, if I don’t cycle, I’ll never see him, which led to us doing a 100-mile bike ride.

But then I got bored and started looking into triathlons. So I signed up to do one before my fortieth birthday, but shortly after was diagnosed with breast cancer. 

LOR: I couldn’t believe when I was diagnosed that I might not be able to exercise for the next five/six months during chemo. It had become a really important part of my life and I didn’t know what to do, what was safe. Everyone says ask your doctor if it’s safe to exercise, but I’m a doctor. I’ve had no training.

So I turned to Twitter and I found some amazing athletes who are still cycling, rowing, kayaking and training – some of them with metastatic cancer. And I thought sod it, I’m just going to do my thing.

Plus, I was told by a friend the best thing I could do to help the symptoms of chemo was to exercise every day, and it worked. So I started walking every day with a neighbor. I started doing park runs, bald as a kook with everyone staring but I didn’t care. I even did a pool-based sprint triathlon halfway through chemo.

LOR: The chemo for me was four or five days of feeling like absolute hell and then I’d get a great week. And although I walked every day, I wanted to see if I could carry on running, cycling and swimming during chemo.

I had my chemo in the summer, so I would cycle to my sessions and my husband would drive me back. It was so good just to bob along the country lanes with the wind in my hair – well, not my hair because I was bald, but just feeling free.

I swam at the local health club because I had a tunneled line, so it was safe. And I just thought to myself, I wonder if I can do a triathlon, because I was meant to be doing a half Ironman in September and obviously, I couldn’t with chemo.

My local club was doing a sprint triathlon and I begged them to let me do it. I had to promise I’d be sensible and that I wouldn’t need a doctor and I wouldn’t race. Because the slowest people went off first, I wasn’t last but it took me two and a half hours.

I was filled with the feeling that cancer hasn’t taken everything from me. When I crossed that finish line, I was just Liz. My husband and I were crying, and it just meant so much to be able to carry on with some part of my life and hopefully inspire other people.

LOR: It’s really hard as the patient, hearing that you have to exercise because a lot of the treatments we give women with breast cancer makes them put on weight and can make them go into the menopause.

And you think, sod it, I’ve had cancer. Now you’re telling me I need to go and run? Exercise can sound like a dirty word, but it is so important. It is something you can take control of. It can be as simple as walking every day to your heart rate, just seeing how far you can walk.

The Couch to 5k app is a great way of getting into running. Most breast cancer centers will also have information about moving on groups and often the local councils will do programs, including swimming and various fitness classes that are reduced.

But the thing that will help women the most is having a sense of community – and that’s why I love park runs. The 5k your way, where you are doing it with other people – and you have to turn up because they are. You just have to make it part of your life and ideally, bring your family on board.

LOR: When I was just coming to the end of treatment, I started trying to find other people who were exercising, just to inspire me to think, oh I could try that. And I realized there’s nothing out there. There’s nothing for the elite athletes who want to carry on doing Iron Mans. or for the man in his truck with prostate cancer.

So what I’ve done is create a charity with four other people called CancerFit. It’s about to go live in a couple of weeks, with a website full of patients stories – people with cancer, metastatic cancer, of all ages who are exercising. There’s blogs you can read to help you get inspired.

We’re also putting in all the evidence showing what you need to do and why you should do it. It’s designed to educate doctors and nurses too, so they know how important it is to keep telling patients to exercise.

LOR: It’s now two years since I had my local recurrence and new guidelines have come out came out about the importance of aerobic exercise and resistance (weight) training – and I realized I wasn’t doing any resistance training. I can’t be a spokesperson for exercise and cancer if I’m not lifting weights myself. So I started going to the gym, and I love it.

I’m only in there for 45-50 minutes a time. I’m lifting weights really heavy. I’m getting really strong. There are muscles on muscles I’ve never seen and my shoulder strength has improved hugely.

And not only is it reducing my risk of recurrence, it’s improving my bone strength. It’s reducing the risk of lymphedema and I just feel so fit. 

LOR: I actually think weight training is even more important than the aerobic training. Not only to improve your bone strength and reduce risk of osteoporosis but also to help, especially older in life.

One of the biggest reasons people go into nursing homes is that they cannot stand up from a chair. People with metastatic cancer will stay in their homes longer if they can walk upstairs and get themselves off the toilet. It’s just basic looking after your body.

You won’t get big if you go to the gym and lift heavy weights – it takes years and years to do that. And it can be at home. It could be doing lunges, calf raises, using tin cans, doing press ups against the kitchen counter to get you going. There are lots of exercise videos on YouTube that you could do.

LOR: The great thing about the #MagTeam100 challenge is that it’s encouraging everyone to exercise, not just breast cancer patients. It’s not going to eat cake and give money, it’s being healthy.

If we can get doctors and the team at Endomag exercising, they will encourage their friends. And hopefully patients will be encouraged to do it because exercise can reduce your risk of getting cancer in the first place, as well as reducing the risk of recurrence when you have it.

It really needs to be the fourth treatment that everybody is talking about it. And the fact that the money is going to research to help prevent breast cancer and maybe other cancers in future can only be a good thing.

You can still join the hundreds of people across the world taking part in the #MagTeam100 challenge this October – just click here to find out more.