Art Therapy?

Can art offer a pathway to resilience?

Our discussion on art explored our experiences of playing with our inner artist and we shared how making art and other creative projects helped us to cope with the effects of breast cancer.

    Naz told us that the brain mechanisms behind creativity involve letting go, a kind of mindlessness, the brain shows. Perhaps we feel art rather than think it? Resting our brains can lead to new ideas and problems can be solved without thinking about them. Resting our brain through art engages a part of the brain called the default mode network (DMN) and this can assist us to regulate our thoughts and emotions, it can re-energise us and bring harmony to our racing and anxious thoughts.

    

    Although not fully understood, art in a therapeutic sense can bring us resilience via an increase in our ability to access our own inner strength.
Our members, who are women with both primary and secondary breast cancer diagnoses, described a myriad of different forms of creativity that they found helpful, from playing a musical instrument to painting, photography to poetry, glass-work to knitting and crochet, beading to writing plays. Many women had found writing helpful during and after treatment, as a way of dissipating uncomfortable feelings, though some had felt their creativity was paralysed.

    For some, art is an escape from the everyday, and can be described as both mindful and mindless. We have a sense of losing ourselves in single-minded focus on a creative activity which frees us from our fears and anxiety. Discovering a new hobby or creative outlet can lead to increased confidence and sometimes new friends. Some picked up an old passion that they had loved when they were younger, perhaps a paintbrush or a musical instrument they used to play. For others, a journey of discovery into a new area of creativity has helped find a new pastime. Whatever direction our artistic and creative interest took us, it was clear that art offered them a sense of renewed purpose, and giving pleasure to others by sharing their creations with others was another reward.
    

    Many use their art to help others, perhaps selling items for charity, donating them to people in need or giving them away to friends. This sharing of something handmade, unique and personal can bring huge joy to both maker and recipient. Some creative pastimes provide special alone-time, while others, like singing encourage us out into the world. Many of us had found choirs and other singing groups to be extremely helpful in providing a joyful confidence building experience.

    Undoubtedly we are a group of talented creative women! Our enthusiasm for art indicates our dedication to self-care, a big element of building resilience. Each piece of art created, whether it’s a cardigan knitted for a baby, a blog about cancer, a heartfelt poem, a music recital, a memorable painting, or perhaps a song in the shower or a nicely presented meal, holds some of the essence of the creator.

Complementary Therapies

 

Research shows our mind and body are intricately connected. Ongoing studies are documenting that, when we try to nurture ourselves during the depths of diagnosis, treatment and beyond, we should take a holistic approach.

    Complementary therapies can play a large role in our ability to cope through treatment, even helping to maintain a standard of fitness, where possible. This can really help to boost our natural resilience. We must stress that the term is not to be confused with complementary or alternative medicine, which is often used interchangeably, but is actually very different.

    Reflexology was mentioned in our discussions a number of times, as was Mindful Meditation, Acupuncture, Hypnotherapy and Reiki. For those wishing to do something a little more active, Yoga, Pilates and Tai Chi are popular options, incorporating gentle guided movement and stretching. The Himalayan Singing Bowls/Sound Bath gives us music to sooth and relax to.

    Getting the timing right when trying a longer term therapy such as counselling is key, as acting too soon after diagnosis may result in a negative experience which may be off-putting for later when the talking therapy may be more useful. The trauma of a breast cancer diagnosis may take some time to process, and trying to crystalise our feelings may be harmful if taken on at a time when numbness is a useful self-protection mechanism. A good therapist will help us to make the right judgement at the right time.

    Self-awareness can be profoundly liberating when achieved via counselling, CBT, psychotherapy or other kind of talking therapy, but it can also be very challenging work. We have to be ready to face our fears, to dig deep inside and look at what we have been through, what it means to us, now and in the future.

    Our members have all had a primary diagnosis of breast cancer and many are living with a secondary diagnosis. Many reported finding the relaxation therapies very helpful both during and just after treatment, Reiki and reflexology proving very popular. Many cancer hospitals and centres offer these types of therapies to cancer patients free of charge and many of our members took advantage of this. Massage is also very relaxing, but many beauty salons and spas won’t offer massage to people who’ve had cancer without a letter from a GP or other medical professional, so it’s worth being aware of this when inquiring.

    Sound therapy has been tried by a few of us and has helped considerably with fatigue. Herbal remedies have been used alongside our traditional medication to enhance healing and wellbeing and to counteract the side effects of our post-cancer medicines.

    Some of us have shied away from complementary therapies, perhaps seeing themselves as someone who ‘just wants to get on with it.’ Personal wellbeing practices such as meditation and journalling are helpful. Others have taken a ‘bury my head in the sand’ approach, believing they don’t need or wouldn’t benefit from additional help.

    

    Calming meditative activities such as crochet, knitting and sewing are popular, providing both focus and distraction. Some of us feel that exercise is our therapy, we run or practice yoga or walk in nature.
Some of us are unclear on what therapies might be available and whether we have access to them as cancer patients. Many centres continue to support patients for up to 5 years after diagnosis, and those with a secondary diagnosis may find they have open access to their local centre. However some centres only actively offer complementary therapies during and just after treatment and this may not suit us, particularly if we are working as much as we can through treatment.

    

    Therapies offered vary considerably by region, and sometimes we may decide to find our own private therapists. It is key to trust the therapist and believe in the treatments undertaken. For some of us, we want to go to therapists who have been through cancer themselves, and/or have had specialist training in working with cancer patients.

    Counselling is generally offered as a series of six sessions which may not be long enough to be fully effective, and as private counselling is expensive this can be a problem. Scratching the surface and opening up deep wounds but not following them through may leave issues unresolved once the counselling stops. Some of us have had unpleasant experiences with therapies, and it’s worth taking the time to find the right one at the right time, and to check qualifications of the therapist.

    There were a few points raised that we need to be aware of. Firstly, there is a lack of funding, as with most things. Secondly, most of the therapies available are not state regulated, only self regulated. So as it stands, anybody can call themselves a complementary therapist. That’s not to say that there aren’t skilled people around, but there is no central organisation or strict guidelines that they must be answerable to. The people treating us also need to be aware of the changes in our bodies caused by our cancer treatments, such as neuropathy, fatigue, joint pain, among many, many other side effects, and should be able to adapt their specific skills to our individual needs.

    As with most things on the NHS, accessing these treatments and classes is a bit of a postcode lottery and can have rather strict and unfair qualification criteria, even where they are available. Cancer charities can be a good place to start and they will often only ask us to donate what we can afford towards the cost, if anything.

    The financial cost of paying for the sessions ourselves certainly seems to be a substantial barrier in accessing them longer term. Having had a cancer diagnosis, sadly, many find their incomes and ability to work very much depleted, so their recovery is hindered due to lack of opportunity and support.

    So, we would always suggest telling your Breast Care Team if you choose to join any of the sessions named above, so they can keep a full picture of your health and treatment choices on record. It is also helpful for them to see if your recovery has been aided by any of the complementary treatments.

    The therapies will obviously not be up everyone’s street and some treatments are more popular than others, but in our discussion we had such positive feedback that we can only encourage people to try. We hope you will be able to pick out and experience something that is suitable for you!

    As a group we believe that psychological help should be part of the package of treatment following a cancer diagnosis, with much better information about how to access complementary therapies and what they can do for us.

Supplements?

 

Is there a role for supplements following a diagnosis of breast cancer?

    Our discussions on diet have highlighted controversial scientific, as well as lay, views about the role of specific diets in cancer prevention, progression and treatment. Naz told us the literature shows there is a similar level of disagreement regarding the role of specific supplements when it comes to targeting cancer. Evidence from clinical trials showing direct causal links between the effects of some supplements/treatments on cancer are weak or non-existent.

    However, as Naz explained, this does not mean that we should rule out theoretical ideas based on these links. The effect of supplements on general health is also debatable, whether herbal or chemical. While there is general knowledge that certain compounds are healthy and can boost our immune systems, evidence based trials to prove their efficacy are scarce or have not been able to produce replicable results.
Where does this controversial, and sometimes overwhelming evidence leave us?

    Our discussions which included women with primary and secondary breast cancer, highlighted our hopes for better health, irrespective of the evidence, because we want to feel better and we want to support our physical well-being. Controlling what we eat and ensuring that we are providing our bodies optimum nutrition is an obvious way forward to help both our physical and our mental health.

    Many of us described wanting to re-build our strength and immune system following debilitating treatments and continue to suffer short-term and long-term side-effects such as fatigue and pain. Janet summed up how many of us felt:

'It makes sense to me that our cells require optimum nutrition to work properly.....'

    Hormonal treatments, and early menopause, impact on bone health and many of us took calcium as well as Vitamin D, under the supervision of our GP. Vitamin D3, we heard, was thought to be most beneficial. Vitamin C, magnesium, iron and probiotics were other popular choices, as well as Omega 3 and turmeric. Some women had sought advice from Nutritional Therapists, or done considerable research to educate themselves on this subject. Others had attended workshops at their local cancer support centres or said they were wary of taking supplements and had instead adjusted their diet to try to ensure optimum nutrition.

Workability and our Professional Identity

 

“Whether we work to live or live to work, our occupation often contributes hugely to our identity.”

 

Will I still be employable after I've been diagnosed with breast cancer? Will my employer still see me as someone worth investing in? How will I be seen if my organisation needs to make cuts? How should I approach my employer if I need support?

As a group of women with primary and secondary breast cancer, our experiences were very varied. We heard of supportive employers as well as shocking examples of discrimination and injustice, which not all of us felt we had the emotional or practical resources to challenge. Some had felt forced to give up careers they loved, others had taken early-retirement. Many of us wanted to continue in careers that we loved but were struggling.

A few of us maintain our continuity at work throughout, describing our careers as a refuge in the storm of cancer. Others shared how they had valiantly used up precious annual leave to recover from surgery, either from unsympathetic employers or small businesses. Others had taken an extended period of sick leave.

Erosion of self-confidence was a common response. Self-doubt creeps into the mind of the most competent of us, and the realisation that we are not the same person we used to be adds to our anxiety. So many of us have little voices inside our heads telling us that we can’t be successful now. And yet, we do not want to be seen as less capable or less competent than our peers in workplaces which are increasingly competitive and under pressure as a result of economic and legislative demands.

The gap between expectation and reality creates huge pressures when we are feeling vulnerable and fearful.

A supportive line manager or supervisor can make a huge difference - someone willing to try to understand our experiences and who is willing to help us to balance our needs and our capabilities. Those of us who had received robust support, suitable adjustments and flexibility valued it enormously and felt our performance improved as a result.

Our experiences highlighted that employers and sickness procedures often view us as idlers and shirkers. This can lead us to feel worthless and severely undermined.

Many of us take stock and consider our futures. We make tough decisions about work, including reducing hours or responsibility, changing roles or finding something completely different to do. Some of us give up work altogether, perhaps via medical retirement or redundancy. Others are determined to prove themselves as capable as they always were, and take on perhaps more than we should in order to continue to keep ahead of the game.

Despite clear legal requirements and guidelines for employers, our experiences indicate that they are not always being followed, and when challenged, the resulting stress caused can be just too much for us. Occupational health teams, designed to assist both employer and employee in coming to a suitable agreement regarding reasonable adjustments, can be helpful, or punitive. Some of us had chosen to fight for our rights, others walk away.

A common theme was managing unrealistic demands and some of us felt we had been set up to fail. We don’t always have knowledge of our rights or the energy to challenge discrimination and poor practice. We can end up being managed out of jobs by employers based on capability. We also feel uncomfortable or a nuisance for continued reduced capability or significant sick leave, and employers often show their displeasure by reducing or removing sick pay once they have delivered on their legal obligation.

Very few of us have found excellent bosses with whom we can be honest and admit our vulnerabilities. These bosses are rare, it seems!

What we need is supportive adjustments such as a smaller workload, staggered start-times, reduced hours, time off for hospital appointments and regular breaks. We need helpful colleagues not snide remarks about shirking. We hope, if you are a line manager or colleague of someone with a breast cancer diagnosis reading this, that you understand the legal and moral obligation on you to support us, and how much we have to offer given the right assistance. We've been to hell and back, and if we ask for time off for an appointment then this is key to our well-being. We know how precious time is, and we aren't going to waste it. We will give you our best, every minute of every day, as we want our time to count.

 

For those of us who have had to change careers, reduce our hours or give up work, it is a huge decision that isn't taken lightly. Following a breast cancer diagnosis, with the battering our bodies take and the psychological toll stripping us of our former energy and capability, we may become depressed and our self-confidence plummets. We are fragile and vulnerable. For some, the decision to find a less stressful job or to give up work (for those lucky enough to be in a financial position that allows this) is triggered by a change in priorities. Having faced serious illness, we find we no longer want to spend our days working flat out. For others, it's going back to work that helps us feel normal again, that gives us a sense of purpose and satisfaction, and fills our days with productive activity, helping us not to dwell on our thoughts about our cancer.

 

For women with secondary breast cancer and who need continuous treatment, the only option may be to stop work as sustaining productivity levels commensurate with their position may not be possible. For these women, priorities often centre around spending time with family and friends. While giving up work may be a relief, there is still loss – the loss of career and routines; it can also be very hard to give up who they were as professional and working women and there is, of course, often significant financial implications.

 

There is often a conflict for many of us returning to work, particularly those of us who are young, ambitious women and who are on a career path. How do we balance the desire to succeed, to climb the promotion ladder, with wanting to see more of our families, to spend more time doing things we enjoy, to take it easy?

Being understood in our workplace can be a defining factor in helping us re-build our self-esteem upon returning to work, or, conversely undermine our already fragile confidence and self-esteem.

There are, we discovered, no easy answers. We need to try and adapt and adjust, to cope with the feelings of being lost and bewildered, as if we don't quite belong. A phased return to work can be really helpful, with the intervention of occupational health professionals as appropriate. Macmillan also provide objective advice and guidance to women who need it. Not everyone was aware of the protection afforded to us by Equalities legislation, or that this would continue for the rest of our working lives.

Those working in organisations with clear procedures seemed to fare better, but not always. We learned that it helps if managers can have a conversation with us about our cancer and can separate poor performance, from support to help us to perform well.

To conclude, here are some practical suggestions for both employers and employees:

·       A realistic phased return which introduces us back into the workplace

·       Part-time working

·       Staggered start and finish times

·       Reduced workload/caseload

·       The ability to rest in the day

·       Support to plan and prioritise work 

·       Equipment, for instance if we have lymphedema

Improving Our Cognitive Health

 

 "What do you take to make your brain work again? My brain is not what it used to be after diagnosis”

Naz started by saying how diagnosis, treatment and an overload of information means our brains can be sluggish and we cannot think as clearly and concentrate as we did before breast cancer. Cognitive efficiency is reduced and this can lead to a downturn in our psychological well being. We discussed how we are individually affected, how this manifests itself. After treatment for our primary cancer, the trauma and the medication can leave our brains fatigued, and after news about a secondary diagnosis, we feel “shocked” and “numb” and this awful news can affect our brains in a similar way to how we respond after a primary diagnosis.

    Lack of sleep was a big contributing factor, as it was noted to make us feel foggy, when our sleep improved, there was also a considerable improvement noted in our ability to concentrate. Prolonged periods of broken sleep give physical and mental difficulties, and getting our brains working again gets even tougher. It was also emphasised how concentration for any length of time is very difficult. Noticing when this is happening helps, and we can take a “pause”. Anxiety makes us feel foggy too, and negative thoughts about ourselves exhaust us. Work can sap us of our energy using all our, now more limited, brain power so we have little left for out of work in our home lives.

    Our brains need reawakening and our members discussed strategies and techniques to do that. Breaking down big tasks into small chunks was a method that one member found helpful and others agreed. To challenge and stretch her brain, one member learnt new musical pieces. Another theme that came up was how mindfulness can help and when we pause and take a three minute break, we can come back refreshed, with improved concentration.
    

    Creative activities are demonstrated to improve the elasticity of our brain and a member, after some very difficult news, has taught herself to crochet, and learnt how to focus on something new which has given her a great sense of achievement. We wanted to keep our brains “active” and these creative pursuits alongside puzzle books, escape rooms and reading non-fiction achieves that. Even if we are exhausted, if our brains are active, it is very satisfying. If we are participating in an enjoyable activity, we can become more relaxed and happier, and the frustration at our brain fog may lessen. Although this may not directly improve our brain fog, it gives a sense of well being and can divert from the anger we may be directing at ourselves. Those members who had participated in BRiC’s cognitive training research reported that they had seen a marked improvement in their concentration and attention which had helped the brain fog lift.

    Tackling the anxiety that makes us exhausted is really useful - and practising mindfulness helps us find some peace of mind, we might sleep better as a result. Self awareness of how our brains may process information differently now may help too, and acceptance with the understanding of the need to not tipping over into doing too much.
From a practical point of view, having a rest day and taking supplements seemed to help some. Vitamin D, zinc, vitamin C, glucosamine and magnesium were all mentioned along with the B vitamins. Staying hydrated seems to help in addition.

   It appears that better sleep is the holy grail, but if this is out of reach, there are various mindful and creative pastimes to give our poor brains a little boost, and help us adapt and live with this new normal.

  

Mindfulness Meditation

 

‘What is mindfulness? Here is one dictionary definition:

‘a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.’

    Mindfulness has become a fashionable panacea for all trauma and distress, the modern antidote to frantic living. Courses are available in abundance, and it’s commonly taught in the workplace and even in schools. There is little research on how it actually works on the brain, and feedback is mixed on its efficacy, with some reports even finding it to be the opposite of helpful. Mindfulness is prevalent in the buddhist tradition and can include meditation and prayer. Some studies show it improves concentration, can help with a good night’s sleep, enhances quality of life.
    

    Many of our women, all of whom have had a breast cancer diagnosis, some primary, some secondary, have found mindfulness very useful. It can be calming in stressful situations to breathe deeply and simply focus on the self or on our surroundings. However, focusing on our emotions can bring up all sorts of negativity and as a result, far from calming the mind, it can cause panic or upset. Accepting a flood of emotion in the moment, when what we are seeking is distraction from a difficult current situation, can be frightening. The idea that with practice we can actually control our thoughts and feelings is perhaps an attractive one, but it is difficult to master, and even more difficult to put into practice when most needed.
    

    The link between body and mind is also the subject of much research, and it is undisputed that relaxing the body via breathing exercises can calm the mind. The vagus nerve is affected by controlled deep breathing and this has been shown to improve equilibrium. Acceptance is what mindfulness teaches, acceptance that the present moment is as it is, and that we are safe in that moment, despite what is going on inside us and outside us. It’s not resignation, a giving in type of acceptance, it’s an empowering peaceful way of keeping ourselves grounded. As one of our members put it, ‘(there are) subtle and not so subtle feelings that can emerge when we are focusing, and how in riding the waves of those feelings, we can drift safely back to shore.’
    

    Visualising a calming scene when we’re feeling anxious can be a useful form of mindfulness - imagining being on a beach with the waves lapping against the shore can be helpful in counteracting the stress of a medical scan, for example.
    

    Our women described many different ways of using mindfulness. Some of us have attended formal courses, some have used online apps, some have read books, some are self-taught. Some are using breathing techniques for relaxation without knowing much about mindfulness, others have taken elements of what we’ve learned, perhaps meditation or a body scan, and we use these to help them to calm our racing brains. Others have picked up on techniques of mindful eating and use these to address healthy eating issues. Yoga may be seen as a moving form of mindfulness, focusing as it does on proper breathing and fusing body and mind in relaxing movement.
    

    Many of us probably practice a form of mindfulness unknowingly. Any focussed task that takes concentration can be done mindfully, and in a way that brings calm and relaxation. Crochet and knitting are a great example. This type of craft is both a distraction and a mindful activity, repetitive and calming.
    

    For deep-seated trauma, such as may be caused by a breast cancer diagnosis, mindfulness may not be the right ‘therapy’ to address the issues. For some, mindfulness can bring on sadness and panic, and this is a common reaction and often seen as failure. However this is perfectly normal and just means that mindfulness doesn’t suit everyone. It’s become so prevalent, everyone seems to be doing it. Mindfulness uses bodily sensations to connect to the present, through breathing or observing sensations in the body, and for those in pain or with scars and ‘broken bodies’ this means facing our trauma head on, which is just too much for many. Many reported finding mindfulness helpful during periods of relative calm in their lives, but found it too hard to do, for instance following a bereavement.
    

    Perhaps instead of practising mindfulness we could consider slowing down our pace of life, so that we are naturally mindful of our own needs, the needs of others. For those with secondary breast cancer, this slowing down may be enforced by health needs, and for some it reveals a different way of living, a more mindful way of being. Would we actually be better off spending time with a good friend, really connecting, really listening to what’s going on in their lives, as opposed to taking time out alone to focus on ourselves? There is a lot to be said for mindful living.

    Mindfulness has found a place in our world and its popularity speaks for its efficacy. However, it doesn’t take the place of talking therapies for deep issues and post traumatic stress disorder (PTSD.) Perhaps the best use of it is to find what works for you and practice that.

    We are eternally grateful to our amazing Laura Ashurst for her truly calming and inspiring sessions of mindfulness that we enjoy once a month.  

Exercise

 

“We are finding new ways of keeping moving, and celebrating smaller achievements like walking a kilometre rather than running a marathon, sailing a cruiser instead of a dinghy, or cycling on an electric bike rather than a manual one.”

    The benefits of exercise as part of a healthy lifestyle are well documented, and it makes common sense that a fit body will contribute to a resilient mind. Our group, which is made up of women with both primary and secondary breast cancer diagnoses, were interested in the specific ways in which dance and exercise help us to feel better. 

    Naz explained that exercise may lead us to feel more positive, energised and lighter. Our brains work more efficiently and this, in turn, can lead to better emotional regulation. Exercise can lift our spirits as it releases neurotransmitters in the brain which increase the brain’s reward responsiveness, which may become dormant when we are depressed.  

    We shared how we had used exercise, relied on exercise, tried exercise for the first time, given up and restarted exercise, become positively addicted to exercise. Some of us stopped exercising during treatment - either because we felt too poorly, or as rest became a priority, some of us continued as much as we could, while others stuck to a gentle toned down routine. 

    For those of us who love exercise and have a strong routine, a breast cancer diagnosis can be extremely frustrating as we may have to modify both frequency and intensity. Treatments like chemotherapy and radiotherapy may put a stop to exercise, and fatigue is a very common problem. When we feel weary, forcing ourselves to get up and move is difficult but may be as energising as rest, and many reported feeling lethargic when they missed a few days of exercise. 

    For many of us, exercise is a pleasurable part of our lives.  It may be running or walking, swimming, yoga, horse riding, sailing, gardening, cycling, climbing, rowing, caving, dancing. Any activity that involves repetitive movement can be helpful on many levels. It can also be a mindful meditative practice, calming the mind while working the body. 

    

    More challenging activities that require co-ordination of mind and body, such as more formal dance where we are learning steps and routines, are an excellent mental as well as physical workout. 

    The joy of moving our bodies to movement is evident in the comments from those of us who participate in dance. We listed ballroom, tap, ballet, disco, belly & salsa, and many of us have trained for medals and performances, adding the extra dimension of formally recognised achievements to the mix. Zumba is increasingly popular, and many different fitness through dance classes are now available. Music touches us emotionally and dancing brings our bodies closer to our brains and increases the fitness of both. It brings a sense of freedom as we lose ourselves in the music and move, as well as discipline as we learn new moves. Dancing to the radio whilst doing the household chores is also very popular for us! 

    We reported feelings of wellbeing associated with all types of exercise, including a sense of release, of alleviating worries and anxieties. Team games can help with feeling cameraderie, a part of something. Exercise has brought a better night’s sleep for many of us, helping us to feel physically refreshed and rested. Many find it’s helpful in managing anxiety. 

    Some of us are continually frustrated that since being diagnosed with cancer we are unable to exercise as much as we used to, with some activities proving impossible due to fatigue, aches and pains, and lymphodema (swelling in the armpits, chest and arms as a result of breast cancer treatment.) We felt that there is a need for advice and physiotherapy to help us and offer individually tailored advice.

    Although finding it hard to accept the changes in activity levels forced upon us by cancer, or by the side-effects of our treatment, we are all focused on what we can do rather than what we can't do. We are finding new ways of keeping moving, and celebrating smaller achievements like walking a kilometre rather than running a marathon, sailing a cruiser instead of a dinghy, or cycling on an electric bike rather than a manual one. We keep trying, we stumble, we start again, we never give up. When we feel weary and beaten, a gentle stroll around the block can completely change our mood. 

    A breast cancer diagnosis can undermine our confidence, and our eagerness to join in with group exercise can wane as a result. However exercise can also help to rebuild that lost confidence, and many of us have managed to join classes, gyms or teams. For others, walking in nature with friends, a dog or on our own provides peace and calm, and escape from the hustle and bustle of everyday life. 

    A breast cancer diagnosis brings fear and anxiety. For some of us there comes the question - what’s the point? We may put all sorts of things on hold, including our exercise regimes, while we recover physically and emotionally from the trauma of our diagnosis. Once active treatment is complete, many but not all of us, reported that feeling able to get back on track and exercising again can feel like one step on the path towards feeling good again.

    Exercise related goals and achievements can make us feel good about ourselves, whether we complete a marathon or manage 10,000 steps a day, it doesn’t matter.   There may be days when getting off the sofa and shuffling round the house may be a huge effort, and when we have down days, moving can really help us feel we’ve accomplished something good. 

    As an extra positive, a few of our members were inspired by our discussion to get out there and exercise after and reported back about how much better they felt.  However hard it feels initially, moving our bodies undoubtedly helps our minds to function better, so making the effort to find something we love to do is well worth the effort.

Physical limitations and exercise

'Accepting our physical limitations is one of the most difficult mental challenges we face with serious illness.'

    We all know that exercise is good for our bodies and our minds. It's good to raise our heartbeat, move our limbs, stretch our muscles. Exercise releases feel good chemicals into our brains and it lifts our mood. Recent research shows that exercise positively affects our brain, improving processing ability and connectivity. We just need to get up out of our chairs and move. It's as simple as that. Or is it?

    Our personal experiences bear out the idea that being a regular exerciser does not stop us getting breast cancer. Nor can it prevent recurrence or the development of secondary cancer. There is no evidence to suggest that exercising can prevent progression of cancer either. Many of us were 'fighting fit' and still got the disease.

    What exercise can do is help us to feel better about ourselves. It can assist in speeding up recovery from harsh cancer treatments and surgery, helping our bodies gain strength and heal better. Exercise can, most importantly, lift our mood. It may be the hardest thing, but to get out of our chair and move our body, whether this is a few gentle stretches or a full gym workout, will undoubtedly help us to feel less fatigued and less stressed, and better equipped to deal with daily life.

    We were reminded that for many women, exercise is curtailed following a breast cancer diagnosis because of the debilitating effects of active treatment and the side effects of ongoing treatment. When getting out of bed and showering becomes a major feat, then exercise has to take a back seat. Much as many of us might like to be swimming the channel and running marathons, for many of us this just isn't possible. We do what we can, and rest when we can't.

    Accepting our physical limitations is one of the most difficult mental challenges we face with serious illness. As one member put it, we need to stop beating ourselves up about what we should/shouldn't be doing. We each need to find a way to enjoy exercising in a way that supports our healing.