University of São Paulo: Pandemic worsened health conditions of women in remission of breast cancer

The research was carried out with women in breast cancer remission who practice rowing at USP’s Olympic Lane through the Remama Project, which seeks to offer quality of life to patients who have undergone the treatment of the disease at the Cancer Institute of the State of São Paulo (Icesp) – Photo: Remama Program Archive
THEpandemic has led a group of women in breast cancer remission to worsen their health conditions. Before active in the practice of physical activity, during social isolation, a period in which they had to be removed from the canoeing of USP’s Olympic Streak, they presented body weight gain (from 1 to 15 kilos), 90% stopped or reduced the practice of physical activity and the majority (58%) had symptoms related to covid-19. The details of this research, carried out with paddlers who practice canoeing at USP’s Olympic Lane, are described in the article “Determinants of health and physical activity levels among breast cancer survivors during the Covid-19 Pandemic”, which will be published soon in the Journal Frontiers in Physiology .

Patrícia Chakur Brum, professor at USP’s School of Physical Education and Sport (EEFE) and research coordinator – Photo: Personal archive
“Understanding correlations of this dynamic is fundamental, since obesity is a risk factor for recurrence of several types of cancers, including breast cancer, in addition to contributing to the worsening of covid-19”, explains Patricia Chakur to the Jornal da USP Brum, professor of Exercise Physiology at the Department of Biodynamics, USP’s School of Physical Education and Sport (EEFE) and research coordinator.

The results found confirm other studies in the area that show that social distance has increased physical inactivity and sedentary behavior among the general population and, more profoundly, among people at increased risk, such as the elderly and people who have chronic diseases. communicable diseases.

“Physical inactivity can exacerbate comorbidities among the elderly, including cardiovascular disease, cancer and dysfunctional inflammatory responses,” he exemplifies.

Professor Patrícia, together with a team of researchers, advisors and professionals from EEFE, from the Cancer Institute of the State of São Paulo (Icesp), from the Lucy Montoro Institute and from the Center for Sports Practices (Cepeusp) at USP, carried out a study of monitoring of 41 women who underwent breast cancer treatment by the Unified Health System (SUS), at Icesp, and who, after being rehabilitated, begin to row at USP’s Olympic Lane.

The Remama group, as it is known, has been welcoming women in these conditions since 2013, keeping them active so that they can find new perspectives on life after having passed through cancer. Many underwent mastectomy (partial or total breast removal), chemotherapy and / or radiation therapy. The group’s monitoring and supervision are carried out by physical education professionals and professors from USP. In addition to keeping active by paddling twice a week on the lane, they raise the banner of breast cancer prevention (done through periodic examinations).

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They were invited to participate in a survey survey on the impact of the pandemic on levels of physical activity in breast cancer remission. Of the 41 women, 37 responded to the survey questionnaires. The average age of the volunteers is 57 years. Twenty-two (59%) reported an increase in body mass and the most common symptoms were headache, myalgia, cough and sore throat. Although three rowers were hospitalized, none developed serious complications of the disease, reports Aline Rachel Bezerra Gurgel, first author of the article and visiting researcher at the EEFE Laboratory of Cellular and Molecular Physiology of Exercise.

According to Aline, the only factor associated with the difficulty of staying physically active and engaging in activities was the fact that some of them had performed more than three cancer treatments – surgery, chemo and radiotherapy. Women undergoing these procedures found it more difficult to maintain the levels of physical activity recommended by the World Health Organization (at least 150 minutes of moderate intensity activity per week).

From this data, Aline explains that it is possible to make a correlation between the difficulty they encountered and the long-term side effects of cancer therapy, which include fatigue, insomnia and lymphedema (swelling of the arms), among others.

Project seeks to offer quality of life to patients who have undergone treatment for the disease at the Cancer Institute of the State of São Paulo (Icesp) – Photo: Arquivo Programa Remama
For the rowers, the disincentive came from the loss of contact with colleagues, women who live in identical conditions to cope with the neoplasm, the lack of a pleasant environment and the outdoors that the Olympic Streak provided them, and the lack of supervision of physical exercises, besides, of course, the negative aspects that the pandemic imposed on them: unemployment, loss of income (most women were autonomous), physical distance, uncertainties and the risk of contamination by a virus that is still known a lot little.

For infectious diseases Anna Sara Levin, professor in the Department of Infectious Diseases and coordinator of the Hospital Infection Control Group at Hospital das Clínicas, USP Medical School (FMUSP), the level of exposure to SARS-CoV-2 that women, in potential they faced during the pandemic was one of the factors that could have led to the disease. And, in fact, at the height of the pandemic, in July, August and September, 60% of women were using public transport to go to work and guarantee family income, the study says.

The fact that they are more exposed to the virus through the use of public transport could impact the contagion index; already being part of the risk group, either due to age or having had breast cancer, and having increased body mass gain are factors that influence the course of the disease, explains the infectologist.

Online classes

Distance physical activity classes for women in breast cancer remission were a strategy found to reduce levels of physical inactivity during the pandemic – Photo: Programa Remama Archive
According to Patrícia, the research findings were fundamental for the development of a strategy that would lead the participants to reduce the levels of physical inactivity during the pandemic and to recover the gains obtained since the beginning of the Remama program in 2013: the creation of a program, with structured classes, synchronous and online, with the participation of researchers, graduate and undergraduate students (scholarship holders of the PUB-university extension program). Since November, volunteers have trained twice a week and receive individualized guidance.

In this way, they met again in the virtual environment. Teachers and monitors try to make up for the distance by reinforcing stimuli during classes. “It is important for everyone to be engaged. Physical activity improves the quality of life and the effectiveness of therapies, mitigating potential adverse effects inherent in cancer therapy and drug toxicity ”, he concludes.