Imagine being told that a simple, accessible activity could significantly improve your strength, balance, and overall quality of life while battling advanced breast cancer. It sounds almost too good to be true, but groundbreaking research is proving just that. Supervised exercise programs are emerging as a powerful tool in the fight against metastatic breast cancer, offering hope and tangible benefits to patients. But here's where it gets controversial: while exercise has long been touted as beneficial for general health, its role in advanced cancer care has been largely overlooked—until now.
New findings presented at the Advanced Breast Cancer Eighth International Consensus Conference (ABC8) reveal that aerobic and resistance exercises can dramatically enhance physical performance in patients with metastatic breast cancer. Professor Anne May, a leading expert in clinical epidemiology of cancer survivorship from the University Medical Center (UMC) Utrecht and the Netherlands Cancer Institute, shared results from the PREFERABLE-EFFECT study. This nine-month supervised exercise program demonstrated remarkable improvements in muscle mass, strength, and balance—particularly in the arms and legs—for patients whose cancer had spread to other parts of the body.
Why is this a big deal? Patients with metastatic cancer often face debilitating side effects from treatment, such as fatigue, nausea, and pain, coupled with the physical toll of the disease itself. These factors frequently lead to a decline in skeletal muscle mass, which negatively impacts body composition, strength, and functional performance. Professor May highlights that low muscle mass in patients undergoing chemotherapy has been linked to increased treatment-related toxicities, dose reductions, and poorer outcomes. Hormonal therapy further exacerbates this issue. Yet, until this study, patients with metastatic cancer were often excluded from exercise research, leaving a critical gap in evidence.
The PREFERABLE-EFFECT study, the largest of its kind, enrolled 357 patients across five European countries and Australia. Participants were divided into two groups: one receiving standard care and the other engaging in a nine-month exercise program. This program included supervised aerobic, strength, and balance training twice a week for six months, followed by a mix of supervised and unsupervised sessions in the final three months. All participants received activity trackers and general advice to engage in at least 30 minutes of daily physical activity.
And this is the part most people miss: After just six months, the exercise group showed significant improvements in physical performance, including balance and muscle strength. Whole-body lean mass increased in the exercise group, while the control group experienced a decline. On average, muscle mass was 0.79 kg higher after three months and 0.32 kg higher after six months in the exercise group compared to the control group. Even more striking, muscle mass in the arms and legs—critical for movement and load-bearing—increased by 0.6 kg at three months and 0.48 kg at six months in the exercise group, while the control group saw a decline. The skeletal muscle mass index, a key indicator of muscle health, also improved significantly.
Here’s the kicker: Balance, a critical yet often overlooked aspect of physical health, improved notably in the exercise group. For patients with bone metastases, better balance means a reduced risk of falls and fractures—a life-changing benefit. One participant, who initially struggled to board a bus, regained this ability after the program, allowing her to visit the city center and library again. This isn’t just about physical health; it’s about reclaiming independence and joy in daily life.
However, not everyone is convinced. Some argue that exercise programs may be too demanding for patients already battling advanced cancer. Others question whether the benefits outweigh the effort required. What do you think? Is supervised exercise a feasible and essential addition to cancer care, or is it an unnecessary burden for patients already facing immense challenges?
The ABC Global Alliance is taking action, launching a Physical Activity Resource Hub in 2026 to provide personalized, safe, and supervised exercise guidance for patients, caregivers, and healthcare professionals. Isabelle Aloi-Timeus, a cancer physiotherapist and founder of Salvati AC, emphasizes the importance of tailored exercise programs. Eva Schumacher-Wulf, a patient living with metastatic breast cancer, underscores the need for programs that address the unique challenges of advanced cancer patients.
Professor Fatima Cardoso, President of the ABC Global Alliance, sums it up perfectly: “In managing advanced breast cancer, finding a balance between quantity and quality of life is crucial. Research like Professor May’s not only improves treatment outcomes but also empowers patients to take control of their health.”
So, the question remains: Could exercise be the unsung hero in the battle against advanced breast cancer? Let’s keep the conversation going—share your thoughts in the comments below!
