Christine Cosby: Recovering after Breast Cancer Treatment Thanks to Prehab and Rehab

Age: 52Toronto, Ontario, Canada

I was diagnosed with stage 3 breast cancer in March 2018. After the diagnosis and before my surgery, chemotherapy, and radiation, I participated in a pilot clinical study of prehabilitation that improved my fitness and helped me maintain a positive attitude throughout treatment. I experienced a lot of side effects from my treatments, so my medical team referred me to a rehabilitation program. Both prehab and rehab benefited me physically and mentally, and today I am slowly but surely recovering.

My cancer journey began when I felt a lump in my right breast. I was sent for a mammogram and an ultrasound by my primary care physician. This was followed by a biopsy at the rapid diagnostic center at Princess Margaret Cancer Centre.

Just a few days later, my husband and I met the oncologist to learn the results from the biopsy. I was overwhelmed to hear that I had breast cancer. There is no history of the disease in my family, so this was totally out of the blue.

Right after giving us the devastating news of my cancer diagnosis, the oncologist outlined my treatment options. I decided I would have a full mastectomy; they would remove my entire right breast and many of the lymph nodes under my right arm.

We next met with a researcher who talked to us about a pilot clinical study of a prehabilitation exercise program. She explained to us that the idea is that participating in the exercise program before breast cancer surgery can help recovery. Being told that there was something positive that I could do to help myself was very appealing and I was motivated to sign up. I also believe that it is important to support research that will help patients in the future.

There were only two weeks between my diagnosis and surgery, but taking part in the prehab program gave me something positive to focus on and distracted me somewhat from my fears of the upcoming treatment.

The researchers provided me with a simple exercise program after they had taken some baseline measurements of my grip strength and cardio fitness. I was shown how to do five exercises with a resistance band, which I could do at home to build my upper body strength, and I was told that running up the steps at my neighborhood park for 10 or 20 minutes a day would improve my cardio fitness.

I had a tracking sheet to log my progress and this helped motivate me to exercise almost every day before the surgery. I know that the prehab improved my physical fitness because right before the surgery they repeated the grip strength and cardio fitness measurements and both had improved. It also taught me that a little exercise goes a long way, which has helped me enormously because I now know that I only need to take small steps to gain benefit.

The time after surgery is a bit of a blur for me. I had eight cycles of chemotherapy from May until August and then 25 radiation treatments from August to October. Since then, I’ve been taking letrozole every day.

I struggled badly with side effects from the treatments, in particular pain, fatigue, and lymphedema. As a result, my medical team referred me to an eight-week group rehabilitation program. There were 10 of us in the weekly classes, which introduced us to new strength and cardio exercises, and provided us with information on nutrition, mental health, and brain health. I also began physiotherapy and massage to help manage the pain and the lymphedema.

Overall, I feel that the prehab and the rehab programs really benefited my body and my mind. Physically, I saw improvement in my pain and fatigue almost as soon as I started the rehab program, and I know that my strength and cardio fitness are better than before surgery. Being able to see the physical progress also helps mentally; it helps me maintain a positive attitude, even when I experience setbacks.

Today, there is no sign of cancer in my body and I’ve recovered enough to go back to work part time. This has taken time away from my exercise program, but I’m learning to balance work, exercising, and socializing. My husband and I spend a lot of time together, and we just keep celebrating every day.