Cancer symptoms and those brought on by its treatment can have a huge impact on everyday life. Physical symptoms commonly include fatigue, post-surgery pain, hormone-related symptoms in-cluding hot flashes, sweats, palpitations, urinary incontinence and cognitive and mood changes. Psychological effects such as anxiety and depression are also common. Physical symptoms exacerbate anxiety as they are a constant reminder of the cancer and add to the worry about whether it will recur. Some of these symptoms are seen in cancer survivors as long as 20 years after the cancer has gone.

Participants in this study from New Mexico and western Washington were asked to score their lev-els of pain and physical sensation, hormone-related symptoms, sexual interest/dysfunction, fatigue and physical health-related quality of life at 6, 29 and 39 months post-diagnosis. They were also asked to quantify their physical activity levels based on household activity, moderately vigorous activity, vigorous activity and sports/recreational activity at these times. The authors expected to see higher levels of activity being related to fewer physical symptoms and higher health-related quality of life.

Surprisingly, women who had done a lot of exercise before their cancer had no fewer symptoms than those who had not done much exercise. However, the biggest difference in cancer-related symptoms and quality of life was seen in those who either maintained or increased their activity levels over the cancer experience. Increased physical activity, especially post cancer, was consis-tently related to better everyday functioning and reduced fatigue and bodily pain. This was most marked in those who did regular vigorous or sports/recreational activity compared to moderate or household activity.

An added bonus of this study was that it emerged that those who maintained vigorous activity levels reported less weight gain and cared more about their appearance. Since excess body weight is associated with increased recurrence of breast cancer and lower survival rates this can only be a good thing.

The message then is clear: It is never too late to start. Even for those doing little exercise at diag-nosis, starting some form of vigorous exercise should have a significant positive effect on life after its successful treatment . What we need to know now is what type of activity is best and why.-Springer