Breast Cancer Survivor Shares Benefits of Strength Training on Chemo

LaShae D. Rolle is a pre-doctoral fellow student in Prevention Science & Community Health in the Department of Public Health Sciences, University of Miami, as well as a breast cancer survivor. Her unique experience as both a cancer researcher and survivor allowed her to conduct research within the space.

Throughout her research, Rolle aimed to understand if continuing to participate in elite-level strength training would either positively or negatively affect her chemotherapy treatment outcomes, as well as her physical and mental wellbeing.

Rolle sat down for an interview with CURE to discuss the research in depth.

CURE: What inspired you to study strength training during active breast cancer treatment, and how can your research help patients safely incorporate exercise into their care?

Rolle: I wanted to turn this into a research project because I noticed that I had enough data for it to become a case study. The big premise behind me sharing my story online and starting Strong After Cancer was to be able to share my story with others who might be going through the same thing.

On Instagram, where a lot of people see my story, they would message me and ask me how to get started and what to do. While this is a case study, I tell everybody that it's a case-by-case basis and is based on the amount you can do. I thought that by getting it into the research literature, physicians and other patients might be able to see it and apply it to themselves.

Can you explain the methods of your research on strength training during chemotherapy and what specific exercises or protocols you studied?

I essentially did the same training that I was doing before, but I lessened the intensity right after each chemo cycle. I would give myself a break and then ramp it back up. So, it would follow a traditional powerlifting structure where you do a ramp-up and a deload. I did nothing different from before, except I used the chemo weeks as my deload week.

How do your findings on strength training during cancer treatment challenge the belief that patients should only do low- to moderate-intensity exercise, and what implications could this have for future research?

I do think that the intensity of your exercise has to coincide with where you were at a baseline strength. At baseline, I was always powerlifting, and that was my intensity. What might seem to be high-intensity training for one person might not be as high for another.

I use a Rate of Perceived Exertion (RPE) scale, which is how exerted I felt. I gave it a scale from one to ten; that was the one I used because they have one to twenty as well. I tried to keep it around a six, which is moderate, and then I would ramp it up to a nine or ten right before each chemo cycle. This was to basically take advantage of how I felt, because by the time you get to your next chemo cycle, you start to feel “normal” again, or close to your baseline. I timed it up around there.

I think that, yes, you can challenge it, and that everybody is a case-by-case basis, so it depends on the person. If they were doing no exercise, obviously they can’t just jump straight into high intensity. They have to kind of start at low and medium and treat that person like any other individual, especially once they get further out from their initial cycle. The later you are in your cycle, the more you are able to do things.

I do think that patients are capable, and they can do moderate to high-intensity physical activity. However, again, it's a case-by-case basis, and I think that it should be tailored toward the person and where they were at baseline.

Beyond the physical benefits, how does continuing strength training during active breast cancer treatment impact your mental and emotional well-being during such a difficult time?

From the moment of a cancer diagnosis, you lose a sense of control over what's happening to you. You have no control over what you have to do. You have to go to appointments and get whatever treatment is recommended. For me, it was surgery, chemo and radiation. I had pretty much no say in that, and I just wanted to get better. What I did have a say in, and what I did have control over, were my workouts and my mentality, and that's what I focused on. It helped me stay focused and become unstoppable.

For those moments, I was able to have a sense of normalcy. A normal day for me would be working out, and so I was able to do that throughout treatment. That's what exercise was for me. It made me believe that this wasn't it and that I could come back after cancer. By being able to have numbers so close to my max numbers in the middle of chemo, it made me believe that this was not the end. I can come back, and I can truly be strong after this diagnosis. It was just amazing for me from a mental and confidence standpoint post-cancer.

My hope is that physicians and all clinicians are able to read this research and apply it to their patients and tell them that it's an individualized approach. I would hope that for every patient, when they get a prescription for medicine or any kind of therapy, they also get an exercise prescription telling them what they can do.

That's the end goal: for people to know that they can exercise during and after cancer treatment and that they have some sort of regimen to follow… [My] full workout regimen can be tailored sometime in the future for other patients.

As both a researcher and a cancer survivor, what are your hopes for how individualized, high-intensity exercises might be integrated into cancer care in the future?

My hope is that physicians and all clinicians are able to read this research and apply it to their patients, telling them that it's an individualized approach. I would hope that for every patient, when they get a prescription for medicine or any kind of therapy, they also get an exercise prescription telling them what they can do.

The end goal is for people to know that they can exercise during and after cancer treatment and that they have some sort of regimen to follow. That's why I put my full workout regimen in the appendix, so that maybe this can be tailored sometime in the future for other patients.

Transcript has been edited for clarity and conciseness.

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