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Riding the waves: Exercise helps her cope with breast cancer
Danielle Cass worked with her Kaiser Permanente care team to stay active during cancer treatment. Surfing gave her strength, calm, and a sense of control.
During 3 months of chemotherapy, Danielle Cass never stopped surfing.
Three days after her first chemotherapy treatment, Danielle Cass of Berkeley, California, grabbed her surfboard, drove to the beach, and paddled into the ocean to catch some waves.
“Getting breast cancer makes you feel so powerless. It doesn’t matter if you’ve done everything right in your life. You can still end up getting cancer,” she said. “But when I paddled out, it was like, ‘I’m going to get through this.’”
Cass started surfing later than most people, at age 52. Several years later, she still surfs like she’s making up for lost time.
That commitment helped her cope during 3 surgeries and 12 rounds of chemotherapy.
“Surfing really helps. I just keep moving,” she said.
Early detection, surgery, and chemotherapy
Kaiser Permanente clinicians discovered Cass’ tumor during a routine mammogram when she was 56. Tests showed it was HER2 positive, meaning the cancer was fast-growing but treatable.
Her care team recommended a double mastectomy followed by chemotherapy.
One of the first things Cass asked was, “How can I get back in the water as soon as possible?”
“Starting the day after my double mastectomy, I worked with my breast surgeon, Dr. Veronica Shim, on a plan to stay active while I healed,” she said. “Dr. Shim told me how many walks I could take each day, and for how many minutes, and she called me several times that first week to check in.”
To speed her recovery, Cass decided not to get breast implants. Instead, plastic surgeon Rose Fu, MD, performed what’s known as an aesthetic flat closure.
“This type of breast reconstruction allows me to improve the appearance of the chest after a mastectomy by rearranging the soft tissue,” Dr. Fu explained. “I worked with Danielle’s breast surgeon to carefully plan the incision and preserve as much healthy tissue as possible.”
Seven weeks after her mastectomy, Cass was cleared to surf. She drove straight to the beach and paddled out.
Exercise and cancer survival
Cass laughs with nurse Keri Johnson during a chemotherapy session at the Kaiser Permanente Medical Center in Oakland, California.
Cass kept surfing through 3 months of chemotherapy that winter, despite cold ocean temperatures and rough waves. It helped her fight fatigue and stay positive.
She had the full support of her medical team.
“I’ve always been a huge advocate of exercise during chemo, especially if the patient is feeling fatigued,” said Eva Thomas, MD, Cass’ oncologist. “It sounds counter-intuitive, but women tell me that when they push themselves to exercise, they feel better. Mood is better, sleep is better, energy is increased, and body aches are reduced.”
Research backs up Dr. Thomas’ approach. Physical activity can help improve survival for people with breast, colorectal, or prostate cancer, Kaiser Permanente scientists found.
It may help people with other types of cancer, too. Regular exercise can also help reduce anxiety, depression, and fatigue.
Moderate exercise during chemotherapy
Talk with your doctor before starting or continuing to exercise after a cancer diagnosis.
“Once you get the OK, try to do as much of your normal activity as you can,” Dr. Thomas said. “If you’re a runner, keep doing it but maybe for 20 minutes instead of 40 minutes if your endurance is lower.”
If you don’t usually exercise, you can still start during chemotherapy — but start small.
“Take baby steps if you’re not fit,” Dr. Thomas said.
Now that chemotherapy is behind her, Cass keeps surfing as she recovers and continues treatment.
She gets Herceptin infusions every 3 weeks. The medicine is designed to slow the growth of breast cancer cells.
And she takes an estrogen blocker, which also slows cell growth in some types of breast cancer.
She’s grateful to her doctors for encouraging her to keep surfing during her diagnosis and treatment.
“It’s very calming for me — like I can do scary things,” Cass said. “It made me feel powerful and gave me agency while this big, scary, destabilizing thing was happening.”