Cancer has overtaken heart disease as the No. 1 killer in the United States, according to Jane E. Brody of the New York Times. oncologist's now take a page  from heart doctors' play book...EXERCISE: The new cancer therapy

by: Stephanie Oakes

Regular workouts help women like breast cancer survivor Karen Hornbostel endure the painful effects of treatment.

When cancer treatments left Karen Hornbostel of Littleton, Colo., with a paralyzed left shoulder for eight months, she felt she had to motivate herself. 'As my shoulder began to function again," she says, 'I knew I had to do something extra to get it back to 100%." She opted to swim and decided to train for a triathlon. It worked. Hornbostel, right, has participated in Denver's Danskin triathlon since 1999 with Team Survivor, a group of women who have survived cancer.

At least 1 million American women who have had breast cancer are alive today, but 190,000 more are diagnosed with the disease each year. And the harsh reality is that during any kind of cancer treatment women can suffer fatigue, nausea, anxiety and other debilitating symptoms. Yet women like Hornbostel find that, as draining as cancer therapy is, exercise can improve both their physical and psychological well-being.

In the past few years, cancer-and-exercise programs have been sprouting up at health clubs and hospital wellness centers. One such facility is Cancer Wellness in Santa Barbara, Calif., whose director, Eric P. Durak, says: 'Exercise and cancer represents one of the most exciting areas of sports medicine. New research from Oregon Health and Science University shows that women who exercise as little as 10 minutes every other day feel less tired and do better on physical tests than non-exercisers. Additionally, women who exercise more intensely keep a higher sustainable energy level than those who have no exercise routine."

Originally diagnosed in August 1993, Hornbostel went through a mastectomy and chemotherapy at age 40 and had recurrences in 1997 and '98. More symptoms prompted her to go back on chemo last April. 'It's a low dose, and I seem to be responding well," she says. 'I may be in some kind of treatment on and off for the rest of my life, but as long as I can stay strong, then hopefully I can keep cruising till I'm 90."

Stephanie and Karen discuss her experience:

How did you have the strength to exercise during chemotherapy and radiation?

Having exercised most of my life and having been a competitive cyclist really helped, because I went into my first round of treatment really fit. I have metastatic breast cancer, so I have had to continue with various types of treatments since 1993, and each time, exercise has made a world of difference in how I feel. Sometimes, when I'm stuck in my big easy chair and overcome with such intense fatigue that I feel like my muscles are frozen, if I make myself get up and do a brief walk in the neighborhood, I feel 100% better.

What types of exercise did you do, and how often?

My routines have varied depending on the time of year, my fitness going into treatment and what I have felt like doing. Personally, I love a good cardiovascular workout in the Colorado mountains. So if I can go out for a walk, hike, run, bike, cross-country ski or snowshoe, I'm completely happy. If I felt up to it, I would do anywhere from 15 minutes to an hour. Needless to say, I've gotten slower, but that's OK.

What effect did exercise have on your recovery?

It has helped tremendously to be fit to tolerate the treatments. It also helps me stay emotionally strong. If I have to take several days off from exercising, I have more difficulty coping. Exercise helps me face the challenges of cancer. I don't know if I have two months or 40 years ahead of me, but I do know I'm going to live fully and actively while I'm here.

EXERCISE TIPS for women undergoing cancer treatments

Select activities that are comfortable, accessible and enjoyable, including cardiovascular, strengthening or flexibility exercises and a course of relaxation or meditation at each session. Try a variety of exercises, then choose those that help to maintain or increase your energy during treatment.

Cardiovascular activity can boost your spirit, decrease fatigue, help your immune system and speed your recovery. Walking is a simple way to start. Begin with 5-10 minutes, once or twice every other day. Gradually increase at a comfortable pace so you can walk daily, up to 30-60 minutes. But if 10-15 minutes is what feels most comfortable, stay at that level.

On days you feel good, exercise a little longer; on days you feel tired, work out a little shorter or select an easier activity, such as stretching or a gentle movement program.

Check to see if there are exercise programs supporting cancer survivors in your community, or find an exercise partner who will help keep you motivated.

Keep a diary of your activity, including how you felt during your exercise sessions.