Metastatic breast cancer takes a toll on sufferers’ bodies, and treatments for the disease can do the same. But new research shows that exercising can counter some negative physical and mental symptoms.

Stage 4, or metastatic, breast cancer patients who took part in a nine-month exercise program reported an improved quality of life and less pain and fatigue compared to patients who did not undergo the program, according to trial results presented this week at the San Antonio Breast Cancer Symposium.

The trial involved 357 metastatic breast cancer patients, of which 178 were randomly assigned to twice-weekly supervised exercise sessions involving balance, resistance and aerobic exercises. The patients were assessed every three months for fatigue levels, as well as physical, mental, emotional and financial quality of life. 

There were “statistically significant” differences between patients who were given the exercise program and those who were not. Participants on the exercise program had “significantly” better scores in social functioning and major decreases in pain and shortness of breath.

Metastatic breast cancer is the most advanced form of the disease and occurs when cancerous cells have spread beyond the breast to other areas of the body. It is estimated that more than 168,000 women in the U.S. live with metastatic breast cancer.

Breast cancer and its treatments — which may include chemotherapy, hormone therapy, immunotherapy and clinical trials — can cause side effects like fatigue, nausea, pain and shortness of breath, which can decrease a patient’s quality of life.

“Optimizing quality of life is, of course, important for everybody, but especially for patients living with metastatic disease who undergo continuous treatment,” Anne May, the study’s presenter, said in a release. “By improving quality of life through enhanced symptom management, we can help patients better enjoy their personal, social, and, if applicable, working life.”

Previous research has shown that physical activity is linked to a lower risk for several types of cancer, including breast cancer, and that exercise can be beneficial to patients with less-advanced stages of cancer. But this new study is one of the first to test whether exercise benefits those with late-stage breast cancer, according to May.

Based on the latest study — a collaboration between several countries called the Preferable-Effect trial — researchers say health professionals should routinely recommend supervised exercise to people living with metastatic breast cancer, and that insurance companies should cover the costs of exercise programs for patients.