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Physical activity has been linked to a lower risk of developing several types of cancer, including breast cancer. Walking a few hours a week may even decrease the risk of a breast cancer recurrence as well as dying from the disease. The American Cancer Society currently recommends that people recovering from cancer should exercise at least 150 minutes per week.

But people with breast cancer often face a number of challenges to establishing a regular exercise program. Chemotherapy and radiation can affect heart and lung function, and about 60 percent of breast cancer survivors have reduced strength in their legs as a result of a loss of muscle mass. In addition, more than 80 percent of women gain weight after a diagnosis of breast cancer. These factors, along with fatigue from treatment, can prevent breast cancer survivors from being as active as they want to be.

Knowing that exercise is beneficial for people with breast cancer but that they face challenges, researchers at the University of Alabama at Birmingham (UAB) are looking at new ways to improve breast cancer survivors’ response to exercise. Their study compares the effects of exercising under low-oxygen conditions—similar to that seen at an altitude of 7,000 feet—with exercising in normal oxygen conditions at sea level.

Elite athletes sometimes train in mountainous areas—between 5,000 and 8,000 feet above sea level—to improve their performance. The air at high altitudes is thinner and contains less oxygen. Lower oxygen levels help boost the number of red blood cells that carry oxygen around your body. Exercising at high altitudes also lets you train harder without the added stress on your joints and muscles that occur at sea level.

While it is impractical to take cancer survivors to the mountains, UAB researchers are trying to bring the mountains to the patients During exercise sessions, participants wear a mask that is connected to a machine that controls the amount of oxygen they breathe in. This mimics the low-oxygen levels of a high-altitude workout.

The study is ongoing, so it is too soon to know how beneficial exercising under lower oxygen levels will be. However, the researchers predict that exercising in low-oxygen conditions will trigger a number of physiological changes that will let people with breast cancer be more active and improve their overall health. If the results of the study are correct, it may lead to new approaches to help breast cancer survivors lead a more active life.

John Chatham, DPhil, FAPS, is a professor of pathology and director of the Division of Molecular and Cellular Pathology at the University of Alabama at Birmingham.