Hot flashes can be a lingering side effect for many breast cancer survivors. The hot flashes occur when changes in hormone levels interfere with the body's ability to regulate its temperature.

Hot flashes can affect younger women treated with chemotherapy (which can shut down their ovaries), and also is one of the main side effects of the commonly prescribed hormone therapies, such as tamoxifen or an aromatase inhibitor such as Arimidex.

Hormone replacement therapy can be used to control hot flashes, but breast cancer survivors are recommended not use them because of concerns the hormones may increase the risk of their breast cancer returning.

An article published in the Annals of Oncology reported on a German study that was conducted to compare Effexor and clonidine therapy. Effexor is an antidepressant and clonidine is a drug used to treat high blood pressure.

The researchers concluded that Effexor significantly reduces the frequency of hot flashes compared with Catapres (clonidine) among patients with breast cancer who suffer from at least two hot flashes a day.

There are other anti-depressive agents that also reduce the amount of hot flashes throughout the day. Talk to your doctor to see if any of these drugs can give you some relief.

I'm trying to keep breast cancer away. I've had it once, and I really don't want it again. So I am committing myself to all strategies for keeping the disease out of my life -- like eating right, maintaining a normal weight, not drinking, not smoking, and as of yesterday, exercising strenuously.

New research shows strenuous exercise is what it takes to minimize the risk of breast cancer. Not moderate. Strenuous.

OK, I'm on board.

Now I've been a student of moderate fitness for most of my life. But now I'm embracing this new approach, this new way of pushing my body to its near limits. I figure if my choice is cancer or strenuous exercise, I better take the route that will leave me sweating and huffing and puffing, not sick and weak and bald. And so yesterday I took my first stab at what I will try to do at least five hours per week -- what experts say it takes to make a difference.

It all started with a warm-up lap on my treadmill -- just one lap at 4.5 miles per hour. Then I upped my speed to 5.3 and ran for a mile and a half. I continued running for another half mile at 6 miles per hour and then began walking again. I started at incline 1 for one minute, then moved to incline 2 for one minute, then incline 3 for one minute, and so on until I reached incline 10. My goal was to then continue walking while decreasing the incline each minute for ten minutes -- but I was so out of breath and fatigued, I jumped the incline down to 4 for one minute, then did 3 for one minute, 2 for one minute, 1 for one minute, and then I stopped. The whole process took about 40 minutes and left me soaked with sweat and gasping for air. Then, just in case my workout wasn't strenuous enough, I did 20 push-ups, a handful of sit-ups, and a few other floor exercises before heading to the shower.

So that's my version of strenuous. Now, I don't plan to do this same exact routine for all five hours I must complete each week, but I do intend to sweat and huff and puff just as much as I did yesterday. Because if strenuous is what it takes to ward off evil cancer cells, then I'm game.

I like to exercise. I like the challenge, the sweat, the mental release, the physical results, the time to myself. I like everything about it -- practically.

What I don't like about exercise is the pressure to accomplish the feat over and over again for the rest of my life. For years, the pressure I put on myself was palpable. I thought about exercise all the time. I stressed about what to do and when to do it. I fought to convince my kids to climb into a double stroller long after they were too big to sit comfortably in the wobbly contraption and when I found time to exercise all by myself, I struggled with an overwhelming desire to spend quality time with my little boys. I felt rushed to complete my workouts -- because my kids were waiting, dinner was waiting, work was waiting.

I was faithful about exercising -- even through treatment for cancer -- because of my self-induced pressure and despite the stress and worry it caused me. And then something happened.

It was probably a combination of cancer and my relentless push for physical fitness that caused my body to crash. I became tired and exhausted and could barely lift my legs to walk up the neighborhood hills I typically conquered with ease. My oncologist told me to stop, to give my body a break, to let go of my high expectations. He advised me to exercise two to three times per week -- and that's it.

It took some time but I have finally embraced this approach. I have abandoned schedules and routines and plans and I now exercise when I can, when it fits into my day, when I really want to do it. My fitness trainer friend Fitz, a new blogger on That's Fit, wrote in one of her first posts that we should all stop trying to get fit -- and we should just do it. "Don't wake up tomorrow with the idea of trying to go for a jog," she says." "Get up and go for a jog! Put it in your planner and make it happen."

Fitz might not like my approach, but I have stopped putting exercise on my planner. For me, this works. It takes away the pressure, the stress, the worry. It gives me peace to confront each day free of exercise anxiety. It makes me happy to tackle exercise on my own terms, without some preconceived notion of what I should be doing.

I should share something else about myself. I am a perfectionist. I want everything to be just right. As child, I tore up drawings that may have had one stray mark. I wouldn't leave my house for school until my ponytails were flawless. My house is clean and neat, my toenails are pedicured and painted, my hair is styled just so. Perfectionism, sometimes just a step away from obsession, can be an unhealthy practice. And for me, exercise was becoming an emotionally unhealthy endeavor.

I am confident my perfectionist tendencies will keep me in the exercise loop for all of time. Just knowing I need exercise will propel me to conform. But I must say that I am so relieved to have let go of some of my exercise burden.

I like exercise. I really like it. And today, when I ran three miles -- because I had the time and felt up for the task -- it was refreshing, empowering, cleansing. I think it's the lack of pressure that allowed me to lose myself in the moment today. For me, letting go of exercise has lightened the load.

I'm headed for a Saturday morning workout with my fitness trainer. For one hour, I will physically challenge my body and emotionally charge my spirits. I will sweat and pant and if I am required to do the inner thigh exercise, I will scream. I will also whine -- it's in my nature -- and I will push, pull, bounce, balance, lift, squat, lunge, and run until it's quitting time. I will fall short on some of my exercise expectations. And I will surprise myself and exceed others. In the end, I will feel accomplished, strong, motivated, and ready to tackle the day.

I'm making a comeback. I have come back from the depths of cancer and all of its accompanying treatment, and I have invited this powerhouse of a girl to transform me. She has accepted the challenge -- and she has helped me evolve from a weak, shaky, dizzy cancer patient to a semi-strong, 5K-running breast cancer survivor with biceps that are almost visible at a close distance.

This spunky fitness girl -- also an accomplished kick boxer, wife, and mom of two little ones -- has accepted another one of my challenges. I asked her to share some of her health and fitness expertise so that we all may reap the benefits. And so she kindly extracted some important tidbits from her vast library of knowledge and concisely crafted the responses that follow.

Take it from Fitz Koehler -- exercise and healthy eating habits are key for survival. For all of us. Cancer survivors included.

Why is fitness important for everyone?

100% of the population needs to exercise in some way. For the most part, if you're not working to get stronger, you're going to get weaker. Whether it's tummy time as an infant, gym class as a kid, weight training as an adult, or short walks as a senior, in order to live well and live long, we must eat well and exercise. Plus, a fit lifestyle prevents so many horrible ailments and diseases -- heart disease, some cancers, diabetes, GERD. Who wants any of that?

I just ran three miles on my treadmill. I have never been the athletic one in my family. My sister is the one who was born with the athletic streak -- she played softball and lettered in tennis after giving the sport a try with no previous experience and may have helped her high school basketball team win a state championship if it weren't for the major knee injury she suffered just before the big game. I, on the other hand, was born with a streak that has something to do with hair, nails, and lots of shoes. I was never interested in sports, gym shorts, or sweating -- which is what makes running three miles a big deal for me.

I wish I had started running long ago -- because I really like it. I like the loud music that pumps through my MP3 player and the change in my cadence as each new song begins. I like the motivation of knowing I'm pushing my body and accomplishing a physical challenge. I like that my endurance improves with each mile I travel. I like the mental release and the thoughts that run through my head and the cleansing effect I get from running. And I like sweating.

It's possible running would not have appealed to me long ago, even if I had given it a try -- because times were different long ago. I was healthy. I was happy. And I had no reason to marvel at the possibilities of my body. Without a natural impulse for physical fitness and challenge, I was completely satisfied with the status quo. But now I have an acquired impulse -- because cancer has threatened the very body I once took for granted. And I want it to be strong. I want it to be healthy. I want it to stand up to any possible threat. So I run. And when I am not running, I look forward to running.

In just a few weeks, I will run in the 5K Making Strides for Breast Cancer event with my athletic sister. I will run by her side. With my loud music for motivation. With the inspiration that I am making a difference for my body and for women everywhere. With my gym shorts on. And a ball cap covering my hair. With sweat dripping down my face. I can't imagine a better feeling.

I have tried to exercise most of my adult life -- at times because I felt obligated to participate in what I knew was good for me and at times to justify eating my favorite foods while maintaining an appropriate weight and at times because I wanted to actually have a toned, healthy body.

At this exact time in my life, I exercise with all of these motivations in mind -- plus a few more. I like to sweat and know I am accomplishing a physical feat. I like the mental release I get when I push my body to perform. I like the time to myself, the loud music I hear on my MP3 player, and the results I see from a little bit of hard work. And lately -- as a result of a new weight training program -- I know I am benefiting my body more than ever before.

The following are just seven of the many gifts that come from weight training. Gifts that will make me a happier, healthier cancer survivor.

Noticeable physical results -- Mostly, walking and occasional jogging have been my methods of exercise. And I've seen results from this type of workout -- leaner legs, more defined calf muscles, and the knowledge that I am increasing my cardiovascular health, as confirmed by the technician who performed an ultrasound on my heart in preparation for my Herceptin treatment for breast cancer. He told me he could tell I exercised regularly because of my low resting heart rate. But until I started weight training a few months ago, I never witnessed quick results. Yet after a few weeks of resistance exercise -- lifting 20-pound weights for my arms, shoulders, back, and chest -- I could see definition and tone that clearly would not have resulted from my purely cardio workouts.

Improved strength and endurance -- Lunges and squats and jumping with resistance bands have strengthened my legs. Lifting weights has strengthened my arms -- and I can now lift heavier weights than when I first started my new routine. I can do more push-ups now too -- not girl push-ups on my knees but real push-ups -- than I ever could have imagined doing when I could barely lower my own body weight and would crash to the floor on my stomach. My strength has improved. My endurance has improved. I feel more powerful.

Increased energy -- Fatigue (or maybe it's laziness) sometimes prevents me from happily jumping up to begin exercising. But when I push myself and exert myself and get lost in my exercise routine, my energy returns -- and not just during my workout but for some time afterwards too. Some say energy increases from strength training because it contributes to loss of fat which means we have less to lug around each day.

Burning of more calories -- Weight training raises basal metabolism which causes more calorie burning over a 24-hour period of time. Calories even burn during sleep as a result of weight training.  For every additional pound of muscle you gain, your body burns 50 extra calories every day -- 50 more calories than the few hundred that might burn from aerobic exercise. Research shows that regular resistance training can increase your Basal Metabolic Rate by 15%. So for someone who burns 2000 calories per day, that's upwards of 300 extra calories burned every single day. 

Decreased onset of illness -- Weight training can reduce the risk of adult onset diabetes and the risk for developing colon cancer and can improve the functioning of the immune system and the efficiency of the heart. It decreases the risk of low-back injuries, decreases resting blood pressure, increases good cholesterol (HDL), and improves posture. The list goes on -- and so does healthy living if weight training becomes a way of life. As a young person already having experienced a life-threatening illness, this comforts me.

Prevention of osteoporosis -- My recent bone density test revealed that I am not at this moment at risk for developing osteoporosis. I don't want this to change. Strength training can help me maintain this status because it can significantly increase bone mineral density -- which is important because we naturally lose bone density as we age. Strength training helps protect against osteoporosis. And age should not be a deterrent. Individuals who begin training late in life -- at age 65, for example -- can restore bone loss.

Improved outlook on life -- As a result of toning and shaping my body, burning calories, enjoying greater strength and energy, and working toward a disease-free future, weight training gives me an improved outlook on life. And weight training has recently been reported to significantly improve the quality of life of women recently treated for breast cancer. A May 2006 study indicates six months of twice weekly exercise was enough to improve the overall physical and emotional condition of patients.

Twice weekly is my weight training goal. I will continue to walk and run -- and bike on occasion too -- but strength training will be my priority. Because health is a priority.