Exercise Against Cancer

Moving your body provides momentous benefits for your health.  Get up and get going!  

The most common therapeutic treatments for cancer are well known: surgery, radiation, chemotherapy, hormone and biological therapy.  Exercise has a place too!   

Exercise is a potent form of medicine.  Some of the most respected organizations like The American Cancer Society (ACS), American Institute for Cancer Research (AICR), and The American College of Sports Medicine (ACSM) are all backing the benefits of exercise for cancer.   

Recent evidence suggests that moderate exercise can help to lower the risk of 13 different types of cancer [i]. And this was a positive correlation!  Meaning that the more one exercises, the higher the chances of living and staying cancer free are.  Need specifics?  Check it out! 

 

Traditional Benefits of Exercise

“Exercise a day, keeps the doctor away!” 

Traditionally, exercise has many well-known benefits.  It reduces body fat, regulates blood sugar and lipids, strengthens your bone, heart and muscle tissue, helps regulate digestion, helps fight inflammation while improving immunity, boosts mood and mental health, and increases physical and mental strength to cope with some of our most challenging days.  Diabetes, heart disease, obesity, high cholesterol, and high blood pressure are all decreased because of exercise, thus helping to fight and stay cancer free.  What a way to go!    

 

Improved Quality of Life for Cancer Patients

Feeling tired or stressed from your treatment?  Exercise helps improve quality of life too! In a large systematic meta-analysis in the Oncology Nursing Forum, 12 weeks was all it took for the active subjects to significantly improve their energy levels and overall mood, while reducing fatigue and stress levels, compared to those who didn’t exercise. The exercise was moderate to vigorous in intensity and consisted of a combination of aerobic and strength training [ii].

 

Benefits of Exercise

Exercise has been shown to significantly influence specific cancers common to the American population. 

Colorectal Cancer is in fact, directly associated with reduced physical activity through different pathways related to hormones, carcinogen exposure and weight gain [iii]. In fact, waist circumference resulting from large deposits of visceral “organ” fat are strong predictors of colon cancer.  This weight gain resulting from inactivity has been associated with colorectal, endometrial, esophageal, breast and kidney cancers [iv]. 

Exercise is linked to lower incidence for breast cancer diagnosis and improved outcomes during treatment.  A recent study published in the Journal of Community Support Oncology and then reviewed by the AICR looked at 17 Randomized Controlled Trials including exercise interventions among women undergoing breast cancer treatment.  The study found conclusive evidence for improved muscular strength, cardiovascular health, and quality of life which probably translates to improved overall mental and physical wellbeing during and after treatment [v]. Unfortunately,  Cardiovascular Disease (CVD) is a frequent problem for woman after diagnosis of breast cancer because of inactivity and weight gain from specific therapeutic modalities.  Exercise may help to prevent CVD caused from breast cancer therapy [vi].

People with prostate cancer are also reaping the benefits.  Exercise keeps weight off, reduces inflammation and may slow progression of any tumors resulting in better prognosis.  Lower BMI is observationally associated and suggested to lower risk for prostate cancer, especially when exercise and proper nutrition are the root causes for the low weight [vii].

Ultimately, a 38% reduced risk for developing colon, breast and prostate cancer has been concluded in the literature [viii].  Research is still needed, but exercise may reduce cancer through several specific mechanisms even more complex than just weight loss.  Influences in hormone metabolism, insulin sensitivity and decreases in free radical exposure at the cellular level are all hypothetical, but may still be mechanistically connected to heavier weights and increased fatty tissue.  And remember, many of the same advantages of physical activity in colon, breast and prostate have been seen in 13 total cancers! 

 

Mechanisms

Most commonly, weight gain and obesity are the culprits. 

Exercise keeps weight off, and that alone plays a huge role in keeping cancer at bay.  Weight gain and obesity results in a dire systemic response: insulin resistance, whole body low grade inflammation, skewed hunger cues, hormonal imbalances, and release of inflammatory cytokines [ix].

Excessive fat tissue increases the release of insulin, growth factor and leptin, which may lead to activation of cellular markers, initiating cancerous biochemical pathways that can induce cell cycle progression, formation of new blood vessels and protein synthesis, ultimately increasing the chances for cancerous tumors to develop throughout the body [x].   In other words, using physical activity to control weight is highly beneficial to kick cancer!   

To monitor your own body, measure it.  Calculate your Body Mass Index (BMI).  Normal, healthy BMI should be around 18.5-24.9kg/m2 . Strive to keep it within that range while building lean muscle mass to take the place of fat.  And don’t just rely on weight!  Muscle weighs more than fat, and those building lean mass may not lose significant weight initially.  Consider keeping tally on ratios of your tissue by getting a Bio Electrical impedance Analysis (BIA) done at the clinic to measure ratio of lean body tissue to fat.  Schedule it for the morning, and drink plenty of water beforehand.  Just a tip: keep measurements to help to adjust to the new habits for the first 6 months or so, and after that, you will understand what feels and looks right for you, so you won’t need to measure.  Cause who wants to keep doing that!

 

How much is ideal?

The amount is still up in the air, but it may be best to follow ACSM guidelines calling for 150 minutes of moderate exercise per week to start.  That’s 5 days a week for 30 minutes; perhaps a nice routine walk on your lunch break. 

 More specific, short bouts of exercise, anywhere from 3 – 10 minutes are satisfactory.  Even better, moderately intense aerobic exercise prescriptions for 10 – 90 minutes per day for 3 to 7 days per week are effective at managing burdening symptoms as well as improving quality of life among cancer patients and survivors.  The more the better, as tolerated [xi].  

Remember, exercise should be safe!  If in doubt about physical exertion, contact a clinician to make sure that your body is ready for exercise.  If needed, have a clinical exercise physiologist tailor an exercise regimen that is well tolerated with your current fitness and health status.  Find a trainer who is certified in cancer to really tailor a unique, personalized plan of action.  Since there are countless exercise options, you will surely find something for you.   

Now that you know the WHY, it’s time to learn about the options and which may be best for you.  Stay tuned.

 

References:
[i] Exercise linked with lower risk of 13 types of cancer. American Cancer Society. Accessed at: http://www.cancer.org/research/acsresearchupdates/cancerprevention/exercise-linked-with-lower-risk-of-13-types-of-cancer
[ii] Mishra, S.I; Scherer, R.W; Snyder, C; Geigle, P; Gotay, C. The effectiveness of exercise interventions for improving health related quality of life from diagnosis through active cancer treatment. (2015). Oncol Nurs Forum. 42(1): E33-53
[iii] Slattery, ML. Physical activity and colorectal cancer. (2004). Sports Medicine. 34(4): 239–252.
[iv] Obesity and cancer. 2017. National Cancer Institute. Accessed at: https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet
[v] Effects of exercise interventions during different treatments in breast cancer. 2016. Fairman CM, Focht BC, Lucas AR, Lustberg MB. J Community Support Oncol. May;14(5):200-9.
[vi] Anthony F. Yu and Lee W. Jones. Breast cancer treatment-associated cardiovascular toxicity and effects of exercise countermeasures. Cardiooncology. (2016) 2
[vii] Davies, N.M; Gaunt, T.R; Lewis, S.J; etal. 2015. The effects of height and BMI on prostate cancer incidence and mortality: a mendelian randomization study in 20,848 cases and 20,214 controls from the PRACTICAL consortium. Cancer Causes and Control. V26(11) Pp 1603-1616
[viii] Brown, J.C; Winters-stone, K; Lee, A; Scmitz, K.H. 2012. Cancer, physical activity, and exercise. Compr Physiol. 2(4). Pp 2775-2809.
[ix] Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K; 2016. International Agency for Research on Cancer Handbook Working Group. Body fatness and cancer—viewpoint of the IARC Working Group. N Engl J Med. 375(8):794-798
[x] Slattery, M.L; Fitzpatrick, F.A. 2010. Convergence of hormones, inflammation, and energy-related factors: a novel pathway of cancer etiology. Cancer Prev Res. 2(11): 922-930.
[xi] Mustian, K.M; Cole, C.L; Lin, P.J; Asare, M; etal. 2016. Exercise recommendations for the management of symptoms clusters resulting from cancer and cancer treatments. Seminars in Oncology Nursing. V32(4). Pp 383-393
Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

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