Exercise and Cancer

Breast Cancer Survivors: A Journal of Clinical Oncology study found that an increase in aerobic exercise and strength training led to a significant decrease in the amount of arthralgia reported by breast cancer survivors being treated with aromatase inhibitors. The researchers reported that although an improvement in pain was seen after only 3 months, the largest benefit-about a 30% reduction in joint pain scores-occurred in women who continued the exercise program for 12 months. The exercise regimen consisted of 150 minutes per week of aerobic exercise and twice-a-week supervised strength training. Baseline worst pain scores were 5.6 for women assigned exercise and 5.9 for those assigned usual care. Women assigned the intervention decreased their worst pain scores by an average of 1.6 points (29%) compared with 0.2 points in women assigned to usual care (P < .001).[2] Image © Tomasz Trojanowski / shutterstock.com

Breast Cancer Risk: A recent study published in Cancer Epidemiology, Biomarkers & Prevention found that regular moderate exercise is associated with a lower risk of invasive breast cancer among postmenopausal women. Those who engaged in at least 4 hours of walking (12 metabolic equivalent task [MET]-hours) per week for 4 years had a 10% lower risk of the disease compared with those who exercised less frequently in the same time period. The researchers stressed that maintaining a regular exercise program was important: Among the women who had engaged in more than 12 MET-hours of exercise per week for 5 to 9 years, those who subsequently became less active had a significantly increased risk of breast cancer compared with women who continued to exercise (hazard ratio, 1.16).[3] Images © michaeljung (left), Sebastian Kaulitzki (right) / shutterstock.com

Prostate Cancer: A study published in Oncology Nursing Forum found that supervised group exercise programs improved prostate cancer patients’ physical and mental health, and also provided much-needed emotional and social support. Researchers interviewed 12 patients participating in a structured, clinic-based group exercise program led by an exercise physiologist. The researchers found that participating in prostate cancer–specific exercise groups appeared to break down men’s preconceived notions of health and wellness as feminine concerns, which often prevent them from seeking support. The researchers concluded that group exercise programs should be incorporated into supportive care services for prostate cancer patients.[4] Images © Monkey Business Images (left), Sebastian Kaulitzki (right) / shutterstock.com

Lung Cancer: A study in the Journal of Thoracic Oncology concluded that exercise and physical activity should be therapeutic options for lung cancer patients, since they have been shown to reduce symptoms; improve exercise tolerance and quality of life; and potentially decrease length of hospital stay and complications following surgery. The researchers found that the majority of lung cancer patients want guidance from their physicians regarding physical activity and exercise; they encourage all treating physicians to prescribe exercise before, during, and after lung cancer diagnosis and treatment.[5] Images © Anetlanda (left), Sebastian Kaulitzki (right) / shutterstock.com

Ovarian Cancer Risk: Although the evidence of an association between recreational physical activity and risk of ovarian cancer is mostly inconclusive, researchers continue to study this patient population. This review of the literature, published in Gynecologic Oncology, concluded that despite the lack of evidence, clinicians should encourage physical activity for ovarian cancer patients. The review included 26 studies, with case-control studies being more likely to find a protective effect between physical activity and epithelial ovarian cancer risk. The majority of these studies demonstrated significant risk reductions between 30% and 60% for the most active women. However, cohort studies showed no significant association.[6] Images © Macrovector (left), BlueRingMedia (right) / shutterstock.com

Colorectal Cancer: A study in the Journal of Clinical Oncology examined the effects of recreational physical activity and leisure time sitting on colorectal cancer diagnosis. Participants in the study completed questionnaires regarding physical activity and leisure time at baseline, before their cancer diagnosis, and after their cancer diagnosis. Participants engaging in 8.75 or more metabolic equivalent task (MET)-hours per week of recreational physical activity (equivalent to approximately 150 minutes per week of walking) vs fewer than 3.5 MET-hours per week experienced lower all-cause mortality. Spending 6 or more hours per day of leisure time sitting vs fewer than 3 hours per day was associated with higher all-cause mortality.[7] Images © KieferPix (left), Sebastian Kaulitzki (right) / shutterstock.com

Gastric Cancer Risk: A British Journal of Sports Medicine meta-analysis of observational studies sought to find an association between physical activity and the risk of gastric cancer. Using seven prospective cohorts and four case-control studies, the researchers found a modest association between sufficient physical activity and gastric cancer risk (relative risk, 0.81 [95% confidence interval (CI), 0.69–0.96] for the prospective cohorts; and relative risk, 0.78 [95% CI, 0.66–0.91] for the case-control studies). Other factors, such as smoking and cancer subtype, weakened the association.[8] Images © michaeljung (left), Sebastian Kaulitzki (right) / shutterstock.com

Leukemia: A study published in Integrative Cancer Therapies was conducted to test the feasibility of an in-hospital exercise program for acute leukemia patients undergoing chemotherapy. Ten patients were included in the study and were assessed for body weight, body composition, cardiorespiratory endurance, fatigue, depression, and quality of life, among others, at baseline and at the end of treatment. Aerobic and strength training exercises were performed 3 times per week, twice daily, for 30 minutes. Significant increases in cardiorespiratory endurance (P = .009; baseline 8.9 ± 8.8 minutes, postexercise intervention 17 ± 14.3 minutes), with decreases in total fatigue scores (P = .009; baseline 4.6 ± 1.7, postexercise intervention 1.8 ± 1.6) and depression scores (P = .023; baseline 19 ± 11.5, postexercise intervention 12 ± 8.2), were noted.[9] Image © Giovanni Cancemi / shutterstock.com

Head and Neck Cancer: A randomized controlled trial involving 48 head and neck cancer patients being treated with chemoradiotherapy was conducted to assess the effects of exercise on functional capacity and quality of life. The patients were split into an intervention group that followed a supervised exercise program for 6 weeks and a control group that received instructions to engage in physical activity. Endpoints were assessed using the six minute walk distance (6MWD) and the 36-item Short Form Health Survey (SF-36). After 6 weeks, the 6MWD improved by 42 meters (P < .05) in the exercise group; the control group showed a decrease by 96 meters (P < .001). There was also an improvement on the mental component score of SF-36 for the exercise group (4.8; P < .05). A decrease was seen in the control group for both the physical and mental scores (-5.9; P = .064 and -17.3; P < .05).[10] Images © Monkey Business Images (left), Sebastian Kaulitzki (right) / shutterstock.com

Pancreatic Cancer: Researchers conducted a single case study with a 49-year-old man with stage IIb pancreatic cancer to assess the safety and efficacy of a 6-month supervised exercise program while the patient was undergoing adjuvant therapy. The program consisted of twice-weekly sessions of resistance and aerobic exercise. The patient tolerated the program well, with 73% attendance throughout the 6 months. Improvements were noted at both 3 months and 6 months with regards to physical capacity and functional ability, disease-specific quality of life, cancer-related fatigue, sleep quality, and psychological distress, among others.[11] Images © wavebreakmedia (left), Sebastian Kaulitzki (right) / shutterstock.com

Multiple Myeloma: A study conducted in Australia sought to understand the benefits and barriers of physical activity for recently treated multiple myeloma patients. Interviews with participants were used to assess the benefits (psychological and social benefits) and barriers (recovery from symptoms and side effects of treatment, low motivation). Although all participants were currently engaging in low- to moderate-intensity physical activities, such as walking and gardening, women were more likely to report benefits than men. Patients treated with autologous stem cell transplant were also more likely to report benefits to physical activity (with fatigue as a potential barrier), while patients treated with other therapies, including chemotherapy and radiotherapy, were more likely to report pain as a barrier.[12]

Kidney Cancer Risk: A study in Medicine & Science in Sports & Exercise found that incident kidney cancer risk may be reduced from walking and running, independent of other known risk factors. After adjusting for age and sex, risk decreased by 1.9% per metabolic equivalent task (MET)-hour per week run or walked (hazard ratio, 0.981 [95% confidence interval, 0.964–0.997]; P = .02). Compared with walking or running below guideline levels (< 7.5 MET-hours per week), the risk for incident kidney cancer was 61% lower for meeting the guidelines, 67% lower for exercising 1 to 2 times the recommended level, and 76.3% lower for exercising 2 or more times the recommended level.[13] Images © Maridav (left), Sebastian Kaulitzki (right) / shutterstock.com

Brain Cancer Risk: This study used data from the National Runners’ and Walkers’ Health Studies to find whether exercise had an effect on brain cancer mortality. After adjusting for sex, age, race, education, etc, the risk for brain cancer mortality was 43.2% lower for those who exercised 1.8 to 3.5 metabolic equivalent task (MET)-hours per day (95% CI, 2.6%–66.8%; P = .04) and 39.8% lower for those who exercised ≥ 3.6 MET-hours per day (95% CI, 0.0%–64.0%; P = .05) compared with < 1.8 MET-hours per day at baseline. The researchers concluded that walking and running energy expenditure was associated with a decrease in the risk of death due to brain cancer.[14] Images © Sebastian Kaulitzki (left), astarot (right) / shutterstock.com

Endometrial Cancer Risk: The American Institute for Cancer Research and the World Cancer Research Fund International published findings that showed that about 60% of cases of endometrial cancer in the United States could have been prevented if patients had maintained a healthy weight and exercised regularly. Obese women have more than double the risk of endometrial cancer, with excess body fat being a prominent risk factor. Exercising for at least 30 minutes a day and maintaining a healthy body mass index were shown to reduce the incidence of endometrial cancer by 59%. Exercise can also prevent recurrence.[15] Images © Suzanne Tucker (left), Alila Medical Media (right) / shutterstock.com

Sarcoma: A study published in the Journal of Sports Science & Medicine found that continuous exercise decreased the size of sarcoma tumor by about 50% in mice. Based on the understanding that regular exercise has the ability to decrease the incidence and progress of certain cancers, the researchers transplanted murine sarcoma cells into three groups of mice: control mice, exercise trained mice that ended exercise at the time of transplantation, and tumor-bearing mice that continued exercise. The researchers concluded that the mice that continued exercise had significantly decreased tumor size, although the underlying mechanisms are unknown.[16] Image © Eric Isselee / shutterstock.com

Cervical Cancer Risk: Women who do not engage in regular physical activity have an increased risk of developing cervical cancer, according to a case-control study published in the Journal of Lower Genital Tract Disease. The researchers analyzed data from 128 women diagnosed with cervical cancer and 512 women who were evaluated for suspected cervical neoplasms but not ultimately diagnosed with cervical cancer. In an age-adjusted model, the odds of women with cervical cancer reporting no participation in physical activity were twice as high compared with the control group (odds ratio [OR], 2.16). There was no difference in reported occupational physical activity between the two groups (OR, 1.02).[18] Image © Syda Productions / shutterstock.com

Communication: A small study published in JNCCN found that while both oncologists and cancer patients recognize the benefits of physical activity during treatment, oncologists may feel ill-equipped to give recommendations on exercise. The researchers conducted focus groups and interviews with 20 patients with both metastatic and non-metastatic disease, and nine oncology providers. Only three patients recalled receiving physical activity instruction from oncology providers during their cancer treatment. Only one of the nine clinicians surveyed documented discussion of exercise in patient charts.[19] Image © Andrey_Kuzmin / shutterstock.com