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Life After Cancer A Roadmap for Cancer Survivors

Benefits of Physical Activity
Francine Manuel, RPT, Ernest H. Rosenbaum, MD and Jack LaLanne

Exercise Effects on Specific Cancers
Exercise Benefits

Exercise Effects on Specific Cancers
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Over the past thirty years, a growing number of evidence-based scientific papers have compared those who exercise versus sedentary patients. In general, those exercising 30 or more minutes per day with moderate to more vigorous activity will have an increase in survival, decreased risk for cancer recurrence or a new cancer, improved quality of life with less fatigue, a decrease in overweight and obesity, and positive treatment benefits for those undergoing cancer therapy.

A recent study examined physical activity and its role in prevention of cancer.

Physically active men and women have about a 30-40% reduction in the risk of developing colon cancer compared to inactive persons; 30-60 minutes of moderate to vigorous daily exercise was needed to decrease the risk.

Breast Cancer
Many studies have shown a relationship between physical activity and decreased risk of recurrent breast cancer. This may in part be due to better weight control and hormone effects.

The breast cancer evidence is reasonably clear that 30-60 minutes per day of moderate to vigorous physical activity provides a 20-30% reduction for the risk of breast cancer compared to inactive women. A large study found that both lean and overweight breast cancer survivors who had increased activity levels showed a reduced risk of recurrence and/ or death. Another study found that, one year after diagnosis, only 50% of breast cancer survivors had resumed their level of pre-diagnosis physical activity; for overweight patients the percentage was even greater.

Effect of Exercise on Hormones
There is a relationship between sex hormones (estrogen and progesterone) and exercise in postmenopausal women. Women who exercise regularly have a 25-50% lower circulating estrone and androgen concentrations when compared to sedentary women. Lower levels of estrogens have been associated with a lower incidence of breast cancer.

There is increasing evidence that exercise also influences other aspects of cancer including coping, rehabilitation, brain function, and survival both for women with breast cancer and for men with prostate cancer through effects on serum factors, such as sex hormones.

Prostate Cancer
American men who gain weight are at greater risk for prostate cancer, a leading cause of cancer morbidity and mortality in men. Fortunately, 86% of men diagnosed with prostate cancer have local or regional disease with about a 100% five-year relative survival.

A large medical study showed a reduced risk of prostate cancer in men who were most active. Another study found that physical activity was beneficial against both prostate cancer incidence and the progression of the disease in those already afflicted. Researchers suggest that regular, vigorous activity can slow the progression of aggressive prostate cancer and might be recommended to reduce prostate cancer mortality.

Colon Cancer
Physical activity has consistently been shown to decrease the incidence of colorectal cancer.

The mechanism is not known, but it is believed by some that colon cancer risk is related to sedentary lifestyle and hyperinsulinemia (elevated blood insulin). Insulin and the insulin-like growth factor family have been associated with enhanced tumor growth.

Recent studies demonstrated that physical activity in patients with colorectal cancer stage I-III (non-metastatic) had a lower risk of developing recurrence and had a prolonged survival if they had increased physical activity.

In another study, women who were more physically active following a diagnosis of non-metastatic colorectal cancer had a significantly decreased risk of colorectal cancer-specific death, as well as death from any other cause. Patients who increased their activity above their pre-diagnosis level were found to have an approximately 50% reduction in mortality for both colorectal cancer and other causes.

Exercise Benefits
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Physical fitness is healthy for everyone, of course, but is essential for all cancer patients. The benefits of exercise in cancer prevention and treatment are documented in the medical literature. There are causal relationships between both exercise and prevention, and exercise and quantity and quality of life. Survivors must be convinced that even though it is hard to find the energy to exercise, the benefits of keeping your body in an active physical state are too great to ignore.

Exercise benefits consist of:
Improved prognosis - when you are in better physical condition, you are better able to tolerate aggressive cancer treatments which can promote an increased chance for survival and cure.
Prevention of muscle wasting and deconditioning while undergoing cancer treatments and even during prolonged periods of bed rest.
Faster recovery following treatment if you exercise even when you are sick and/or bedridden. It helps prevent some of the dangers of bed rest like blood clots and bedsores.
Better physical fitness and promotes better health and quality of life. It helps improve longevity, increase survival, and decrease risk of death for breast, prostate and colon cancer.

Motivational Tricks
Use a simple program.
Work with a class/group or with friends or family.
Use guided audiotapes, videotapes or DVDs with encouraging professionals leading exercises.
Realize that any amount of exercise is better than none. Use charts to monitor your progress or increased activity.
Make up an exercise kit with weights, rubber stretchers (resistance bands) and spongy balls that will help challenge muscles.
Follow a program with various stages of exercise to correlate with your wellness status, which can also be used throughout treatment.
Purchase some exercise equipment for home or join a gym. A stationary bicycle, rowing machine, treadmill and stepping machine are just a few options. Survivors can also walk briskly, swim, play tennis, or engage in some other sport.

Exercise and Weight Loss
Diet and exercise are the essential combination to achieve weight loss (for those overweight or obese); it can also be a prescription for cancer prevention.

A very large medical study found that those who exercised more had a 22% reduced risk of colon cancer, and those who maintained a normal weight obtained the greatest cancer preventive benefits versus those overweight or obese. Either brisk walking or running or strenuous housework (vacuuming, scrubbing floors, cleaning windows) helped burn off extra calories.

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First appeared February 21, 2008; updated August 2, 2008