You Can’t Keep a Good Fiend Down: Exercise and Cancer–National Breast Cancer Awareness Month

Posted on October 2, 2015 by

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If you’re starting to get the idea, after being subjected to posts like Running For Your Life: How I View Depression and Exercise and Of Bipolar Disorder, The Hippocampus, and The Return of the Exercise Fiend that I’m, well, an exercise fiend, who believes exercise can make just about anything better–you’re spot on. And if you’re tired of listening to how great I think exercise is [and did you enjoy the picture of my headstand in yoga??]–just pity my poor family. But here’s the thing about it–it’s not enough for my poor family and friends (and blog readers) that I already think exercise will improve just about anything that ails you. I’m aided and abetted in my single-mindedness by a continuing flow of research that just supports me.

It’s tough when you’re always right, I’ll tell you.

But more on that later, perhaps. For now, let’s address the role exercise plays in the health of cancer patients and survivors. I actually had some difficulty in writing this post, for the oddest of reasons. Sometimes it’s hard to find good, solid research to support what you intuitively believe to be true. Here it was nearly impossible to choose from the hundreds of studies to present to make the point.

So if you take a look at the research I’ve quoted, and you don’t like it, and you’d like to use your distaste for it as reason to avoid exercise–aha! You’re caught in the act. Just google exercise and cancer and pick what you do like from the smorgasbord of research that proves exercise’s benefits to the cancer survivor.

Some studies dealt with exercise’s positive impact on cancer survivor’s in a number of ways correlated with general physical and mental health.  You know I think no self-respecting blog post should skip the word “meta-analysis,” so I chose “Physical activity for cancer survivors: meta-analysis of randomised controlled trials” published in the January 2012 issue of the British Journal of Medicine (see all citations below).

I particularly enjoyed this one for some of its findings that seemed on the rather self-evident side (Did you know that they actually found that cancer survivors who exercised had, and I quote, ” significant improvements in body mass index (BMI), body weight, peak oxygen consumption, peak power output, distance walked in six minutes, right handgrip strength”? Seriously?), but it also found, more to the point, signficant reduction in fatigue and in quality of life, both physically and mentally.

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Mutrie et al found, in a study you know comes out of the UK, entitled (get this spelling), “Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial” that, compared with a placebo group, the exercise group spent fewer nights in the hospital than did the placebo group, and made significantly fewer vistsis to their general practitioner, the equivalent of our internists.

There’s a great deal of research on quality of life improvement, and, suited to my interests, specifically on depression.  Since I’m on a roll with meta-analyses, why not see “The efficacy of exercise in reducing depressive symptoms among cancer survivors: A meta-analysis”? The study by JC Brown et al found a small but signficant decrease in depressive symptoms among cancer survivors who exercised, but, interestingly, the effect increased with increased exercise (specifically aerobic).

And physical activity during and after treatment is associated with decreased recurrence rates, as well. Seems like exercise can reduce the risk of recurrence, specifically for breast and bowel cancer. Meyerhardt et al (see the CALGB 89803 study) found that those who exercised regularly, for about an hour per day, 6 days a week (one day off for good behavior, or the Sabbath, apparently) reduced their risk of cancer recurrence by 49%. Holmes et al found that breast cancer survivors who engage in the equivalent of approximately 3 hours of walking per week at a moderate pace have a 26% to 43% decreased risk of recurrence.

And of perhaps greatest interest, of course, is exercise’s impact on survival rates. Studies found exercise improved survival statistics for a variety of cancers, from Kenfield et al’s study that found it improved both overall mortality and prostate cancer-associated mortality. Breast and prostate cancer patients can reduce their risk of dying from the illness by around 30-40%, compared to those doing less than one hour a day a week of aerobic exercise. Bowel cancer patients doing around six hours of moderate physical activity reduced their risk of dying by a whopping 50% (see Meyerhardt).  And how could I address this topic without including another meta-analysis, this time by Ibrahim and Al-Homaidh, whose analysis of 8 studies concluded there was a distinct inverse relationship between physical activity mortality?

A fascinating report by Macmillan Cancer Support in England, with the great title”Move More:Physical activity the underrated ‘wonder drug’” includes a number of compelling statistics on the power of exercise, plus the history of exercise in cancer treatment, recommended guidelines–and a call to action. It’s worth looking at.

Once I get started it’s hard to stop (have I told you about my newest pilates moves yet?), but I’ll restrain myself in the hopes that I’ve convinced you to lace up your gym shoes and at least start a walking regimen. And if you’d like more information on the topic, please feel free to contact me. A fiend never tires.

References

Brown JC, et al. Cancer Survivors: A Meta-Analysis. PLoS ONE 7(1):e30955.

Fong, Daniel et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. British Medical Journal 2012; 344:e70.

Holmes MD et al (2005) Physical Activity and survival after breast cancer diagnosis. JAMA 2005;  293(20):2479-86.

Ibrahim EM, Al-Homaidh A. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Medical Oncology 2011; 28(3):753-65.

Kenfield Stacy, et al. Physical Activity and Survival After Prostate Cancer Diagnosis in the Health Professionals Follow-Up Study.  Journal of Clinical Oncology 2010; 31:5226.

Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. Journal of Clinical Oncology 2011; 29:726-732.

Meyerhardt JA, et al. Physical activity and survival after colorectal cancer diagnosis. Journal of Clinical Oncology 2006; 24:3527-3534.

Meyerhardt JA, et al. Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. Journal of Clincial Oncology 2006; 24:3535-3541.

Mutrie Nanette, et al. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. British Medical Journal 2007; 334(7592):517.