Exercise may prevent and control cancer

Exercising daily not only prevents different forms of heart disease but is also highly beneficial for the people living with and beyond cancer, suggests a study. To spread the message, an initiative called -- Moving Through Cancer -- led by Kathryn Schmitz, professor of Public Health Sciences at Penn State College of Medicine, and an international team of health practitioners and researchers -- has been started.

In a paper published in 'CA: A Cancer Journal for Clinicians', Schmitz and her fellow researchers outline new exercise recommendations for people living with and beyond cancer. "With more than 43 million cancer survivors worldwide, we have a growing need to address the unique health issues facing people living with and beyond cancer and better understand how exercise may help prevent and control cancer," said Schmitz, who is also a member of the Penn State Cancer Institute.

"This esteemed, multidisciplinary group of leaders at the forefront of exercise oncology aimed to translate the latest scientific evidence into practical recommendations for clinicians and the public and to create global impact through a unified voice," added Schmitz.

According to the researchers, exercise is important for cancer prevention and can lower the risk of developing colon, breast, endometrial, kidney, bladder, esophagus and stomach cancers. Exercise during and after cancer treatment can help improve fatigue, anxiety, depression, physical function, and quality of life, and can also help improve survival after a breast, colon or prostate cancer diagnosis.

Depending on the patient's activity levels and abilities, the researchers generally recommend 30 minutes of moderately intense aerobic exercise three times a week and 20 to 30 minutes of resistance exercise twice a week. But, Schmitz said health care professionals can also customise exercise prescriptions to individual patients.

"Through our research, we've reached a point where we can give specific FITT exercise prescriptions -- which means frequency, intensity, time and type -- for specific outcomes like quality of life, fatigue, pain, and others," Schmitz said. "For example, if we're seeing a head and neck cancer patient with a specific set of symptoms, we could give them an exercise prescription personalised to them."

The recommendations are one result of a roundtable of experts formed by Schmitz and the American College of Sports Medicine (ACSM) to review the latest scientific evidence and offer recommendations about the benefits of exercise for prevention, treatment, recovery and improved survival for people living with and beyond cancer.

Schmitz said the second piece of the initiative is resources and programs to help get people with and beyond cancer moving. The Moving Through Cancer website has an exercise program registry that can help patients, families, health care providers and others find programs near them.

The final piece is policy, Schmitz said, which could be used to increase the likelihood that health care professionals will talk to their patients about exercise and that patients will be adequately referred to as they move through cancer.

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Research shows how nordic walking may benefit breast cancer patients

Nordic walking, an aerobic activity performed with walking poles similar to ski poles, may benefit patients with breast cancer, according to a review of existing research.

The low-impact exercise improved swelling, physical fitness, disability and quality of life, the study authors conclude.

“The main strategy in rehabilitation for women with breast cancer is a change of habits, where physical exercise is a fundamental tool,” said study co-author.

“It’s not easy to turn a sedentary person into an amateur athlete, so sports such as Nordic walking are accepted more easily,” the author told, particularly since the activity doesn’t require expensive equipment, can be done in a group with others, and is easy to learn.

Introduced in the 1980s as a summer training exercise that was similar to cross-country, or Nordic, skiing, Nordic walking became more widespread in the 2000s. It’s now part of some exercise-based rehabilitation programs, especially in Northern Europe where it is more common, he noted.

He also owns a personal training company,  that creates physical activity programs for people with specific needs, including injuries, obesity, pregnancy, postpartum and women with breast cancer, and he specializes in Nordic walking training.

To see if this form of exercise helps women treated for breast cancer to reduce side effects like arm swelling, and offers other benefits of exercise, the researchers analyzed nine studies. Four studies were randomized controlled trials comparing Nordic walking to other activities; the other studies focused on specific effects of Nordic walking.

Periods of exercise in the studies ranged from 30 to 80 minutes and were performed on one to five days a week for up to 12 weeks.

In eight of the nine studies, Nordic walking had a positive effect on a number of breast cancer symptoms, including lymphedema, fitness, upper-body strength, disability and perceptions of pain and swelling.

A handful of studies also showed improvements in depression, self-efficacy for managing pain and improvements in physical activity levels. They didn’t find any adverse effects, and the study participants seemed to stick with the programs.

The biomechanical gesture of Nordic walking, compared to just walking, seemed to counteract some of the side effects that can come from cancer treatment, such as shoulder-arm mobility and postural problems, the study team writes.

“(Many) health professionals and therapists do not realize that there are contraindicated exercises during breast cancer rehabilitation and that alternatives such as Nordic walking can be very effective,” he said.

“Nordic walking is a structured form of physical activity which nowadays has been shown to be ‘more complete’ than basic walking,” said a researcher, who wasn’t involved in the research review.

“Another important point that is less stressed by these authors: quality of life,” he said in an email. “Nordic walking gives huge benefits because breast cancer patients are survivors, and from a socio-psychological point of view, that really impacts their life.”

Future studies should also investigate the intensity, frequency, duration, and length of exercise needed to help breast cancer patients, said another researcher, who also wasn’t involved in the review.

“What is most evident is the growing interest of the scientific community in tracking the needs, interests and preferences of patients,” he said by email.

“Offering them novel forms of physical activity that are both effective and engaging has become one of the new and stimulating research fields in cancer therapy and management.”

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