1. Exercise and Cancer Prepared by Joelle Lappala for CBI 360° Health

2. What is Cancer? Uncontrolled cell growth that can invade other tissue Abnormal cells can be spread through the blood and lymph systems There are over 200 types and each type can behave very differently. They grow at different rates and respond differently to different treatments.

3. Cancer Statistics Approximately 170 000 new cases of cancer were expected to be diagnosed in 2009. On average, 62% of people are expected to survive at least 5 years after diagnosis with cancer Only 22% of survivors are physically active Over 18% of survivors are obese 20-45% of survivors experience emotional distress

4. Cancer and Lifestyle Recent research shows that up to 1/3 of all cancers can be prevented by changes in lifestyle These lifestyle factors include: – Smoking – Alcohol Consumption – Exercise – Diet – Sun Exposure

5. The Role of Exercise In the past, bed rest was recommended due to safety concerns. It is now known that this can cause symptoms to get worse Research is consistently showing both physical and psychological benefits throughout the ENTIRE cancer process

6. Lifestyle and Types of Cancer Losing weight is most likely to reduce your risk of developing breast and prostate cancer Other cancers that may be affected by lifestyle include colon, endometrial and kidney cancer

7. Cancer and Body Weight 14-20% of cancer related deaths are related to excess body weight More research is needed to know exactly how excess body fat is linked to cancer. Some possible causes include: – The processing of sugar and fat – Immune system function – Levels of hormones like insulin and estrogen – Excess fat may affect factors that regulate cell division

8. Reduce your Risk Quit Smoking - 30% of all cancer deaths and more than 85% of lung cancer cases are related to smoking Lose Weight – Eat lots of fruits, vegetables and fibre and reduce your intake of sugars and fat. Also important to get the recommended amount of exercise Limit alcohol intake to less than 1/day for women and 2/day for men Consider taking a vitamin D supplement

9. Framework PEACE Physical Exercise Across the Cancer Experience In 2001, Courneya and Friendenreich, proposed an organizational framework that divided the cancer experience into 6 areas: In 2001, Courneya and Friendenreich, proposed an organizational framework that divided the cancer experience into 6 areas: Prescreening – Exercise may have a protective effect Prescreening – Exercise may have a protective effect Screening/Diagnosis – Exercise may influence screening measures Screening/Diagnosis – Exercise may influence screening measures Pretreatment – Exercise prior to treatment may provide a buffering effect Pretreatment – Exercise prior to treatment may provide a buffering effect Treatment – Exercise may help patients cope with treatment Treatment – Exercise may help patients cope with treatment Post-treatment – Exercise may allow for better rehabilitation Post-treatment – Exercise may allow for better rehabilitation Resumption – Exercise may increase cancer survival Resumption – Exercise may increase cancer survival Bottom Line: Exercise has physical and psychological benefits during all stages of cancer

10. Cancer and Quality of Life The side-effects of treatment can be severe and interfere with treatment completion, day to day functioning and quality of life The side-effects of treatment can be severe and interfere with treatment completion, day to day functioning and quality of life Symptoms include fatigue, sleep disruptions, depression and impaired muscle and cardiorespiratory function Symptoms include fatigue, sleep disruptions, depression and impaired muscle and cardiorespiratory function Most of the exercise research has focused on symptom management to improve quality of life Most of the exercise research has focused on symptom management to improve quality of life

11. Exercise During Cancer Treatment

12. Frequency/Duration Less fatigue was experienced when patients exercised for only 10-minute bouts at least every other day Aerobic exercise – 10-90 min 3-7 days per week Resistance training – 3 times per week

13. Intensity Low intensity aerobic exercise is as beneficial as moderate intensity in improving aerobic capacity, body composition, QOL, fatigue and anxiety Symptom-dependent – based on stage of cancer, treatment or recovery as well as other co-morbidities – Progress slowly, accommodate for limitations In the absence of limitations work up to: – 40 to 60 percent of 1-repetition maximum for strength training – 40 to 60 percent heart rate reserve (HRR) for aerobic exercise

14. Aerobic vs. Resistance Exercise Both types are associated with decreased mortality and increased QOL Both types are associated with decreased mortality and increased QOL – Resistance training also associated with faster chemotherapy completion rates and longer term improvements in fatigue

15. Yoga and Cancer Yoga is increasingly being incorporated into cancer rehabilitation worldwide Yoga is increasingly being incorporated into cancer rehabilitation worldwide Lower levels of fatigue and pain and higher levels of invigoration, acceptance and relaxation were reported the day after a yoga session in women with breast cancer Lower levels of fatigue and pain and higher levels of invigoration, acceptance and relaxation were reported the day after a yoga session in women with breast cancer The ability to perform daily activities, diminished stress and increased levels of sleep have been shown to change after participating in yoga The ability to perform daily activities, diminished stress and increased levels of sleep have been shown to change after participating in yoga

16. Conclusion Cancer may be prevented by changes in lifestyle Exercise during cancer treatment can help manage symptoms and reduce the risk of reoccurrence

17. References American Cancer Society [http://www.cancer.org] Canadian Cancer Society [http://www.cancer.ca] National Cancer Institute [http://www.cancer.gov] Additional References upon request