December 10, 2021 – Oncologist Nancy Howe was adamant: You need to calm down. It was 1997, and Howe just had head and neck surgery Cancer. Now she had to endure 7 weeks radiation therapy, and the side effects that accompany it – profound fatigue more than anything.
Howe has always been physically active, but she lost muscle and felt depressed whenever she couldn’t training due to injuries.
“I knew it would be better for me to stay as active as possible,” says Howe of Phoenix, AZ.
Howe defied her doctor’s orders to rest during cancer treatment, common advice of the late 1990s. She continued to go to the gym, even if for a few days, all she could endure was a few minutes on a stationary bike, and she walked around her neighborhood. Her instinct for maintenance paid off.
“I went through the treatment a lot better than anyone expected,” says Howe, now 65. “I had more energy and didn’t lose a lot of muscle, which made my recovery easier after radiation.”
Unknown to her, Howe embraced an idea that is still accepted in medicine today: Exercise is a powerful weapon against cancer.
Research in a fast growing area exercise oncology has left little doubt that staying physically active improves symptoms and side effects during cancer treatment. And now there is strong evidence that exercise reduces the risk of some cancers and reduces the chances of dying if you are diagnosed with certain forms of the disease.
However, in the minds of many, including some oncologists, exercise and cancer do not go together, says Dr. Kathryn Schmitz, director of the Oncology, Nutrition and Exercise Group at the Penn State Cancer Institute.
“If you ask the average person on the street if your Aunt Betty, who has cancer, needs to exercise, they’ll say, ‘Damn, no, you should sit with a blanket over your knee,'” says Schmitz, author of the book. Going through cancer and an evangelist for exercise oncology. Cardiologists have ordered the heart attack survivors to rest, she says, “but now we’re getting them out of bed the next day and we have them in cardiac rehabilitation within a week.”
Attitudes about exercise in oncology are changing, he says, but much remains to be done.
Forty years of exercise oncology
The beginnings of exercise oncology usually date back to the 1980s, when a series of studies at Ohio State University discovered that breast cancer patients who have chemotherapy who exercised regularly – which was a radical idea at the time – had less fatigue, nausea and disability than treatment.
This revolutionary work helped launch a tsunami of research into the connection between exercise and cancer. In 2019, Schmitz co-chaired an international group of experts who reviewed science and found that exercise during and after cancer treatment relieves fatigue, anxiety, i depression, with improved quality of life and bodily function. That is, the ability to lead a normal day.
Meanwhile, prevention is also part of the equation. Studies strongly suggest that exercise reduces the risk of seven forms of cancer: bladder, breast, colon, endometrial, esophagus, kidney, and stomach.
There are also intriguing clues that exercise helps prevent cancer of the lungs, blood, head and neck, ovaries, pancreas and prostate. Exercise appears to reduce the risk of dying in people diagnosed with breast, colon and prostate cancer, ranging from 40% to 50%. Those kinds of numbers and that amount of research are hard to ignore.
How could blowing and blowing fight cancer? No one is sure, but Schmitz points out that exercise lowers the level inflammation and insulin, which have been linked to some cancers.
Also, exercise stimulates angiogenesis, or the creation of new blood vessels, he notes, which could mean that more blood-based cancer drugs can be delivered to malignant tumors.
“Exercise can actually change the power of chemotherapy,” says Schmitz.
Why It Helps
Immune function also plays a role. While the cancer is weak immune system, one exercise attack creates a flood of veterans’ immune cells, says Dr. Michael Gustafson, scientific director of Nyberg’s Cellular Cell Therapy Laboratory on the Mayo Clinic campus in Arizona.
Gustafson and co-workers found that 10 minutes of pedaling at full speed on a stationary bike can increase 10 times the fight against tumors called natural killer cells; protective T and B cells also grow in the blood.
“I don’t believe that exercise alone can cure you of cancer, but I believe it can be of great help,” he says.
Using exercise to help cancer patients build larger armies of defense stations, Gustafson believes it might be possible to create powerful immunotherapy treatments work better. These treatments “teach” the patient’s own immune cells to attack tumors.
It is also well known that body fat produces a hormone estrogen, which can cause some forms of breast cancer, says Betsy O’Donnell, MD, director of the Lifestyle Medicine Clinic at Massachusetts General Hospital in Boston.
Exercise, along with reducing calories, helps reduce body fat, which worries many breast cancer patients, who often gain weight during treatment.
“Weight gain can also have major implications for self-esteem and quality of life,” says O’Donnell.
At her clinic, patients work with a nutritionist, behavioral psychologist and other professionals to help improve their physical condition.
Research shows that aerobic exercise (such as walking, running or cycling) and strength training (such as lifting weights or using resistance straps) can benefit cancer patients.
Often quoted A 2007 study published in Journal of Clinical Oncology Including 242 women with breast cancer who were preparing to start chemotherapy, aerobic exercise showed that patients improved their self-esteem and reduced body fat, while resistance training helped build muscle and increased the likelihood of completing treatment.
The need for personal programs
Not all cancer survivors are eager to go to the gym during or soon after strict treatment, so it is necessary to adjust the intensity of exercise to each patient, says O’Donnell.
Walking is perhaps the most popular option many of her patients choose, especially since many people avoid gyms because of the COVID-19 pandemic. She recommends walking at least 150 minutes a week, maintaining a pace that allows you to talk but not sing.
And if walking isn’t for you, O’Donnell says, some of her patients instead dance, learn tai chi, or find some other form of purposeful movement they enjoy.
“You really have to get to know patients where they are, both in terms of their physical abilities and their desire to participate,” O’Donnell says. (You can find exercise videos for different levels of fitness developed by her clinic here.)
Nancy Howe was so convinced that staying active helped her treat cancer that she resigned as a software engineer and became a fitness trainer for cancer patients and survivors. A doctoral candidate in nursing and health innovation at Arizona State University, her thesis project involves adapting the tools doctors use to select the right level of exercise for cancer patients so that patients can use it themselves.
But in the end, the advice for patients is simple.
“It’s really important to do something now, wherever you are on your path against cancer,” Howe says. “Just start.”