An article just published in the June issue of the Archives of Physical Medicine and Rehabilitation highlighted the significant impact that simple exercises can have on cancer patients recovering from surgery.
Researchers from the Inje University College of Medicine in South Korea reported on a study of patients recovering from stomach cancer surgery. They found that those who began minimal exercising just two days after surgery showed stronger immune function than those who did not exercise. Two weeks after their surgery, those that exercised had significantly more natural killer cells compared with their sedentary counterparts. Natural killer cells in the immune system attack tumor cells and help ward off infection.
The exercises involved simple movements while lying in bed during the first few days after surgery. The patients gradually moved on to aerobic exercises on stationary bikes.
Dr. Young-Moo Na and his colleagues noted that other factors, such as nutrition and cancer therapy itself, might also affect natural killer cells. But they concluded that exercise is certainly one definitive way to boost a cancer patient's immunity.
Boosting Recovery
The Korean study is just the most recent addition to a growing body of evidence demonstrating that exercise, even on a minimal scale, can have a profound impact on recovery in cancer patients-not only in terms of physical recuperation but also for overall emotional well-being.
For example, a study by Canadian researchers found that physical exercise can have a dramatic impact on a cancer patient's quality of life, as measured by a wide range of physical, functional, psychological, and emotional factors.
Dr. Kerry Courneya of the University of Alberta and Dr. Christine Friedenreich of the Alberta Cancer Board analyzed 24 major studies of exercise in cancer patients published between 1980 and 1997. Writing in the Annals of Behavioral Medicine, they noted that some of the most prevalent physical benefits of exercise included increased lung capacity, muscle strength and overall energy levels; reduced nausea and fatigue; and lower pain levels.
They wrote that many oncologists still recommend that patients take it easy and rest during chemotherapy. But they suggested that this might contribute even more to the fatigue factor. They did caution, though, that a patient's ability to exercise can vary at different times during treatment and recovery.
Courneya and Friedenreich also found that certain psychological measures of well-being improved dramatically as a result of exercise during and after treatment. These included increased feelings of competence, control and self-esteem; and reduced symptoms of depression and anxiety.
In a subsequent report in the same journal, Dr. Cindy Carmack of the University of Texas M.D. Anderson Cancer Center in Houston, wrote that regular exercise can also help protect against the physical effects of daily stress.
Previous studies have shown that mental stress can take a direct toll on physical health, and even lead to increased symptoms of anxiety and depression, Carmack noted.
In a study involving 135 college students, Carmack found that during periods of high stress, those who reported exercising less frequently had 37 percent more physical symptoms than their counterparts who exercised more often. In addition, highly stressed students who exercised less often reported 21 percent more anxiety than those who exercised more frequently.
Exercise as a Preventive Measure
While a growing body of evidence is concluding that exercise can help in the cancer recovery process-both physically and emotionally-there has been even more research into the preventive benefits that regular exercise can have in minimizing the risk of cancer and other diseases.
For example, at the recent annual meeting of the American College of Sports Medicine in Indianapolis, researchers from the Cooper Institute reported on two studies which concluded that men's cardiovascular fitness-regardless of weight-was a key factor in whether they eventually died of cancer.
In one study, Dr. Carolyn Barlow and colleagues followed more than 22,700 men aged 20 to 85 for ten years. Men who were classified as "unfit" based on treadmill tests were 80 percent more likely to die of cancer than those in better condition. Interestingly, they found that if a man was fit, being overweight did not raise his cancer risk.
In a second presentation, Dr. Larry Gibbons and colleagues noted that previous research had linked fitness to a higher risk of colon and breast cancer. Yet, little research had been done on lung cancer patients. To study this link, they evaluated nearly 26,000 men for an average of 10 years.
After adjusting for smoking and certain other risk factors, they found that the 20 percent who had the lowest fitness levels were about 2.5 times more likely than the most-fit men to die of lung cancer. The 40 percent of men classified as moderately fit were 1.5 times more likely to die of the disease.
A recent statement by the Food and Nutrition Science Alliance (FANSA) reiterated such findings. It noted that cancer will strike one in three Americans at some point in their lives. But the number of cancers could be cut by as much as one third if Americans adopted simple lifestyle changes such as moderate exercise and a healthier diet.
FANSA is a partnership of four organizations: The American Dietetic Association, the American Society for Clinical Nutrition, the American Society for Nutritional Sciences, and the Institute of Food Technologists.
Dr. Dennis Savaiano, the organization's Chair, said that approximately one-third of cancer cases could be attributed to smoking, one-third to lack of exercise and a poor diet, and one-third to genetic or other factors.
And yet, a disturbing report in the American Journal of Health Promotion cited that as many as 60 percent of American adults remain inactive, despite the long list of well-known health benefits derived from regular exercise.
Dr. Bess Marcus and Leigh Ann Forsyth of Brown University wrote that only about 14 percent of U.S. adults engage in 20 minutes of vigorous exercise, three times a week. The U.S. Surgeon General recently advised that even 30 minutes of moderate physical activity accumulated throughout the day can help prevent heart disease and some cancers.
Take it Slow
While the benefits of exercising to both minimize the risk of cancer as well as to maximize recovery from the disease are well documented, virtually every researcher cautions that such a program should be cleared with your physician.
Some cancer patients in particular may require close medical supervision, and not all will be able to exercise throughout treatment and recovery. Nonetheless, even minimal exercise can usually be tailored to an individual patient's needs, often resulting in significant physical-and emotional-benefits.
SOURCES:
Archives of Physical Medicine and Rehabilitation, June 2000; 81:777-779
Annals of Behavioral Medicine, Sept. 1999
Annals of Behavioral Medicine, Nov. 1999
Annual meeting of the American College of Sports Medicine, June 2, 2000, Indianapolis, Indiana
American Journal of Health Promotion, Dec. 1999; 14:118-123
The Food and Nutrition Science Alliance
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