I'm Aware of Cancer Team Work

What is physic A measure called the metabolic equi characterize the intensity of physical energy expended by a person sitting expend less than 3 METs, moderate- METs, and vigorous activities expend Sedentary behavior is any waking be expenditure of 1.5 or fewer METs wh (1). Examples of sedentary behaviors vehicle, and sitting while watching te A person can be physically active an of time being sedentary.

cal activity? ivalent of task, or MET, is used to l activity. One MET is the rate of g at rest. Light-intensity activities -intensity activities expend 3 to 6 d 6 or more METs (1). ehavior characterized by an energy hile sitting, reclining, or lying down s include most office work, driving a elevision. nd yet spend a substantial amount





What is known about between physical activit Evidence cancer ris studies, i physical diagnose studies c studies in and whe relationsh causal co

t the relationship ty and cancer risk? e linking higher physical activity to lower sk comes mainly from observational in which individuals report on their activity and are followed for years for es of cancer. Although observational cannot prove a causal relationship, when n different populations have similar results en a possible mechanism for a causal hip exists, this provides evidence of a onnection.

There is strong evidence that higher levels risk of several types of cancer (2–4). ·Bladder cancer: In a 2014 meta-analysis o studies, the risk of bladder cancer was 15% level of recreational or occupational physic level (5). A pooled analysis of over 1 million physical activity was linked to a 13% redu

s of physical activity are linked to lower of 11 cohort studies and 4 case-control % lower for individuals with the highest cal activity than in those with the lowest n individuals found that leisure-time uced risk of bladder cancer (6).

Breast cancer: Many studies have shown t lower risk of breast cancer than inactive w included 38 cohort studies, the most physi risk of breast cancer than those who were activity has been associated with

that physically active women have a women. In a 2016 meta-analysis that ically active women had a 12–21% lower e least physically active (7). Physical

Colon cancer: In a 2016 meta-analysis of 1 the highest level of physical activity had a those who were the least physically active Endometrial cancer: Several meta-analyse relationship between physical activity and the lining of the uterus) (12–15). In a meta- active women had a 20% lower risk of end levels of physical activity (12). There is som indirect, in that physical activity would hav observed. Obesity is a strong risk factor fo

126 studies, individuals who engaged in 19% lower risk of colon cancer than e (11). es and cohort studies have examined the d the risk of endometrial cancer (cancer of -analysis of 33 studies, highly physically dometrial cancer than women with low me evidence that the association is ve to reduce obesity for the benefits to be or endometrial cancer (12–14).

Esophageal cancer: A 2014 meta-analysis studies found that the individuals who wer lower risk of esophageal adenocarcinoma active (16). Kidney (renal cell) cancer: In a 2013 meta- control studies, individuals who were the m risk of renal cancer than those who were t over 1 million individuals found that leisure 23% reduced risk of kidney cancer (6). Stomach (gastric) cancer: A 2016 meta-an control studies reported that individuals w 19% lower risk of stomach cancer than tho

s of nine cohort and 15 case–control re most physically active had a 21% than those who were least physically -analysis of 11 cohort studies and 8 case– most physically active had a 12% lower the least active (17). A pooled analysis of e-time physical activity was linked to a nalysis of 10 cohort studies and 12 case– who were the most physically active had a ose who were least active (18).

There is some evidenc with a reduced risk of However, it is possible than in physical activit physical activity with r meta-analysis of 25 ob was associated with re former and current sm of lung cancer among For several other canc association. These incl well as cancers of the liver, and rectum (2, 6)

ce that physical activity is associated lung cancer (2, 4). e that differences in smoking, rather ty, are what explain the association of reduced risk of lung cancer. In a 2016 bservational studies, physical activity educed risk of lung cancer among mokers but was not associated with risk never smokers (19). cers, there is more limited evidence of an lude certain cancers of the blood, as pancreas, prostate, ovaries, thyroid, ).

How might physical ac reduced risks o Exercise has many biological effects on the proposed to explain associations with spec • Lowering the levels of sex hormones, suc have been associated with cancer develop • Preventing high blood levels of insulin, wh development and progression (20) [breast, • Reducing inflammation • Improving immune system function • Altering the metabolism of bile acids, dec tract to these suspected carcinogens (21, 2 • Reducing the time it takes for food to trav decreases gastrointestinal tract exposure t • Helping to prevent obesity, which is a risk

ctivity be linked to of cancer? e body, some of which have been cific cancers. These include: ch as estrogen, and growth factors that pment and progression (20) [breast, colon] hich has been linked to cancer , colon] creasing exposure of the gastrointestinal 22) [colon] vel through the digestive system, which to possible carcinogens [colon] k factor for many cancers





What is known about the relation and the risk of cancer? Although there are fewer studies o risk than of physical activity and ca sitting, reclining, or lying down for e than sleeping)—is a risk factor for d conditions and premature death (4 associated with increased risk for c

nship between being sedentary of sedentary behavior and cancer ancer risk, sedentary behavior— extended periods of time (other developing many chronic 4, 23, 24). It may also be certain cancers (23, 25).

How much phy recomm The U.S. Department of Health and Guidelines for Americans, 2nd edition that, for substantial health benefits diseases, including cancer, adults enga •150 to 300 minutes of moderate-in minutes of vigorous aerobic activity, o intensity each week. This physical ac length. • muscle-strengthening activities at leas • balance training, in addition to aerobic

ysical activity is mended? d Human Services Physical Activity n, released in 2018 (1), recommends and to reduce the risk of chronic age in ntensity aerobic activity, 75 to 100 or an equivalent combination of each ctivity can be done in episodes of any st 2 days a week c and muscle-strengthening activity





ben Yes. Colle Mult Activ (26) testi surv main

Is physical activity neficial for cancer survivors? . A report of the 2018 American ege of Sports Medicine International tidisciplinary Roundtable on Physical vity and Cancer Prevention and Control concluded that exercise training and ing are generally safe for cancer vivors and that every survivor should ntain some level of physical activity.

The Roundtable also found • strong evidence that moderate-intensity ae resistance exercise during and after cancer anxiety, depressive symptoms, and fatigue related quality of life and physical function • strong evidence that exercise training is sa or might develop breast-cancer-related lymp • some evidence that exercise is beneficial quality • insufficient evidence that physical activity cardiotoxicity or chemotherapy-induced per improve cognitive function, falls, nausea, pa treatment tolerance

erobic training and/or r treatment can reduce and improve health- afe in persons who have phedema for bone health and sleep can help prevent ripheral neuropathy or ain, sexual function, or

In addition, research findings have raise may have beneficial effects on survival f prostate canc • Breast cancer: In a 2019 systematic review breast cancer survivors who were the most ph from any cause and a 40% lower risk of death least physically active (28). • Colorectal cancer: Evidence from multiple activity after a colorectal cancer diagnosis is a colorectal cancer and a 38% lower risk of dea • Prostate cancer: Limited evidence from a f activity after a prostate cancer diagnosis is as prostate cancer and a 45% lower risk of death

ed the possibility that physical activity for patients with breast, colorectal, and cers (26, 27). w and meta-analysis of observational studies, hysically active had a 42% lower risk of death h from breast cancer than those who were the epidemiologic studies suggests that physical associated with a 30% lower risk of death from ath from any cause (4). few epidemiologic studies suggests that physical ssociated with a 33% lower risk of death from h from any cause (4).





What additional resear relationship between phy Findings from observational studies between higher levels of physical a However, these studies cannot fully people have lower cancer risk beca lifestyle behaviors. For this reason, participants to exercise intervention because they eliminate bias caused attendant physical inactivity.

rch is under way on the ysical activity and cancer? s provide much evidence for a link activity and lower risk of cancer. y rule out the possibility that active ause they engage in other healthy , clinical trials that randomly assign ns provide the strongest evidence d by pre-existing illness and

To confirm the observational evidenc of the effect, several large clinical tr and/or exercise interventions in can include the Breast Cancer Weight Lo breast cancer patients, the CHALLEN have recently completed chemothe trial in men with metastatic, castra

ce and define the potential magnitude rials are examining physical activity ncer patients and survivors. These oss (BWEL) trial in newly diagnosed NGE trial in colon cancer patients who erapy (29), and the INTERVAL-GAP4 ate-resistant prostate cancer (30).

Many additional questions have ye areas of research on physical activ • What are the mechanisms by which risk? • What is the optimal time in life, inten physical activity needed to reduce the specific sites? • Is sedentary behavior associated wi • Does the association between physi or race/ethnicity? • Does physical activity reduce the ris inherited a genetic variant that increa

et to be answered in several broad vity and cancer: h physical activity reduces cancer nsity, duration, and/or frequency of e risk of cancer, both overall and for ith increased risk of cancer? ical activity and cancer differ by age sk of cancer in people who have ases cancer risk?









Refer

rences

2018 Physical Activit 2018 Physical Activit Scientific Report. Wa Health and Human S McTiernan A, Friede Physical activity in ca systematic review. M Exercise 2019; 51(6)

ty Guidelines Advisory Committee. ty Guidelines Advisory Committee ashington, DC: U.S. Department of Services, 2018. enreich CM, Katzmarzyk PT, et al. ancer prevention and survival: A Medicine and Science in Sports and ):1252-1261.

Rezende LFM, Sá TH activity and cancer: an including 22 major ana cases. British Journal 52(13):826-833. Patel AV, Friedenreic College of Sports Me physical activity, sed prevention and contr and Exercise 2019; 5

H, Markozannes G, et al. Physical n umbrella review of the literature atomical sites and 770 000 cancer of Sports Medicine 2018; ch CM, Moore SC, et al. American edicine Roundtable Report on dentary behavior, and cancer rol. Medicine and Science in Sports 51(11):2391-2402.