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Panel Finds Exercise May Lower Cancer Risk, Improve Outcomes

Posted on by Dr. Francis Collins

Mature woman doing moderate exercise
Credit: gettyimages/vgajic

Exercise can work wonders for your health, including strengthening muscles and bones, and boosting metabolism, mood, and memory skills. Now comes word that staying active may also help to lower your odds of developing cancer. 

After reviewing the scientific evidence, a panel of experts recently concluded that physical activity is associated with reduced risks for seven common types of cancer: colon, breast, kidney, endometrial, bladder, stomach, and esophageal adenocarcinoma. What’s more, the experts found that exercise—both before and after a cancer diagnosis—was linked to improved survival among people with breast, colorectal, or prostate cancers.

About a decade ago, the American College of Sports Medicine (ACSM) convened its first panel of experts to review the evidence on the role of exercise in cancer. At the time, there was limited evidence to suggest a connection between exercise and a reduced risk for breast, colon, and perhaps a few other cancer types. There also were some hints that exercise might help to improve survival among people with a diagnosis of cancer.

Today, the evidence linking exercise and cancer has grown considerably. That’s why the ACSM last year convened a group of 40 experts to perform a comprehensive review of the research literature and summarize the level of the evidence. The team, including Charles Matthews and Frank Perna with the NIH’s National Cancer Institute, reported its findings and associated guidelines and recommendations in three papers just published in Medicine & Science in Sports & Exercise and CA: A Cancer Journal for Clinicians [1,2,3].

Here are some additional highlights from the papers:

Ÿ There’s moderate evidence to support an association between exercise and reduced risk for some other cancer types, including cancers of the lung and liver.

Ÿ While the optimal amount of exercise needed to reduce cancer risk is still unclear, being physically active is clearly one of the most important steps in general that people of all ages and abilities can take.

Ÿ Is sitting the new smoking? Reducing the amount of time spent sitting also may help to lower the risk of some cancers, including endometrial, colon, and lung cancers. However, there’s not enough evidence to draw clear conclusions yet.

Ÿ Every cancer survivor should, within reason, “avoid inactivity.” There’s plenty of evidence to show that aerobic and resistance exercise training improves many cancer-related health outcomes, reducing anxiety, depression, and fatigue while improving physical functioning and quality of life.

Ÿ Physical activity before and after a diagnosis of cancer also may help to improve survival in some cancers, with perhaps the greatest benefits coming from exercise during and/or after cancer treatment.

Based on the evidence, the panel recommends that cancer survivors engage in moderate-intensity exercise, including aerobic and resistance training, at least two to three times a week. They should exercise for about 30 minutes per session.

The recommendation is based on added confirmation that exercise is generally safe for cancer survivors. The data indicate exercise can lead to improvements in anxiety, depression, fatigue, overall quality of life, and in some cases survival.

The panel also recommends that treatment teams and fitness professionals more systematically incorporate “exercise prescriptions” into cancer care. They should develop the resources to design exercise prescriptions that deliver the right amount of exercise to meet the specific needs, preferences, and abilities of people with cancer.

The ACSM has launched the “Moving Through Cancer” initiative. This initiative will help raise awareness about the importance of exercise during cancer treatment and help support doctors in advising their patients on those benefits.

It’s worth noting that there are still many fascinating questions to explore. While exercise is known to support better health in a variety of ways, correlation is not the same as causation. Questions remain about the underlying mechanisms that may help to explain the observed associations between physical activity, lowered cancer risk, and improved cancer survival.

An intensive NIH research effort, called the Molecular Transducers of Physical Activity Consortium (MoTrPAC), is underway to identify molecular mechanisms that might explain the wide-ranging benefits of physical exercise. It might well shed light on cancer, too.

As that evidence continues to come in, the findings are yet another reminder of the importance of exercise to our health. Everybody—people who are healthy, those with cancer, and cancer survivors alike—should make an extra effort to remain as physically active as our ages, abilities, and current health will allow. If I needed any more motivation to keep up my program of vigorous exercise twice a week, guided by an experienced trainer, here it is!

References:

[1] Exercise Is Medicine in Oncology: Engaging Clinicians to Help Patients Move Through Cancer. Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, Ligibel JA, Cheville A, Galvão, DA, Alfano CM, Patel AV, Hue T, Gerber LH, Sallis R, Gusani NJ, Stout NL, Chan L, Flowers F, Doyle C, Helmrich S, Bain W, Sokolof J, Winters-Stone KM, Campbell KL, Matthews CE.  CA Cancer J Clin. 2019 Oct 16 [Epub ahead of publication]

[2] American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control. Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, Gerber LH, George SM, Fulton JE, Denlinger C, Morris GS, Hue T, Schmitz KH, Matthews CE. Med Sci Sports Exerc. 2019 Oct 16. [Epub ahead of publication]

[3] Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Med Sci Sports Exerc. 2019 Oct 16. [Epub ahead of publication]

Links:

Physical Activity and Cancer (National Cancer Institute/NIH)

Moving Through Cancer (American College of Sports Medicine, Indianapolis, IN)

American College of Sports Medicine

Charles Matthews (NCI)

Frank Perna (NCI)

NIH Support: National Cancer Institute


Bike to Work Day 2018

Posted on by Dr. Francis Collins

Dr. Collins riding a bicycle to work

Despite the heavy rain, I joined thousands of Washington area commuters in pedaling to work as part of Bike to Work Day 2018. It was held on May 18.


Are Sports Organizations Playing a Role in America’s Obesity Problem?

Posted on by Dr. Francis Collins

Sports Sponsors

Last September, the National Football League struck a deal with Frito-Lay that allowed the company to produce limited-edition bags of Tostitos tortilla chips, with each package bearing the logo of one of 19 featured NFL teams. Several months earlier, Major League Baseball announced that Nathan’s Famous would be its first-ever official hot dog. Now the first-ever comprehensive analysis of such food and beverage sponsorships by major sports organizations shows just how pervasive these deals are. The confusing messages they send about physical fitness and healthy eating habits can’t be helping our national problem with obesity [1].

Among the 10 sports organizations that young viewers watch most, from the NFL to Little League, the NIH-funded research team identified dozens of sponsors and hundreds of associated advertisements promoting food and beverage products. The vast majority of those ads touted unhealthy items, including chips, candies, sodas, and other foods high in fat, sodium, or sugar, and low in nutritional value.

Those findings are especially concerning in light of the latest figures from the National Health and Nutrition Examination Survey (NHANES), co-supported by NIH [2], It shows that, despite long-standing public health efforts to curb the obesity epidemic, more than 18 percent of young people in America remain obese. Among adults, the picture is even more discouraging: nearly 40 percent of American adults were obese in 2015-2016, up from about 34 percent in 2007-2008.


Muscle Enzyme Explains Weight Gain in Middle Age

Posted on by Dr. Francis Collins

Woman weighing herself

Thinkstock/tetmc

The struggle to maintain a healthy weight is a lifelong challenge for many of us. In fact, the average American packs on an extra 30 pounds from early adulthood to age 50. What’s responsible for this tendency toward middle-age spread? For most of us, too many calories and too little exercise definitely play a role. But now comes word that another reason may lie in a strong—and previously unknown—biochemical mechanism related to the normal aging process.

An NIH-led team recently discovered that the normal process of aging causes levels of an enzyme called DNA-PK to rise in animals as they approach middle age. While the enzyme is known for its role in DNA repair, their studies show it also slows down metabolism, making it more difficult to burn fat. To see if reducing DNA-PK levels might rev up the metabolism, the researchers turned to middle-aged mice. They found that a drug-like compound that blocked DNA-PK activity cut weight gain in the mice by a whopping 40 percent!


Exercise Releases Brain-Healthy Protein

Posted on by Dr. Francis Collins

Exercise

We all know that exercise is important for a strong and healthy body. Less appreciated is that exercise seems also to be important for a strong and healthy mind, boosting memory and learning, while possibly delaying age-related cognitive decline [1]. How is this so? Researchers have assembled a growing body of evidence that suggests skeletal muscle cells secrete proteins and other factors into the blood during exercise that have a regenerative effect on the brain.

Now, an NIH-supported study has identified a new biochemical candidate to help explore the muscle-brain connection: a protein secreted by skeletal muscle cells called cathepsin B. The study found that levels of this protein rise in the blood of people who exercise regularly, in this case running on a treadmill. In mice, brain cells treated with the protein also exhibited molecular changes associated with the production of new neurons. Interestingly, the researchers found that the memory boost normally provided by exercise is diminished in mice unable to produce cathepsin B.


Sound Advice: High School Music Training Sharpens Language Skills

Posted on by Dr. Francis Collins

Band Instruments

When children enter the first grade, their brains are primed for learning experiences, significantly more so, in fact, than adult brains. For instance, scientists have documented that musical training during grade school produces a signature set of benefits for the brain and for behavior—benefits that can last a lifetime, whether or not people continue to play music.

Now, researchers at Northwestern University, Evanston, IL, have some good news for teenagers who missed out on learning to play musical instruments as young kids. Even when musical training isn’t started until high school, it produces meaningful changes in how the brain processes sound. And those changes have positive benefits not only for a teen’s musical abilities, but also for skills related to reading and writing.