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Cancer, Physical Activity, and Exercise

Justin C. Brown, Kerri Winters‐Stone, Augustine Lee, Kathryn H. Schmitz

10.1002/cphy.c120005

Source: Volume 2, Issue 4, October 2012

Published online: October 2012

Full Article on Wiley Online Library



Abstract

This review examines the relationship between physical activity and cancer along the cancer continuum, and serves as a synthesis of systematic and meta‐analytic reviews conducted to date. There exists a large body of epidemiologic evidence that conclude those who participate in higher levels of physical activity have a reduced likelihood of developing a variety of cancers compared to those who engage in lower levels of physical activity. Despite this observational evidence, the causal pathway underlying the association between participation in physical activity and cancer risk reduction remains unclear. Physical activity is also a useful adjunct to improve the deleterious sequelae experienced during cancer treatment. These deleterious sequelae may include fatigue, muscular weakness, deteriorated functional capacity, and many others. The benefits of physical activity during cancer treatment are similar to those experienced after treatment. Despite the growing volume of literature examining physical activity and cancer across the cancer continuum, a number of research gaps exist. There is little evidence on the safety of physical activity among all cancer survivors, as most trials have selectively recruited participants. The specific dose of exercise needed to optimize primary cancer prevention or symptom control during and after cancer treatment remains to be elucidated. © 2012 American Physiological Society. Compr Physiol 2:2775‐2809, 2012.

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Figure 1. Figure 1.

A paradigm of physical activity and cancer research.
Figure 2. Figure 2.

A conceptual model to guide and organize the role of physical activity across the cancer control continuum. Reproduced, with permission, from reference 33.
Figure 3. Figure 3.

Individual risk factor contributions to mortality from all cancers, worldwide. Data adapted, with permission, from reference 175.
Figure 4. Figure 4.

Relative risk and 95% confidence intervals (95% CI) comparing highest versus lowest levels of physical activity and cancer risk reduction.
Figure 5. Figure 5.

Candidate mechanistic pathways linking physical activity and breast cancer. Reproduced, with permission, from reference 163.
Figure 6. Figure 6.

Strength of evidence linking physical activity and hypothesized cancer prevention mechanistic pathways.
Figure 7. Figure 7.

Weight adjusted treatment effect ratio of exercise to control on sex hormone concentrations after 12 months. Data adapted, with permission, from reference 53.
Figure 8. Figure 8.

Adjusted insulin sensitivity according to frequency of participation in vigorous intensity physical activity. Data adapted, with permission, from reference 102.
Figure 9. Figure 9.

Adjusted fasting glucose according to frequency of participation in vigorous intensity physical activity. Data adapted, with permission, from reference 102.
Figure 10. Figure 10.

Exercise intensity and optimal states of infection risk and immunosurveillance. Figure adapted, with permission, from reference 115.
Figure 11. Figure 11.

Prevalence of upper limb dysfunction among breast cancer survivors. Data adapted, with permission, from reference 184.
Figure 12. Figure 12.

Prevalence of congestive heart failure at varying doses of anthracyline. Data adapted, with permission, from reference 160.
Figure 13. Figure 13.

Prevalence of any cardiac event at varying doses of anthracycline. Data adapted, with permission, from reference 160.
Figure 14. Figure 14.

New comorbidities acquired posttransplant at 37‐month follow‐up. Data adapted, with permission, from reference 86.
Figure 15. Figure 15.

Physiologic effects occurring as a result of exercise training during cancer treatment. Data adapted, with permission, from reference 153.
Figure 16. Figure 16.

Psychosocial effects occurring as a result of exercise training during cancer treatment. Data adapted, with permission, from reference 35,153.
Figure 17. Figure 17.

The intersection of cancer and aging. Reproduced, with permission, from reference 136. 1 Instrumental activities of daily living; 2 Activities of daily living.
Figure 18. Figure 18.

Breast cancer surveillance and rehabilitation model. Reproduced, with permission, from reference 64.


Figure 1.

A paradigm of physical activity and cancer research.



Figure 2.

A conceptual model to guide and organize the role of physical activity across the cancer control continuum. Reproduced, with permission, from reference 33.



Figure 3.

Individual risk factor contributions to mortality from all cancers, worldwide. Data adapted, with permission, from reference 175.



Figure 4.

Relative risk and 95% confidence intervals (95% CI) comparing highest versus lowest levels of physical activity and cancer risk reduction.



Figure 5.

Candidate mechanistic pathways linking physical activity and breast cancer. Reproduced, with permission, from reference 163.



Figure 6.

Strength of evidence linking physical activity and hypothesized cancer prevention mechanistic pathways.



Figure 7.

Weight adjusted treatment effect ratio of exercise to control on sex hormone concentrations after 12 months. Data adapted, with permission, from reference 53.



Figure 8.

Adjusted insulin sensitivity according to frequency of participation in vigorous intensity physical activity. Data adapted, with permission, from reference 102.



Figure 9.

Adjusted fasting glucose according to frequency of participation in vigorous intensity physical activity. Data adapted, with permission, from reference 102.



Figure 10.

Exercise intensity and optimal states of infection risk and immunosurveillance. Figure adapted, with permission, from reference 115.



Figure 11.

Prevalence of upper limb dysfunction among breast cancer survivors. Data adapted, with permission, from reference 184.



Figure 12.

Prevalence of congestive heart failure at varying doses of anthracyline. Data adapted, with permission, from reference 160.



Figure 13.

Prevalence of any cardiac event at varying doses of anthracycline. Data adapted, with permission, from reference 160.



Figure 14.

New comorbidities acquired posttransplant at 37‐month follow‐up. Data adapted, with permission, from reference 86.



Figure 15.

Physiologic effects occurring as a result of exercise training during cancer treatment. Data adapted, with permission, from reference 153.



Figure 16.

Psychosocial effects occurring as a result of exercise training during cancer treatment. Data adapted, with permission, from reference 35,153.



Figure 17.

The intersection of cancer and aging. Reproduced, with permission, from reference 136. 1 Instrumental activities of daily living; 2 Activities of daily living.



Figure 18.

Breast cancer surveillance and rehabilitation model. Reproduced, with permission, from reference 64.

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Article Title: Cancer, Physical Activity, and Exercise
 

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Justin C. Brown, Kerri Winters‐Stone, Augustine Lee, Kathryn H. Schmitz. Cancer, Physical Activity, and Exercise. Compr Physiol 2012, 2: 2775-2809. doi: 10.1002/cphy.c120005