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Physical Activity & Breast Cancer. By Janet Foote, PhD. Educational Objectives. Discuss the role of movement in: 1. Prevention of breast cancer onset 2. Appropriateness for breast cancer survivors 3. Prevention of Breast Cancer recurrence. - PowerPoint PPT Presentation
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By
Janet Foote, PhD
Discuss the role of movement in:
1. Prevention of breast cancer onset 2. Appropriateness for breast cancer survivors 3. Prevention of Breast Cancer recurrence
Physical ActivityAnaerobic
Aerobic - most prevention/survival research
Bouts up to 2 mins, highest % effort, uses CP & ATP, & results in lactic acid build-up (burning)
Bouts > 2 mins, sub-max effort, uses aerobic processes (O2), w/ training - can sustain for longer periods
Types of Aerobic Activities
walking, jogging, running
cycling
swimming
skiing
household: sweeping, vacuuming etc.
recreational / occupational
Physical Activity & Breast Cancer Risk
Recent comprehensive review - 2007 C M Friedenreich & A E CustBr J Sports Medicine 42:636-647, 2008
1 1.5 2.00.50.25
increased riskreduced risk
50% less likely
17 of 28 cohort studies
Risk
average 20% risk
reduction
Ref: Friedenreich CM & Cust AE, Br J Sports Med 42:636-647, 2008
Any type of Breast Cancer
26 of 34 case-control
studies
average 30% risk
reduction
Ref: Friedenreich CM & Cust AE, Br J Sports Med 42:636-647, 2008
All Types of Breast Cancer
Risk
All studies - 25% reduction in breast cancer risk
Among only those studies finding that activity reduced breast cancer risk
◦ 36% reduction risk in active
Evidence for Aerobic Activity in Prevention of Breast Cancer Onset
Differences by menopausal status
WCRF AICR rating of benefits*:* Premenopausal: “limited suggestive” * Postmenopausal: “probable”
Cohort & Case-control Studies
• WCRF-AICR Food,Nutrition, Physical Activity & the Prevention of Cancer: a Global Perspective,
AICR Washington, DC, 2nd edition 2007.
Breast Cancer Risk: Pre-menopausal
Ref: Friedenreich CM & Cust AE, Br J Sports Med 42:636-647, 2008
Risk
5 signif.
14 n.s.
29 of 31
aver. 40%
Breast Cancer Risk: Post-menopausal
RiskRef: Friedenreich CM & Cust AE, Br J Sports Med 42:636-647, 2008
20 signif.
10 n.s.
30 of 35
aver. 33%
Recreational activityLifetime, activity after age 50 Decreasing categories of BMIAsian, Black, Hispanic (50%, 40%, & 30%)Women with no family historyWomen - ER-/PR- (0.61) vs. ER+/PR+ (0.86)Parous women (28% vs. 22% reduction nulliparous)
Effects were greater for:
Activity Responsive Pathways Immune function
Growth factors, GF binding proteins
Sex hormones & binding proteins
Endogenous antioxidant enzyme systems
Oxidative stress DNA repair
Phase II xenobiotic systemGood review: A. Rundle, Molecular epidemiology of physical activity and cancer, CEBP 14(1):227-236, 2005
Decreased lifetime exposure to estrogen
Decreased % of body fat
Increases immunity & antioxidant defense systems
Intervention Studies
Majority among breast cancer
Significant physiological benefits
Significant psychological benefits
Improved QOL, depression, anxiety
Improved self-esteem
Ref.: DA Galvao & RU Newton, Review of Intervention studies in cancer patients, J Clin Onc 23(4): 899-909, 2005
Intervention Studies
Mostly aerobic activities
Positive effects: resistance training
- anaerobic
Flexibility
Do - able! Benefits!
Activity: Recurrence Prevention Minimize post-treatment weight gain
Maintenance lean body mass (BMD)
Enhance immunity/antioxidant systems
Enhance QOL, fatigue and anxiety
Enhance self-esteem & depression
Advantages: aerobic & resistance tr.
Enhance range of motion flexibility
Getting StartedBring up the subject!
“Here are some things you can do as part of your treatment,…to help you live better and longer”.
Be specific in advice
Provide an exercise prescription
Exercise Prescription Elements1. Frequency - how often
2. Intensity - % effort, 60 - 80%
3. Duration - how long each bout lasts
Initial fitness level
Type of exercise
Additional considerations:
Exercise Prescription: Br CA
Start slowly, but be specific
“3 times during the next week, walk 2 blocks away from your house, turn & walk 2 more blocks & continue until you’ve walked back to your house”
“keep 2 canned goods near your TV & every commercial alternate holding out front, to the side, overhead, curls”
Watching 2 hrs TV nightly:
Physical Activity - Breast Cancer
decreases risk
enhances treatment
improves survival
Beneficial Physical
Activity types
aerobic (cardiovascular)
anaerobic (resistance training)
flexibility (range-of-motion)
Promoting regular activity among:
women at riskwomen undergoing treatmentsurvivors
* Develop own hand-out:check boxes for prescription, diaries
Join: gym w/ set classes (like Curves) program/organization(Bone-builders, Walk Across Arizona, Better Than Ever, litter patrol, dog walkers, Masters Swim club, hiking club, dance classes, etc.)
Enlist: friend, spouse, dog
Pedometer: log steps / day on the calendar working to a 10,000 steps / day goal
Activity Resources
Model it Make it happen