Abstract
Objective
Existing information regarding the impact of physical activity after a cancer diagnosis on all-cause mortality is limited. We examined the association between different types of physical activity (domestic, walking, sports) and mortality in 293 participants (65.5% women) with a cancer registration prior to the baseline assessment.
Methods
Participants were drawn from the Scottish Health Surveys (1995, 1998, 2003) that were linked to a national database of cancer registrations and deaths. The main outcome was all-cause mortality during a mean follow-up period of 5.9 ± 3.2 years. Cox proportional hazards models were used to estimate the risk of all-cause mortality by levels of physical activity.
Results
There were 78 deaths during follow-up. The lowest risks for all-cause mortality were seen in sports activity groups [multivariable-adjusted hazard ratio (HR) for any compared with groups of no sports: 0.47, 95% CI 0.23–0.96, p = 0.039] although light and moderate activity such as domestic activity (HR = 1.04, 0.60–1.80) and regular walking (HR = 0.95, 0.57–1.56) did not confer protection.
Conclusion
Participation in an average of more than three sessions of vigorous exercise per week for at least 20 min/session was associated with the lowest risks of all-cause mortality following a cancer diagnosis. Vigorous physical activity could therefore be a more important determinant of survival than duration or total volume of exercise in cancer survivors.
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References
Cancer Research UK. UK Cancer incidence statistics. http://info.cancerresearchuk.org/cancerstats. Accessed Feb 2008
Information Services Division. Cancer in Scotland (2007) NHS National Services Scotland. http://www.isdscotland.org/isd/5323.html. Accessed Feb 2008
Yancik R, Ries LA (2000) Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am 14:17–23. doi:10.1016/S0889-8588(05)70275-6
Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G (2005) Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 23:3830–3842. doi:10.1200/JCO.2005.02.148
Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 14:1588–1595. doi:10.1158/1055-9965.EPI-04-0703
McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175:34–41. doi:10.1503/cmaj.051073
Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, McTiernan A, Rock CL, Thompson C, Gansler T, Andrews KS, The 2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 56:323–353
Department of Health (2004) At least five a week: evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer
Holmes MD, Chen WY, Feskanich D et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486. doi:10.1001/jama.293.20.2479
Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ, Baron JA, Egan KM, Willett WC (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386. doi:10.1158/1055-9965.EPI-07-0771
Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541. doi:10.1200/JCO.2006.06.0863
Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534. doi:10.1200/JCO.2006.06.0855
Haydon AM, Macinnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55:62–67. doi:10.1136/gut.2005.068189
The Scottish Government Statistics. Scottish Health Survey Publications. http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-healthsurvey/Publications. Accessed Nov 2007
Giovannucci EL, Liu Y, Leitzmann MF, Stampfer MJ, Willett WC (2005) A prospective study of physical activity and incident and fatal prostate cancer. Arch Intern Med 165:1005–1010. doi:10.1001/archinte.165.9.1005
Patel AV, Rodriguez C, Jacobs EJ, Solomon L, Thun MJ, Calle EE (2005) Recreational physical activity and risk of prostate cancer in a large cohort of U.S. men. Cancer Epidemiol Biomarkers Prev 14:275–279. doi:10.1158/1055-9965.EPI-04-0583
Campbell KL, McTiernan A (2007) Exercise and biomarkers for cancer prevention studies. J Nutr 137:161S–169S
Saxton JM (2006) Diet, physical activity and energy balance and their impact on breast and prostate cancers. Nutr Res Rev 19:197–215. doi:10.1017/S095442240720294X
Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain and survival after breast cancer. J Clin Oncol 23:1370–1378. doi:10.1200/JCO.2005.01.079
Bastarrachea J, Hortobagyi GN, Smith TL, Kau SW, Buzdar AU (1994) Obesity as an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer. Ann Intern Med 120:18–25
Obermair A, Kurz C, Hanzal E et al (1995) The influence of obesity on the disease-free survival in primary breast cancer. Anticancer Res 15:2265–2269
Bassett WW, Cooperberg MR, Sadetsky N, Silva S, DuChane J, Pasta DJ, Chan JM, Anast JW, Carroll PR, Kane CJ (2005) Impact of obesity on prostate cancer recurrence after radical prostatectomy: data from CaPSURE. Urology 66:1060–1065. doi:10.1016/j.urology.2005.05.040
McTiernan A, Rajan KB, Tworoger SS, Irwin M, Bernstein L, Baumgartner R, Gilliland F, Stanczyk FZ, Yasui Y, Ballard-Barbash R (2003) Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 21:1961–1966. doi:10.1200/JCO.2003.07.057
Visser A, Bouter LM, McQuillan GM, Wener MH, Harris TB (1999) Elevated C-reactive protein levels in overweight and obese adults. JAMA 282:2131–2135. doi:10.1001/jama.282.22.2131
Hamer M (2007) The relative influences of fitness and fatness on inflammatory factors. Prev Med 44:3–11. doi:10.1016/j.ypmed.2006.09.005
Manson JE, Greenland P, LaCroix AZ, Stefanick ML, Mouton CP, Oberman A, Perri MG, Sheps DS, Pettinger MB, Siscovick DS (2002) Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 347:716–725. doi:10.1056/NEJMoa021067
Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB (2002) Exercise type and intensity in relation to coronary heart disease in men. JAMA 288:1994–2000. doi:10.1001/jama.288.16.1994
Tsai HK, D’Amico AV, Sadetsky N, Chen MH, Carroll PR (2007) Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 99:1516–1524. doi:10.1093/jnci/djm168
Hutnick NA, Williams NI, Kraemer WJ, Orsega-Smith E, Dixon RH, Bleznak AD, Mastro AM (2005) Exercise and lymphocyte activation following chemotherapy for breast cancer. Med Sci Sports Exerc 37:1827–1835. doi:10.1249/01.mss.0000175857.84936.1a
Meijer EP, Goris AH, van Dongen JL, Bast A, Westerterp KR (2002) Exercise-induced oxidative stress in older adults as a function of habitual activity level. J Am Geriatr Soc 50:349–353. doi:10.1046/j.1532-5415.2002.50069.x
Campbell KL, McTiernan A, Li SS, Sorensen BE, Yasui Y, Lampe JW, King IB, Ulrich CM, Rudolph RE, Irwin ML, Surawicz C, Ayub K, Potter JD, Lampe PD (2007) Effect of a 12-month exercise intervention on the apoptotic regulating proteins Bax and Bcl-2 in colon crypts: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev 16:1767–1774. doi:10.1158/1055-9965.EPI-07-0291
Leung PS, Aronson WJ, Ngo TH, Golding LA, Barnard RJ (2004) Exercise alters the IGF axis in vivo and increases p53 protein in prostate tumor cells in vitro. J Appl Physiol 96:450–454. doi:10.1152/japplphysiol.00871.2003
McTiernan A (2008) Mechanisms linking physical activity with cancer. Nat Rev Cancer 8:205–211. doi:10.1038/nrc2325
Acknowledgments
The authors received grant funding from the British Heart Foundation, UK (MH), and the National Institute for Health Research, UK (ES). The Scottish Health Survey is funded by the Scottish Executive. The views expressed in this article are those of the authors and not necessarily of the funding bodies. We declare that the funders played no role in the concept and design of the study, analysis or interpretation of data, or drafting and critical revision of the manuscript.
Contributors
All authors were responsible for the study concept and design, interpretation of data, and drafting and critical revision of the manuscript. ES was responsible for the acquisition of the data. Statistical analysis and preparation of the data was performed by MH and ES. All authors approved the final version of the article. MH is the guarantor.
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Hamer, M., Stamatakis, E. & Saxton, J.M. The impact of physical activity on all-cause mortality in men and women after a cancer diagnosis. Cancer Causes Control 20, 225–231 (2009). https://doi.org/10.1007/s10552-008-9237-3
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DOI: https://doi.org/10.1007/s10552-008-9237-3