Vida! Educational Series - Health Care Professionals Welcome! - We will begin shortly. If viewing by internet: for technical help: 520-626-0167 Please complete surveys: http://streaming.biocom.arizona.edu/ To call in with your questions/comments
Vida! Educational Series - Health Care ProfessionalsWelcome! - We will begin shortly
If viewing by internet:
for technical help: 520-626-0167
Please complete surveys:http://streaming.biocom.arizona.edu/
To call in with your questions/comments
(best to call in early) 520-626-2801
Exerciseafter Breast Cancer: Promoting a Healthy, Happy Recovery
Joy Kiviat, PhD, MSN, RN
Oncology Certified Nurse
University of Arizona College of Nursing
ACSM certified Cancer Exercise Trainer
and Group Exercise Instructor
Research indicates that cancer patients who exercise:
2012:American Cancer Society guidelines for nutrition and physical activity strongly support exercise as an important part of survivorship care planning (Rock et al., 2012).
(Loprinzi et al., 2012; Pekmezi & Demark-Wahnefried, 2011)
Increased lean body mass, decreased fat
Improved cardiovascular condition (lowers risk of embolism, heart attack and stroke)
Increased bone density and improved balance (reduces risk of falls and injury)
Immune system stimulation (reduces risk for infection and recurrence)
Release of endorphins and other stimulatory neurotransmitters (elevates mood)
Higher energy (calorie) intake leads to:
↑ Insulin & insulin-related growth factors
↑ Free Estrogen & Androgens
↑ Leptin, ↓adiponectin =>↑ tumor growth
↑ Inflammatory chemical messengers
Result: more fuel available for cancer cell growth, excess hormones, and weaker immune response to abnormal cells
Source: Annual Report to the Nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity.
2009 Study: Patients treated for breast cancer enrolled in 12 weeks aerobic and strength training exercise – compared to “usual care” they had significant gains in fitness, strength, lean body mass, and overall quality of life. (Rogers et al., 2009)
2011 Review of 21 RCTs showed exercise is safe for cancer survivors, and improves physical fitness and psychosocial well-being (Pekmezi & Demark-Wahnefried, 2011).
2012 Systematic review: 27 high quality studies of activity and cancer outcomes showed consistent evidence of reduced cancer-related mortality and improved biomarker and immunity profiles.((Ballard-Barbash et al., 2012)
*Sabatino et al. (2007)
Answer yes or no to the following questions:
If you answered yes to any question:
If you answered no to all:
Recent study showed upper body resistance exercise does not increase swelling and was associated with 50% decrease in exacerbations (Schmitz et al., 2009)
141 women with stable lymphedema and no previous hx of weightlifting, randomized to 2x/wk weight training or control group for 1 year
NLN 2011 guidelines: Start with low resistance, incremental increase with regular measurements; advise compression garment if lymphedema already present
No controlled studies on value of compression garments during exercise for prevention of lymphedema
Group classes (YMCA, community centers, fitness clubs)
Personal trainer (some make house calls)
Walking (suggest finding walking buddy or dog for companionship and motivation
Swimming (good for persons with joint or bone pain)
Exercise videos and FitTV channel
Better than Ever program at UACancer Center
ACS & ACSM roundtable concluded cancer survivors should strive for:
(aim for 30 minutes, 5 days a week; try brisk walk, run, swim, dance)
(weights, bands, water bottles…
1-2 days off between sessions)
Source: Schmitz et al., 2010
Ballard-Barbash, R., Friedenreich, C., Courneya, K., Sameer, M., Siddiqi, S., McTiernan, A. & Alfano, C. (2012). Physical activity, biomarkers, and disease outcomes in cancer survivors: A systematic review. Journal of the National Cancer Institute 104(11): 815-840doi:10.1093/jnci/djs207
Irwin, M. (2008). Physical activity interventions for cancer survivors. British Journal of Sports Medicine 32(8) 32-38. doi:10.1136/ bjsm.2008.053843
Loprinzi, P., Cardinal,B., Winters-stone, K., Smit,E. & Loprinzi, C. (2012) Physical activity and the risk of breast cancer recurrence: A literature review. Oncology Nursing Forum 39(9) 269-74. doi:10.1188/12/12.ONF.269-274
Pekmezi, D. W., & Demark-Wahnefried, W. (2011). Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol, 50(2), 167-178. doi: 10.3109/0284186X.2010.529822
Rausch, S., Millay, S., Scott, C.,Pruthi, S., Clark, M., Patten, C., ….Vachon, C. (2012). Health behaviors among cancer survivors receiving screening mammography. American Journal of Clinical Oncology. 35(1), 22-31.
Rock,C.L., Doyle,C., Demark-Wahnefried,W., Meyerhardt, J., Courneya,K. S., Schwartz, A. L., Bandera, E. V., …, & Gansler,T. (2012), Nutrition and physical activity guidelines for cancer survivors. CA: A Cancer Journal for Clinicians. doi: 10.3322/caac.21142
Rogers, L., Hopkins-Price ,P., Vicari,S., Pamenter,R., Courneya,K., Markwell ,S., … Lowy, M. (2009). A randomized trial to increase physical activity in breast cancer survivors. Medical Science Sports Exercise 41(4), 935-46.
Sabatino, S., Coates, R., Uhler R., Pollack, L., Alley, L., & Zauderer, L. (2007). Provider counseling about health behaviors among cancer survivors in the United States. Journal of Clinical Oncology 25(15) 2100-2106.
Schmitz, K., Courneya, K., Matthews, C, Demark-Wahnefried, W, Galvao, D.,…, & Schwartz, A. (2010). American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports & Exercise 42, 1409–1426.
Schmitz,K., Ahmed,R., Troxel,A.,Cheville,A., Smith,R., Lewis-Grant,L., Bryan,C., Williams-Smith,C., & Greene,Q. (2009). Weight lifting in women with breast-cancer–related lymphedema. New England Journal of Medicine 361:664-73.