The following
program presents principles
00:00:01.98\00:00:02.95
designed to promote good health
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and is not intended
to take the place of
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personalized professional care.
00:00:06.06\00:00:07.91
The opinions and
ideas expressed are those
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of the speaker.
Viewers are encouraged
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to draw their own conclusions
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about the information presented.
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Hello and welcome
to Wonderfully Made,
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are you interested
in leading a lifestyle
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that can help in
preventing cancer?
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My name is Don
Morgan and I'm an exercise
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physiologist and
a professor in the
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Department of Health
and Human Performance
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at Middle
Tennessee State University.
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This is the eight
in a series of programs
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describing the
many health and fitness
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benefits that
result from adopting a
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physically active lifestyle.
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In today's program
we're going to discuss
00:01:05.61\00:01:09.07
the role that physical activity
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and exercise can
play in improving
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physical function and quality
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of life in cancer survivors.
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The term cancer
actually describes over
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100 diseases that
can occur in just about
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any body tissue
or organ. Normally,
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body cells grow,
divide and die in a tightly
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regulated fashion.
With cancer however
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there is an
uncontrolled growth in spread of
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abnormal cells that
can destroy surrounding
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tissues and migrate to
other areas of the body.
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Most cancers can
be classified into
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one of four
categories. Carcinomas,
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which develop from
cells that cover glands,
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internal organs and
the surface of the body
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account for 80 to 90
percent of all cancers.
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Prostate, colon
and breast cancers are
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examples of carcinomas.
Leukemia's are cancers
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arising from cells in the blood.
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Lymphomas which
involve cells of the
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immune system, and
sarcomas which occur in
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connective tissue or
other types of cancer.
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Based on
information from the American
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Cancer Society,
Americans have about
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a 41 percent
chance of developing
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some form of
invasive cancer during
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their lifetime.
According to the Centers
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for Disease Control,
cancer was the second
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leading cause of
death in the United States
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in 2003 and
accounted for 23 percent
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of all deaths.
However in the latest report
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from the American
Cancer Society more
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American's under
the age of 85 actually
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died of cancer
rather then heart diseases
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which still remains
the leading cause of death
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in the U.S.
Interestingly, while the
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very oldest
American's continue to die of
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heart diseases more
than they do of cancer
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this trend is
expected to reverse itself
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by the year 2018.
With age the probability of
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developing most
cancers increases markedly
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which makes
cancer a disease that
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primarily affects older adults.
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However some cancers
like Hodgkin's disease,
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non-Hodgkin's lymphoma, leukemia
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and testicular
cancer affect mostly
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younger persons.
Currently the five year
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relative survival
rate for cancer is about
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60 percent
although this figure varies
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depending on the
type of cancer detected
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and the extent of the diseases
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when it's diagnosed.
Given the increase in
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cancer incidents
and the increase in
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survival rates fitness
professionals can expect
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to serve a growing numbers of
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cancer survivors in the future.
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The following
graphic displays risk factors
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for cancer, as shown
in this figure many causes
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of cancer are linked to
the lifestyle behaviors.
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It is a
particular interest to know
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that the
combined influence of diet
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and physical
inactivity is the single largest
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cancer risk
factor. When added in with
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tobacco use as
many as 65 percent
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of all cancers
may be preventable
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by not smoking,
eating a healthy diet,
00:04:57.20\00:05:00.62
performing
regular physical activity
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and maintaining
a healthy weight.
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In studying the
potential relationship
00:05:08.82\00:05:10.90
between physical
inactivity in cancer
00:05:10.91\00:05:13.46
it's important to
recognize that the link
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between these two
factors is not new.
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In a text written
over 300 years ago
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it was suggested
that physical activity
00:05:22.89\00:05:25.81
might play a
role in the expression
00:05:25.82\00:05:28.06
of human cancer.
In 1922 Australian
00:05:28.07\00:05:33.22
researchers noted
that primitive tribes
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who worked
continuously for food displayed
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lower rates of
cancer compared to people
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living in more
civilized societies.
00:05:41.86\00:05:44.44
In the same year it
was also observed that
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most cancer
patients led relatively
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inactive lives and
that men who worked hard
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were less cancer
prone compared to those
00:05:54.51\00:05:57.76
who tended to sit
while performing daily work
00:05:57.77\00:06:00.85
activities. Later in
the 1970's other scientists
00:06:00.86\00:06:06.77
observed that a lower
cancer risk seem to be
00:06:06.78\00:06:09.70
present in
former athletes, people
00:06:09.71\00:06:12.93
who were employed
in active occupations
00:06:12.94\00:06:15.49
and those who exercised during
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their leisure time.
The following graphic
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depicts the
relationship between overall
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cancer death
rates and fitness status
00:06:24.28\00:06:27.07
in a large cohort of
men and woman who have
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studied at the
Institute For Aerobics Research
00:06:29.96\00:06:32.63
in Dallas, Texas as
shown in this figure
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men and women who displayed good
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fitness levels
exhibited much lower age
00:06:39.62\00:06:42.85
adjusted cancer
death rates then those with
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poor fitness levels.
However what is perhaps
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most striking about
these finding is that
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those individuals
who displayed just
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average levels of
fitness demonstrated
00:06:55.74\00:06:58.93
marked reductions
in overall cancer death
00:06:58.94\00:07:01.47
rates compared
with those persons with
00:07:01.48\00:07:04.17
poor fitness levels.
Similar to tracking data
00:07:04.18\00:07:08.84
for cardiovascular
disease and diabetes
00:07:08.85\00:07:11.34
these results
emphasize the importance of
00:07:12.35\00:07:14.72
just getting yourself
in the average fitness
00:07:14.73\00:07:17.62
category by
accumulating at least 30 minutes
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of moderate
intensity physical activity
00:07:21.21\00:07:23.53
on a regular basis.
What are some of the
00:07:24.16\00:07:29.23
biological
mechanisms that may help explain
00:07:29.24\00:07:32.69
the relationship
between physical activity
00:07:32.70\00:07:35.13
and cancer? One
possibility is that
00:07:35.14\00:07:39.81
physical activity
may provide a lifestyle
00:07:39.82\00:07:42.58
protective effect by
enhancing the function
00:07:42.59\00:07:45.85
of the immune
system, this idea has been
00:07:45.86\00:07:49.66
tested by
injecting laboratory animals
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with certain types
of cancer producing
00:07:52.64\00:07:54.47
chemicals
assigning them to exercising
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or non-exercising
groups and then measuring
00:07:57.81\00:08:01.00
cancer growth.
Results from these studies
00:08:01.01\00:08:04.91
have shown that
exercise appears to retire
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the growth of cancer
at a number of sites,
00:08:08.22\00:08:11.03
in humans
moderate physical activity
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like brisk walking
has also been shown to
00:08:15.94\00:08:20.16
enhance the
function of certain cells
00:08:20.17\00:08:22.23
in the immune system
like natural killer cells
00:08:22.24\00:08:25.62
which serve as the
body's first line of
00:08:26.49\00:08:29.18
defense against the development
00:08:29.19\00:08:31.25
and spread of
cancer. However at more
00:08:31.26\00:08:36.00
intense levels of
exercise some short term
00:08:36.01\00:08:39.48
suppression of the immune system
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seems to be
present, viewed collectively
00:08:41.18\00:08:45.26
these findings
provide further support for
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engaging in a
daily routine of moderate
00:08:48.73\00:08:51.57
physical activity, in
addition to it's ability
00:08:51.58\00:08:55.87
to strengthen the immune system,
00:08:55.88\00:08:57.59
physical activity
may further reduce
00:08:58.23\00:09:00.53
overall cancer risk
by improving circulation,
00:09:00.54\00:09:03.79
ventilation, energy balance
00:09:03.80\00:09:07.63
and the ability to repair DNA.
00:09:07.64\00:09:10.29
In general
evidence suggests that
00:09:12.20\00:09:15.98
physical activity
may significant reduce
00:09:15.99\00:09:18.11
the chance of
developing some site specific
00:09:18.12\00:09:21.12
cancers, the
strongest data come from
00:09:21.13\00:09:25.83
research indicating
that physical activity
00:09:25.84\00:09:28.38
may lower the risk of colon
00:09:28.39\00:09:30.82
and breast cancer by as much as
00:09:30.83\00:09:33.25
30 to 50 percent.
Physical activity may
00:09:33.26\00:09:37.94
also exert a
protective effect against
00:09:37.95\00:09:40.72
endometrial
cancer, prostate cancer
00:09:40.73\00:09:43.82
and lung cancer.
While a few researchers have
00:09:43.83\00:09:48.85
attempted to
document the influence
00:09:48.86\00:09:50.81
of physical activity
on ovarian, pancreatic
00:09:50.82\00:09:54.25
and stomach
cancers no clear findings
00:09:54.26\00:09:57.83
have emerged.
Let's take a look at the
00:09:57.84\00:10:03.65
association
between physical activity
00:10:03.66\00:10:05.80
and certain types of
sites specific cancers,
00:10:06.62\00:10:09.22
as mentioned
earlier the evidence linking
00:10:10.45\00:10:13.91
physical activity
and a reduced risk of
00:10:13.92\00:10:16.92
colon cancer
appears quite convincing.
00:10:16.93\00:10:19.51
Out of 45 published
studies 38 or 84 percent
00:10:20.42\00:10:26.94
have reported an
average decline of
00:10:26.95\00:10:30.04
50 percent in
colon cancer risk amongst
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more physically
active people in fact
00:10:33.87\00:10:37.88
it's been
estimated that if the entire
00:10:37.89\00:10:40.79
adult population
in the United States
00:10:40.80\00:10:43.11
increase it's
physical activity level by just
00:10:43.12\00:10:46.34
three hours of
walking per week which
00:10:46.35\00:10:49.78
translates into a
daily walking time of
00:10:49.79\00:10:51.89
about 25 minutes
per day there would be
00:10:51.90\00:10:55.00
17 percent fewer
cases of colon cancer.
00:10:55.01\00:10:58.25
This trend is
supported by result of a study
00:10:59.69\00:11:03.44
involving nearly
48,000 men aged 40 to75,
00:11:03.45\00:11:08.77
in this report the
risk of colon cancer was
00:11:10.19\00:11:13.44
decreased by nearly
50 percent in the most
00:11:13.45\00:11:16.74
physically
active men when compared
00:11:16.75\00:11:19.55
to their sedentary
peers. Specifically
00:11:19.56\00:11:23.29
the greatest
protection from colon cancer
00:11:23.30\00:11:26.07
was observed in
men who were active
00:11:26.08\00:11:28.22
one to two hours
per day conversely men
00:11:28.23\00:11:33.61
who were
physically inactive and obese
00:11:33.62\00:11:36.31
displayed a colon
cancer risk nearly five times
00:11:37.23\00:11:40.38
higher then that of their active
00:11:40.39\00:11:43.08
and more lean counterparts.
00:11:43.09\00:11:44.93
In a similar
study of 89,000 women
00:11:46.41\00:11:49.64
it was found that
colon cancer risk dropped by
00:11:50.35\00:11:52.91
nearly 50
percent in women who were
00:11:52.92\00:11:56.08
the most physically active.
00:11:56.09\00:11:57.72
Now what it counts for
the relationship between
00:11:59.41\00:12:02.36
physical activity
and a lowered risk of
00:12:02.37\00:12:05.46
colon cancer? It's
known that exercise
00:12:05.47\00:12:10.10
and physical
activity stimulate a process
00:12:10.11\00:12:12.52
called
peristalsis or muscle movement
00:12:12.53\00:12:16.24
within the large intestine,
00:12:16.25\00:12:17.82
with enhanced
peristalsis the time
00:12:18.71\00:12:22.25
that cancer causing
chemical in fecal matter
00:12:22.26\00:12:24.86
remain in contact with cancer,
00:12:24.87\00:12:27.72
with colon cells
is decreased thus
00:12:27.73\00:12:31.88
diminishing the
exposure of the intestinal wall
00:12:31.89\00:12:34.44
to carcinogens. It
is also thought that
00:12:34.45\00:12:38.24
reducing the
period of contact between
00:12:38.25\00:12:40.88
carcinogens and
colon cells may reduce
00:12:40.89\00:12:43.94
the growth and proliferation of
00:12:43.95\00:12:45.62
these cells. In
one study looking
00:12:45.63\00:12:49.11
at the effect of
modern exercise on the time
00:12:49.12\00:12:51.77
required for
food residue to pass
00:12:51.78\00:12:54.67
completely through
the body it was observed
00:12:54.68\00:12:57.79
that running and
cycling produced much faster
00:12:57.80\00:13:00.74
transit times compared
to a resting condition.
00:13:00.75\00:13:04.13
So in this sense
exercise produces
00:13:05.15\00:13:09.00
the same effect
on the colon as does
00:13:09.01\00:13:11.89
the ingestion of
the dietary fiber,
00:13:11.90\00:13:13.89
it was also been suggested that
00:13:15.17\00:13:17.53
physically
activity may lead to a lower
00:13:17.54\00:13:19.53
cancer risk by
reducing obesity levels.
00:13:19.54\00:13:22.61
Support for this
assertion can be found
00:13:23.46\00:13:26.71
in animal study
showing that cancer risk is
00:13:26.72\00:13:29.10
lowered when
energy intake is slightly
00:13:29.11\00:13:32.27
reduced below body requirements.
00:13:32.28\00:13:34.91
Both physical
inactivity and obesity can raise
00:13:36.19\00:13:40.83
levels of insulin or
hormone that increases
00:13:40.84\00:13:44.43
cancer risk by
elevating the growth
00:13:44.44\00:13:46.95
rate of cells lining the colon.
00:13:46.96\00:13:48.94
Of course it is
also possible that people
00:13:49.97\00:13:53.31
who are
physically active eat more
00:13:53.32\00:13:55.94
dietary fiber
which would increase
00:13:55.95\00:13:58.96
the protection
against colon cancer.
00:13:58.97\00:14:00.89
However in studies
where dietary fiber intake
00:14:02.31\00:14:05.91
has been
controlled physically activity
00:14:05.92\00:14:08.96
is still shown to
independently decrease
00:14:08.97\00:14:11.60
the risk of colon
cancer. Is there a link
00:14:11.61\00:14:16.32
between physical activity and
00:14:16.33\00:14:18.04
breast cancer, out
of 41 published studies
00:14:18.05\00:14:22.59
25 or 63 percent
demonstrated their
00:14:23.39\00:14:27.50
occupational and
leisure time physical activity
00:14:27.51\00:14:30.18
was associated
with about a 30 percent
00:14:30.19\00:14:32.95
reduction in breast cancer risk.
00:14:32.96\00:14:34.71
In one study of
premenopausal females,
00:14:36.12\00:14:38.69
the risk of breast
cancer was reduced by
00:14:38.70\00:14:41.56
almost 60 percent in those women
00:14:41.57\00:14:44.73
who exercise in
average of more then
00:14:44.74\00:14:46.57
3.7 hours per
week or just more than
00:14:46.58\00:14:49.85
30 minutes per day
since the start of menses,
00:14:49.86\00:14:53.01
these results
highlight the importance of
00:14:54.01\00:14:56.60
leading a
modernly active lifestyle
00:14:56.61\00:14:58.75
beginning early in
life. In another report
00:14:58.76\00:15:03.46
leisure time
physical activity in
00:15:03.47\00:15:06.17
breast cancer
risk were documented
00:15:06.18\00:15:08.52
in over 25,000
women, data from this
00:15:08.53\00:15:12.70
investigation
reveal that as the level of
00:15:12.71\00:15:15.24
leisure time physical
activity increased from
00:15:15.25\00:15:18.68
sedentary to regular exercise,
00:15:18.69\00:15:20.81
the risk of breast
cancer decreased by
00:15:21.52\00:15:23.80
37 percent. Moreover
the lowest breast cancer
00:15:23.81\00:15:29.45
risk was found
among women who were lean
00:15:29.46\00:15:32.12
and regularly
exercised. What are
00:15:32.13\00:15:36.12
some of the
potential mechanisms underlying
00:15:36.13\00:15:38.29
the relationship
between greater levels of
00:15:38.30\00:15:40.78
physical
activity and reductions in
00:15:40.79\00:15:42.89
breast cancer
risk. Women who have
00:15:42.90\00:15:46.38
exercised
rigorously from childhood
00:15:46.39\00:15:48.70
tend to have a
later onset of monarchy,
00:15:48.71\00:15:51.88
some missed
menstrual cycles and greater
00:15:51.89\00:15:55.35
leanness all of
which lower exposure
00:15:55.36\00:15:58.64
of the breast
tissue to estrogen.
00:15:58.65\00:16:00.71
Because estrogen promotes the
00:16:01.75\00:16:03.60
proliferation
and the vision of the
00:16:03.61\00:16:05.20
breast cells there
is a greater chance for
00:16:05.21\00:16:08.22
genetic mutations
to take hold that can
00:16:08.23\00:16:10.88
result in the
development of cancer.
00:16:10.89\00:16:12.83
Estrogen
metabolism also generates
00:16:14.16\00:16:16.77
free radicals which
can produce unstable DNA,
00:16:16.78\00:16:20.56
genetic mutations and
a greater cancer risk,
00:16:20.57\00:16:24.66
in addition
estrogen can stimulate
00:16:25.37\00:16:28.35
the production of
receptors for other
00:16:28.36\00:16:30.57
hormones like
progesterone that can
00:16:30.58\00:16:33.74
cause breast
cancer cells to divide.
00:16:33.75\00:16:36.34
Related to this
discussion is the fact
00:16:37.71\00:16:40.14
that obesity and
especially abdominal
00:16:40.15\00:16:43.12
obesity can heighten
the risk of breast cancer
00:16:43.13\00:16:46.77
by increasing
estrogen levels in the body,
00:16:46.78\00:16:49.46
obesity also
increases insulin which in turn
00:16:50.31\00:16:54.93
can spur the growth
of breast cancer cells.
00:16:54.94\00:16:58.02
Taken together
the role that exercise
00:16:59.54\00:17:02.99
may play in altering
exposure to sex hormones
00:17:03.00\00:17:05.98
reducing obesity
and decreasing levels of
00:17:05.99\00:17:09.26
insulin suggests that
the protection against
00:17:09.27\00:17:12.55
breast cancer
through physical activity is
00:17:12.56\00:17:15.76
biologically
possible. Researchers have also
00:17:15.77\00:17:20.70
investigated the
association between
00:17:20.71\00:17:22.72
physical activity
and endometrial cancer
00:17:22.73\00:17:25.59
in light of the
effects of physical activity
00:17:26.39\00:17:28.68
on the production,
metabolism and excretion
00:17:28.69\00:17:32.04
of sex hormones like estrogen
00:17:32.05\00:17:34.17
and progesterone.
Although the number of
00:17:34.18\00:17:37.93
published studies
on this cancer are
00:17:37.94\00:17:40.16
small a relationship between
00:17:40.17\00:17:43.39
physical activity and
endometrial cancer risk
00:17:43.40\00:17:46.78
has been
observed. In these reports
00:17:46.79\00:17:50.46
a significantly reduced risk of
00:17:50.47\00:17:53.14
endometrial
cancer was observed as
00:17:53.15\00:17:56.27
activity levels increased,
00:17:56.28\00:17:58.20
the protective effect
of physical activity on
00:17:59.95\00:18:03.62
prostate cancer,
the most frequently
00:18:03.63\00:18:06.49
diagnosed cancer in
men is less apparent
00:18:06.50\00:18:10.03
when compared to
available evidence
00:18:10.04\00:18:12.24
for cancers of
the colon and breast.
00:18:12.25\00:18:14.10
Of 28 published
studies 14 or 50 percent
00:18:14.78\00:18:20.09
show that
occupational and leisure time
00:18:20.81\00:18:23.74
physical activity
significantly decreased
00:18:23.75\00:18:26.40
cancer risk in the prostate by
00:18:26.41\00:18:29.12
10 to 70 percent.
In one study involving
00:18:29.13\00:18:33.09
more than 13,000
men those exhibiting
00:18:33.10\00:18:36.85
the highest
levels of aerobic fitness
00:18:36.86\00:18:38.64
displayed a 74
percent lower risk of
00:18:38.65\00:18:42.56
prostate cancer compared to men
00:18:42.57\00:18:45.12
who were least fit.
The fact that the risk
00:18:45.13\00:18:48.72
for prostate cancer
death has been tied to
00:18:48.73\00:18:51.19
higher body mass
index values also suggest
00:18:51.20\00:18:55.89
that overweightness
and obesity may be
00:18:55.90\00:18:58.96
operative factors in promoting
00:18:58.97\00:19:00.73
prostate cancer.
What might explain
00:19:00.74\00:19:04.87
the association
between physical activity
00:19:04.88\00:19:07.18
and a lowered risk of
prostate cancer in men.
00:19:07.19\00:19:10.31
It has been hypothesized
that higher levels of
00:19:11.39\00:19:14.76
testosterone may
fuel the growth of
00:19:14.77\00:19:17.33
prostate cancer
cells. It is also known
00:19:17.34\00:19:21.03
that athletes have
lower levels of circulating
00:19:21.04\00:19:23.23
testosterone
compared to non-athletes,
00:19:23.24\00:19:26.05
hence highly
active men may end up
00:19:26.83\00:19:30.61
exposing their
prostate glands to less
00:19:30.62\00:19:32.98
testosterone there by
reducing their risk for
00:19:32.99\00:19:36.87
prostate cancer. Furthermore by
00:19:36.88\00:19:41.00
encouraging a more
lean body composition
00:19:41.01\00:19:43.63
physical activity
may lower the levels of
00:19:44.33\00:19:47.05
proteins and
hormones that could promote
00:19:47.06\00:19:49.78
prostate tumor
growth in obese men.
00:19:49.79\00:19:52.45
Lung cancer is
the second most common
00:19:54.81\00:19:57.05
cancer among men and women
00:19:57.06\00:19:58.64
in the United
States, like prostate cancer
00:19:58.65\00:20:02.41
the potential
protective effect of
00:20:02.42\00:20:04.74
physical activity
in reducing the risk of
00:20:04.75\00:20:07.44
lung cancer is not as
strong as that seen for
00:20:07.45\00:20:10.43
colon and breast
cancers. None the less
00:20:10.44\00:20:13.78
it has been
speculated that increased
00:20:13.79\00:20:16.61
ventilation and better
blood flow to the lungs
00:20:16.62\00:20:19.95
may act to reduce
the concentration of
00:20:19.96\00:20:22.64
carcinogenic agents
in the breathing passages
00:20:22.65\00:20:25.21
and the length of
time that these agents
00:20:25.22\00:20:28.27
are in contact
with the lung airways.
00:20:28.28\00:20:30.69
Limited data have
shown that for lung cancer
00:20:32.07\00:20:34.79
physical activity
can exhort a protective
00:20:34.80\00:20:37.55
effect of between 20 percent
00:20:37.56\00:20:39.82
and 60 percent. In these studies
00:20:39.83\00:20:42.90
it was observed
that participation
00:20:42.91\00:20:45.29
in modern
intensity physical activity
00:20:45.30\00:20:47.58
reduced cancer
risk after adjusting
00:20:47.59\00:20:50.93
for the impact
of smoking and other
00:20:50.94\00:20:53.40
potential risk
factors. In summary
00:20:53.41\00:20:57.01
physical activity
appears to exhort a
00:20:57.89\00:20:59.96
protective
effect on certain site
00:20:59.97\00:21:02.75
specific cancers.
While more research
00:21:02.76\00:21:06.09
on this topic is
certainly warranted
00:21:06.10\00:21:08.06
it appears that the
performance of moderate
00:21:08.79\00:21:11.41
intensity
physical activity is more
00:21:11.42\00:21:14.10
beneficial then light
activities in reducing
00:21:14.11\00:21:17.52
cancer risks.
There are some general
00:21:17.53\00:21:21.26
guidelines that
are available to help
00:21:21.27\00:21:23.40
prescribe exercise
and physical activity for
00:21:23.41\00:21:26.50
otherwise
healthy cancer survivors,
00:21:26.51\00:21:28.60
while the goals
for cancer survivors
00:21:29.35\00:21:31.95
will vary across
individuals reasonable
00:21:31.96\00:21:35.62
expectations might include being
00:21:35.63\00:21:37.90
able to exercise
on a regular basis,
00:21:37.91\00:21:40.31
maintaining or
improving everyday function,
00:21:40.32\00:21:43.55
optimizing
general health, managing
00:21:44.25\00:21:47.20
specific symptoms
and side effects of
00:21:47.21\00:21:49.53
medical treatment
and preventing diseases
00:21:49.54\00:21:52.45
like osteoporosis,
the cancer survivors are
00:21:52.46\00:21:56.16
at a higher risk
for it. With respect to
00:21:56.17\00:21:59.81
activity mode
walking and cycling are often
00:21:59.82\00:22:02.85
recommended because
they are safe activities
00:22:02.86\00:22:06.22
that can be done at a controlled
00:22:06.23\00:22:07.87
moderate
intensity and a low impact
00:22:07.88\00:22:10.79
in nature. For
certain individuals activity
00:22:10.80\00:22:15.50
may need to be
modified based on patient
00:22:15.51\00:22:18.46
preference as well as the short
00:22:18.47\00:22:21.11
and long term
treatment effects of surgery,
00:22:21.12\00:22:24.09
chemotherapy, and
radiation therapy.
00:22:24.10\00:22:27.40
While the frequency
of exercise should be
00:22:28.34\00:22:30.52
at least three to
five times per week.
00:22:30.53\00:22:32.92
Exercise done at
lighter intensities
00:22:33.66\00:22:36.11
or for shorter time
periods may be optimal
00:22:36.12\00:22:39.23
for
deconditioned cancer patients.
00:22:39.24\00:22:41.79
While it is
recommend that exercise
00:22:42.62\00:22:45.39
duration be at
least 20 to 30 minutes
00:22:45.40\00:22:47.90
accumulating
shorter physical activity
00:22:48.58\00:22:51.08
bouts with
intervening rest periods is a
00:22:51.09\00:22:54.87
reasonable
alternative for patients
00:22:54.88\00:22:56.83
who are less fit,
or who are experiencing
00:22:56.84\00:22:59.40
severe side
effects from treatment.
00:22:59.41\00:23:01.79
With time the volume
of exercise performed
00:23:02.69\00:23:06.49
can be raised, first
by increasing frequency
00:23:06.50\00:23:09.79
and duration
and later by raising
00:23:09.80\00:23:13.01
intensity level.
The progression of the
00:23:13.02\00:23:16.30
exercise program
should be slowing gradual
00:23:16.31\00:23:19.13
for
deconditioned persons and for
00:23:19.14\00:23:22.23
individuals for whom
treatment side effects
00:23:22.24\00:23:24.98
might be especially problematic.
00:23:24.99\00:23:27.66
It should also
be remembered that
00:23:28.97\00:23:30.93
fluctuations in
the ability to perform
00:23:30.94\00:23:33.07
physical activity
ought to be expected.
00:23:33.08\00:23:35.70
In addition to the
physiological benefits
00:23:36.37\00:23:38.88
that are gained
from adopting an active
00:23:38.89\00:23:40.68
lifestyle, the improvement in
00:23:40.69\00:23:42.79
psychological health
that results from being
00:23:42.80\00:23:44.94
physically active
is a prime significance
00:23:44.95\00:23:47.75
for the cancer
survivor. When creating
00:23:47.76\00:23:50.75
a physical activity
program for a person
00:23:50.76\00:23:53.07
with cancer it is
important to recognize
00:23:53.08\00:23:55.91
that medical
treatments and disease related
00:23:55.92\00:23:58.69
declines in
physical functions probably
00:23:58.70\00:24:01.41
account for at least some of the
00:24:01.42\00:24:03.23
psychological
and emotional burdens
00:24:03.24\00:24:05.84
of the cancer
experience, these can
00:24:05.85\00:24:08.55
include
depression, anxiety, body image
00:24:08.56\00:24:11.64
concerns, decreased self esteem
00:24:11.65\00:24:14.20
and a loss of
control. A successful physical
00:24:14.21\00:24:18.33
activity program is
one that is enjoyable
00:24:18.34\00:24:20.86
and builds self-confidence.
00:24:20.87\00:24:22.83
Other factors that
may positively impact
00:24:23.69\00:24:25.96
activity programming
for the cancer survivor
00:24:25.97\00:24:28.34
include the
development of new skills
00:24:28.35\00:24:30.95
and the facilitation
of social interaction.
00:24:30.96\00:24:34.11
In an earlier program
we discussed barriers to
00:24:35.34\00:24:38.98
exercise and identify
it's specific strategies
00:24:38.99\00:24:42.11
to overcome them,
for the cancer survivor
00:24:42.12\00:24:45.80
incentives to
participate in exercise
00:24:45.81\00:24:48.83
and barriers
preventing exercise also exist,
00:24:48.84\00:24:52.20
not surprisingly
many of the incentives
00:24:53.00\00:24:55.90
for the cancer
survivor such as maintaining
00:24:55.91\00:24:58.48
a normal
lifestyle, feeling better,
00:24:58.49\00:25:01.05
improving
psychological well being
00:25:01.06\00:25:03.89
and securing
general health benefits are
00:25:03.90\00:25:07.10
similar to those
which might be appropriate
00:25:07.11\00:25:09.09
for the general population.
00:25:09.10\00:25:10.53
However other
incentives like recovering
00:25:10.54\00:25:14.17
from surgery and treatment,
00:25:14.18\00:25:15.50
gaining control
over cancer and once life
00:25:15.51\00:25:18.99
and coping with
the stress of cancer
00:25:19.00\00:25:21.35
are unique to
the cancer survivor,
00:25:21.36\00:25:23.60
likewise barriers
to exercise such as
00:25:24.30\00:25:27.50
bad weather,
fatigue and lack of time
00:25:27.51\00:25:30.59
are common to many individuals,
00:25:30.60\00:25:32.83
others like nausea and diarrhea
00:25:32.84\00:25:36.13
would again be
specific to the patient
00:25:36.14\00:25:39.03
with cancer. It
is critical that the
00:25:39.04\00:25:42.02
medical support
team recognize the cancer
00:25:42.03\00:25:44.70
survivors will
have special incentives
00:25:44.71\00:25:47.19
and barriers to
physical activity that must be
00:25:47.20\00:25:50.38
addressed when
creating a personalized
00:25:50.39\00:25:52.99
physical activity
program. I like to end
00:25:53.00\00:25:57.12
today by
recounting a personal story
00:25:57.13\00:25:59.66
of a woman from
Australia who is a
00:25:59.67\00:26:02.08
long term
survival of breast cancer.
00:26:02.09\00:26:04.42
It has been more
than three decades
00:26:05.15\00:26:07.06
since Bettina
Woodburn was diagnosed with
00:26:07.07\00:26:10.06
breast cancer,
after learning about
00:26:10.07\00:26:12.95
the warning
signs of breast cancer
00:26:12.96\00:26:14.88
Bettina checked her
breasts and found a lump
00:26:14.89\00:26:17.83
soon there after
she underwent both
00:26:18.63\00:26:20.98
lumpectomy and a mastectomy.
00:26:20.99\00:26:23.27
Following these
surgeries Bettina
00:26:24.00\00:26:26.34
returned to being a
wife and a mother of
00:26:26.35\00:26:28.71
four children but
she was in her own words
00:26:28.72\00:26:32.24
shattered and in
shock from the entire
00:26:32.25\00:26:35.68
experience.
Eventually Bettina became
00:26:35.69\00:26:39.68
more positive
about her cancer recovery
00:26:39.69\00:26:41.86
and spent the time
between the ages of
00:26:41.87\00:26:44.45
50 and 60 becoming
very physically fit in order
00:26:44.46\00:26:48.80
to fight the further
spread of the diseases.
00:26:48.81\00:26:50.88
She also became
mentally fit earning
00:26:50.89\00:26:54.22
three academic
degrees, in addition to
00:26:54.23\00:26:57.60
kayaking and
bicycling to strengthen
00:26:57.61\00:26:59.81
and improve the
efficiency of her arms
00:26:59.82\00:27:01.57
and legs she
joined what is known as
00:27:01.58\00:27:04.31
Veteran
Athletics when she was 60
00:27:04.32\00:27:06.80
and competed in
running, throwing
00:27:06.81\00:27:08.90
and jumping events.
At one point Bettina
00:27:08.91\00:27:12.83
held 15 Australian
records in the Veteran
00:27:12.84\00:27:15.57
and Masters Games
and she was the medalist
00:27:15.58\00:27:18.51
in the world games
in Rome and Melbourne.
00:27:18.52\00:27:20.82
She has also
kayaked to raise money for
00:27:20.83\00:27:23.49
breast cancer
research and now over 80
00:27:23.50\00:27:26.39
she still rides
a road racing bike.
00:27:26.40\00:27:29.02
Bettina's story
is inspiring not only
00:27:29.03\00:27:33.10
because she
successfully overcame
00:27:33.11\00:27:34.99
breast cancer but also because
00:27:35.00\00:27:37.57
she fought the
demons of self doubt
00:27:37.58\00:27:39.71
and negativity and adopted a
00:27:39.72\00:27:42.47
positive attitude
about her recovery.
00:27:42.48\00:27:44.59
For Bettina,
physical activity was an
00:27:45.17\00:27:47.77
important part
of her recovery plan
00:27:47.78\00:27:49.56
and it is
something that has become
00:27:49.57\00:27:51.31
part of her normal lifestyle.
00:27:51.32\00:27:52.79
When asked about
the most important
00:27:52.80\00:27:55.46
health message she
could give to other women
00:27:55.47\00:27:57.49
who have cancer
her response was this,
00:27:57.50\00:28:00.08
stop grieving and
realize that you can
00:28:00.09\00:28:02.93
fight cancer. Watch your health
00:28:02.94\00:28:05.16
and aim for fitness and fun,
00:28:05.17\00:28:06.68
this is a message that
can apply to all of us.
00:28:06.69\00:28:09.52
So until next time keep moving
00:28:09.53\00:28:12.46
step by step
towards better fitness.
00:28:12.47\00:28:15.04