Two studies, one from Europe and one from the United States, advise cancer survivors to be physically active to reduce adverse effects from chemotherapy and improve their health-related quality of life (HRQOL).
The first study, led by Floortje Mols, PhD, from Tilburg University in The Netherlands, found that colorectal cancer survivors who did at least 150 minutes of moderate to vigorous exercise per week had fewer symptoms of chemotherapy-induced peripheral neuropathy (CIPN) in the 2 to 11 years after their diagnosis than their counterparts who did less physical exercise.
In the second study, led by Siobhan Phillips, PhD, from Northwestern University, Chicago, Illinois, prostate cancer survivors who walked at an easy pace for about 3 hours per week had improved hormone and vitality functioning scores. The improvement was similar if they walked for just 90 minutes, but at a more brisk pace.
The studies were published online April 16 in the Journal of Cancer Survivorship: Research and Practice.
Moderate Walking Good, Brisk Walking Even Better
Dr Phillips and colleagues investigated how different intensities and types of physical activity affected quality of life in men after prostate cancer treatment.
"We wanted to study this because the cancer survivor population is growing and there have been great advances in early detection and treatment, but a lot of these treatments are not without side effects," Dr Phillips told Medscape Medical News.
"Physical activity has shown significant promise for helping to reduce some of these negative side effects of treatment and improving quality of life and other factors, but the question people always want an answer to is how little do I have to do, rather than how much do I have to do, and we didn't really know the answer," she said.
Dr Phillips and her team examined associations between postdiagnosis activity and sedentary behavior and HRQOL domains, including urinary incontinence, urinary irritation and obstruction, bowel, sexual, and vitality/hormonal, in 1917 prostate cancer survivors.
These men were part of the Health Professionals Follow-up Study, a prospective study of 51,529 US male health professionals enrolled in 1986.
The men in the current analysis were diagnosed with nonadvanced prostate cancer before 2008 and had provided data on posttreatment physical activity and sedentary behavior in that year.
In 2010, the men completed an HRQOL questionnaire.
The men reported their average time spent during a week walking to work or walking for exercise, as well as time spent jogging, running, cycling, swimming, and playing sports. They also reported their usual outdoor walking pace as easy, average, brisk, or very brisk.
After controlling for prediagnosis physical activity and sedentary time, the results showed that a higher duration of total, nonvigorous and walking activity, especially brisk walking, was associated with better hormone/vitality functioning, affecting fatigue, depression, and body weight (P-trends < .0001).
Survivors who walked 90 minutes or longer per week at a normal pace or faster reported higher hormone/vitality scores (P = .001) than men walking less than 90 minutes at an easy pace.
Even men who were 5 years or more posttreatment with more advanced disease (Gleason score ≥ 7) and who had more than one comorbid condition had higher hormone/vitality functioning if they were physically active.
However, no effect of physical activity was seen on bowel, urinary, or sexual functioning.
"Nonvigorous activity, like walking and outdoor gardening, was associated with higher vitality hormonal functioning scores. Less fatigue, depression, and weight gain were the drivers of this," Dr Phillips said.
"So we can tell our patients that walking at a normal pace, which is 2 to 2.9 miles per hour, can make an important difference in helping them feel better. We should encourage prostate cancer survivors to engage in nonvigorous activity and walking for 3 to 5 hours a week because this may help them manage prostate cancer–related HRQOL issues," she said.
Keep Moving
The study by Dr Mols and colleagues examined data from 1648 colorectal cancer survivors who were part of a Dutch prospective population-based survey of patients diagnosed between 2000 and 2009.
Of these patients, 506 (31%) received chemotherapy.
The development of CIPN is a major concern, particularly now that the indications for chemotherapy with CIPN-inducing agents are being broadened, the researchers write.
Patients filled out the EORTC QLQ-C30 questionnaire to assess their health-related quality of life and the EORTC QLQ-CIPN20 questionnaire to assess their sensory, motor, and autonomic symptoms.
Physical activity was assessed from the European Prospective Investigation Into Cancer (EPIC) Physical Activity Questionnaire. This asked patients how many hours per week, on average, they spent on walking, bicycling, gardening, housekeeping, and sports.
The researchers found that treatment with chemotherapy was associated with a higher percentage of patients reporting CIPN symptoms, regardless of their level of physical activity.
Moreover, not meeting the Dutch physical activity guideline of 150 minutes of moderate to vigorous physical activity per week was associated with more CIPN among patients treated with chemotherapy.
Among patients with low levels of CIPN symptoms, those who did less than 150 minutes of physical activity per week had a mean EORTC QLQ-C30 score for physical functioning of 71.7 vs 88.4 for their counterparts who did more than 150 minutes of physical activity per week (P < .001).
Among patients with high levels of CIPN symptoms, exercise was even more important in improving their quality of life.
Those who did less than 150 minutes of physical activity per week had a mean EORTC QLQ-C30 score for physical functioning of 49.9 vs 77.1 for their counterparts who did more than 150 minutes (P < .001).
Exercising for 150 minutes or more was also associated with significantly better role, emotional, cognitive, and social functioning, as well as global health status (P < .001 for all), and less fatigue, nausea and vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, and diarrhea (P < .001 for all).
The study also found that 9 of every 10 Dutch colorectal survivors were meeting the guideline of at least 150 minutes per week of exercise.
"Regular physical activity plays an important role in colorectal cancer prevention, recurrence and mortality," Dr Mols said in a statement. "Surviving a lifestyle-related illness perhaps makes patients more aware of the importance of physical activity."
Dr Mols and Dr Phillips have disclosed no relevant financial relationships.
J Cancer Surviv. Published online April 16, 2015. Mols abstract, Phillips abstract
Medscape Medical News © 2015 WebMD, LLC
Send comments and news tips to news@medscape.net.
Cite this: Walking Improves Mood, Boosts Energy in Cancer Survivors - Medscape - Apr 23, 2015.
Comments