Cancer Hates Exercise
I like living more than I hate exercise. And, if I want to continue living, the data says I should turn off Netflix and move my body. It’s not a debate. It’s a fact. Another fact? Exercise after diagnosis offers the greatest benefit to mortality; so, don't think it's too late. The party has just begun.
The impact varies for each person— just like every drug or treatment plan. However, as Dr. Kathryn Schmitz explains in our podcast, on average, researchers find a 30-50% risk reduction in recurrence when patients are regularly physically active.
Dr. Schmitz Provides Instructions for Patients
Dr. Kathryn Schmitz provides a detailed program for newly diagnosed, post-surgical, in-chemo, and post-treatment cancer patients in her book, Moving Through Cancer. Its purchase comes with a free 12-month subscription to MyVictory.com, an at-home, on-demand, exercise and community streaming platform for Cancer Survivors.
Exercise Guidelines
Researched Guidelines (Link for specific exercise instructions)
150-300 minutes moderate OR 75-150 minutes intense vigorous aerobic exercise per week
Strength and flexibility exercise 2-3X per week
My workout
70 minutes daily hiking up 900’ elevation (490 min/week). Sometimes I use hand weights while walking if I haven’t been doing a good job with my weights (I find weights a challenge.)
Yoga 2X per week; Bikram (hot room) yoga 2X per month
Weights 2X per week; 3 sets of 10 reps with hand weights across 5 different body positions, squats with kettlebell, and leg lifts for quads. (I keep hand weights under my desk to use when I’m on some calls—I like multitasking.)
Risk Reduction of Death by Cancer Type
Here’s a great analysis of multiple research studies. The study quantifies the benefits of exercise for cancer prevention as well as for risk reduction of mortality for cancer patients. I’ve featured risk reductions of mortality/death for those of us with cancer.
Breast: 48% Risk Reduction
A 2015 meta-analysis of 8 cohorts found that when comparing women with high versus low levels of exercise, those with higher exercise levels had a 48% reduction in risk for all-cause mortality (death).
Colorectal: 42% Risk Reduction
A 2016 meta-analysis of 7 cohort studies indicated a 42% risk reduction in all-cause mortality for those with high levels of exercise versus the lowest levels of physical activity. Two other studies reviewed showed benefits ranging between 25% - 50% risk reduction.
Prostate: 38% Risk Reduction
A 2016 meta-analysis of 3 cohort studies found a 38% risk reduction in prostate-specific mortality when comparing men with highest levels of activity versus the lowest levels.
Dose-Dependent Relationship
For many cancers, dose-response relationships were evident which means that people who exercised more had more reduction in risk of death. However, almost ANY level of activity conferred some benefit.
Research is Primarily with Aerobic
Almost all observed (epidemiologic) data on physical activity and cancer survival focuses on aerobic activity. We just don’t have much data on other types of activity.
Study Citation and Link
MCTIERNAN, ANNE; FRIEDENREICH, CHRISTINE M.; KATZMARZYK, PETER T.; POWELL, KENNETH E.; MACKO, RICHARD; BUCHNER, DAVID; PESCATELLO, LINDA S.; BLOODGOOD, BONNY; TENNANT, BETHANY; VAUX-BJERKE, ALISON; GEORGE, STEPHANIE M.; TROIANO, RICHARD P.; PIERCY, KATRINA L.. Physical Activity in Cancer Prevention and Survival: A Systematic Review. Medicine & Science in Sports & Exercise 51(6):p 1252-1261, June 2019. | DOI: 10.1249/MSS.0000000000001937
Less than 5 Minutes of Intense Daily Exercise May Reduce Risk by 30%
A 2023 research paper suggests that vigorous intermittent lifestyle physical activity (VILPA) is a very time-efficient way to prevent cancer. A total of 22,398 self-reported non-exercising adults engaged in a minimum of 3.4 to 3.6 total minutes of VILPA per day, broken down into brief and sporadic (1-2 minute) sessions during daily living. VILPA was measured by wrist accelerometers and included things like very fast walking or stair climbing. Analysis revealed a 17% to 18% reduction in total incident cancer risk compared with no VILPA while a median daily VILPA of 4.5 minutes increased the risk reduction to 31% to 32%.
Who might benefit?
The data shown in the chart represents 1.44 million adults from pooled data from 12 prospective US and European cohorts with self-reported physical activity. It is considered a seminal study and I encourage you to read it and see why it is a trusted, important information source referenced by medical oncologists.
Some of the risk reduction numbers are not as high in this study as other studies. Remember this is one study, among many, that scientists have used to determine the average risk reduction percentage of 30-50%.
Dr. Kathryn H. Schmitz
Ph.D., M.P.H, FACSM, FTOS, FNAK
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Dr. Schmitz is a Professor in the division of Hematology and Oncology at the University of Pittsburgh School of Medicine. She serves as the Associate Director of Catchment Area Research, Co-leader of the Biobehavioral Cancer Control program and Director of the Exercise Oncology Initiative for the Hillman Cancer Center. Dr. Schmitz’s research focuses on people living with and beyond cancer and investigates the role of exercise in improving physiologic and psychosocial outcomes, including symptoms, treatment tolerance, and other chronic diseases.
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In addition, Dr. Schmitz studies technology based supportive care interventions (that include physical activity) to improve outcomes among advanced cancer patients. She has held NCI funding consistently since 2001. She has published over 350 scientific peer reviewed papers, some in prestigious journals such as JAMA, New England Journal of Medicine, and Journal of Clinical Oncology. Her well regarded research on resistance exercise and breast cancer related lymphedema has been translated into a physical therapy delivered program called ‘Strength After Breast Cancer’ that is available in over 1000 locations across the United States and beyond. Dr. Schmitz was the moving force behind two American College of Sports Medicine development processes for exercise and cancer guidelines for patients in 2010 and 2018. She founded the Moving Through Cancer initiative of the American College of Sports Medicine, which has a bold goal of making exercise standard of care in oncology by 2029. She has written a popular press book to raise awareness about exercise for cancer patients and survivors entitled ‘Moving Through Cancer’ that was released by Chronicle Books in October 2021. She is the winner of numerous awards, most notably the Distinguished Scientist Award from the Society of Behavioral Medicine, the Citation Award from the American College of Sports Medicine, and the Clinical Research Professorship from the American Cancer Society. She is the past president of the American College of Sports Medicine.
Research also shows that having a dog makes you more active. I KNOW that is the case for me. My dog, Cobber, is the reason I hike 1.25 hours a day — rain or shine, he needs to get outside.
It’s not about weight loss
Research shows that exercise helps everyone. You don’t need to lose weight to gain benefits from exercise and you don’t need to be thin to exercise. In fact, they see the biggest benefits coming from people who were sedentary and became active.
Exercise doesn’t need to be work
My mother-in-law likes to put on jazz music and declare a dance party moment. Everyone needs to get up and start dancing. The kids loved it until about junior high when they became self-conscious about dancing around the house with their cousins. It’s sad that we lose the sheer joy of running and dancing and moving our bodies. Who cares what we look like? It feels great. I think we should ban the word “workout”. If we’re doing it right, it’s not work. It’s living.
Here’s my mom and son a couple years ago having a great time in the snow. Walking up the hill with a sled will bring on a sweat and going down definitely gets your heart beating, but no one ever thought about this day as “work.”
