Weekend Warrior and the science of anti-cancer fitness

 By Dr. Geo Espinosa

You want a quick way to get hurt, go out Sunday morning and play 2-hours of any sport while your weekdays are sedentary. This has nothing to do with age.

I play pick up basketball games with men over 60 on the weekends. They play well. And hard. And careful. But they are also in shape.

Staying in the game is extremely important both literally and figuratively. We should all find a sport we like and play it for as long as possible. Some members are in this community are in their 70′s and still playing tennis. Sorry, golf don’t count.

Here’s the deal though: you have to train at least three times a week with a nice combination  of full-body weight resistance exercises, some aerobic and a little stretching.

I should to think this was a ” should do.” Now I firmly believe is a “must do.” We always look for excuses not to exercise despite the mounting evidence showing its protective effects – especially in cancer.

Physical activity is the absolute best method to avoid injuries and prevent most diseases .

A plethora of research have shown that not only does exercise significantly decrease the risk of cancer development but increase quality of life and life expectancy after cancer diagnosis.

Summary of the evidence for exercise helping people before cancer

In Prostate Cancer one can reduce their risk up to 20%. (Liu et al. 2011)  One of the benefits of exercising is to reduce the chances of becoming over-weight pr obese. Carrying extra pounds increases the risk of aggressive prostate cancer. (Buschemeyeret al. 2013)

In Breast Cancer there is a 25% reduction in the risk of breast cancer among the most physically active women compared with those who are least active. a 1989 randomized trial of 45 women undergoing adjuvant chemotherapy for stage II breast cancer demonstrated that 10 weeks of interval-based, aerobic exercise not only improved functional capacity and body composition, but it also decreased chemotherapy-induced nausea. This pioneering work demonstrated that aerobic exercise was feasible, safe, and beneficial for patients undergoing chemotherapy. (Winningham et al 1989)

In Kidney Cancer one study looked at  19 studies documenting  a protective association between physical activity and the formation of kidney cancer. (Behrens et al. 2013)

Summary of the evidence of exercise helping people after cancer

Among the most interesting advances in the field of exercise and cancer in the last decade are several observational studies showing that colon, breast, and prostate cancer survivors who exercise enjoy reduced cancer-specific mortality.

One study called the  Cancer and Leukemia Group B (CALGB) 89,803 studied subjects consisted of 832 subjects with stage III colon cancer. These patients were followed prospectively for a about  10 years. Compared with subjects exercising an hour or less per week, those walking at least 6 hours weekly showed  a whopping 49% decreased risk of death over the course of the study (Meyerhardt et al. 2006).

Another large well known study  called the Nurses’ Health Study (NHS) reinforced this finding. Among 573 colon cancer survivors, those who exercised at least 6 hours weekly gained significant cancer-specific survival compared to those exercising less than an hour a week. (Meyerhardt et al. 2006*).

Yet another trial looked at  over 4,500 postmenopausal women with breast cancer who were enrolled in the study, those who walked briskly for only 3 hours a week had a significantly lower risk of overall mortality compared with inactive women. (Irwin et al. 2011)

With prostate cancer one study demonstrated that men who walked briskly for 90 minutes or more each week had a decreased risk of all-cause mortality.  However, ONLY brisk walking failed to decrease the risk of prostate cancer-specific death. Those exercised most intensely for 3 or more hours weekly not only decreased overall mortality compared with just brisk walking, but vigorous exercise also decreased the risk of prostate cancer-related deaths by an impressive 61%. (Kenfield et al. 2011)

Imagine a drug that would decrease the risk of prostate cancer related deaths by 61%? It would be all over the news and stock holders would make millions overnight.

Besides walking, other moderate-intensity exercise modalities in this study included golf and weight lifting. Among the more vigorous exercise modalities in this study were squash, running, swimming, tennis, and bicycling. (Kenfield et al. 2011)

(Again, unless you carry your own golf bag and walk the course, golf is not considered moderate-intensity – at least in my book)

Bottom line and take home message

I have patients, typically those who live in big cities like New York City, trying to convince me that they walk for exercise. Walking, in and by itself does NOT offer maximal protection against most cancers.

The primary reason why exercising is most beneficial is two-fold: 1. controlling excess body fat formation, 2. controlling the over production of insulin.

Walking fails to improve fat build up, insulin resistance, and inflammation. (Trapp et al 2008)

Supervised exercise programs incorporating small volumes of high-intensity activity, such as repeated short sprints, not only decrease fat production but  improve insulin sensitivity and also achieve these results with an hour or less of exercise per week. (Dipietro et al. 2006) T

Here’s another doozy:

Even if one exercise’s with moderate intensity 3 hours a week, but spends the rest of the day sitting, say … in front of a computer, that increases the risk of chronic disease and cancer. So being consistently sedentary even if you exercise is a problem. (Katzmarzyk et al. 2009)

What can you do?

•    Know that walking is not good enough.

•    Don’t be a weekend warrior. It’s OK to be athletic on the weekends but you must train at least two times a week to avoid injuries.

•    Commit to exerting with moderate intensity 3 to 4 hours a week. This can be 30 minutes a day for 6 days or one hour two times a week plus 30 minutes two other days in a week. Make sure you workup a good sweat. The exercise program MUST include weight resistance, aerobic and stretching exercises like yoga – or simply stretching. Equipment  for weight resistance can be anything that you’d can pull and push: your body weight, exercise bands of weights.

•    Your exercise regimen MUST include some activities you don’t like. Some like running but not lifting. Others like lifting and running but not stretching.  All three are important. Sorry. I’m only the messenger.

•    Play a sport. Yes this can be golf but golf does not count for moderate intensity movement. Tennis does, for example.

•    If you have a job that requires you to sit for a long time, set up an alarm every hour to get up and go for a 5 to 10 minute walk. Suggested activities include climbing a flight or two of stairs, stretching, calisthenics, or taking a short walk. Some office workers make a habit of taking all phone calls standing up.

•    Don’t sit at home after work for a prolong period of time watching the tube. An hour is OK. You can even watch a two hour movie but then get up and do something physical.

Lastly, it has to feel good to know that we have some control of our fate, don’t it? Consider that these anti-cancer benefits are only with exercise. Imagine what can happen when we add good eating habits and the smart use of dietary supplements?

The crux of our upcoming retreat is about implementing the research of lifestyle medicine to improve longevity and quality of life in men who have had prostate cancer. Detailed exercise instruction will be provided. CLICK HERE for more information.

Please share this post with friends and family. It may make a difference in their lives.

Have a great weekend!



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