Studies have shown that exercise may help reduce the risk of recurrence in cancer patients. It can also help improve mood and sleep, reduce anxiety, boost energy, and so much more. Join Dr. Shannon Armbruster, gynecologic oncologist at Virginia Tech’s Carilion Clinic, as she talks about these benefits, exercise guidelines for cancer survivors, her research, and more. One form of exercise that has mind-body benefits for cancer survivors is yoga. Dr. Samantha Harden, an associate professor of Human Nutrition, Foods, and Exercise and 500 hour registered yoga teacher, will share some of the research findings related to yoga for cancer survivors and include a brief, accessible demonstration of the yoga kernels for public health (breathing, movement, moment-to-moment awareness). Learn about and reap the benefits of movement with us during this Gynecologic Cancer Awareness Month!

1. BENEFITS OF MOVEMENT DURING
TREATMENT & BEYOND
Shannon Armbruster MD, MPH
Assistant Professor
Division of Gynecologic Oncology
Virginia Tech Carilion School of Medicine
@SArmbrusterMD

2. AGENDA
INTRODUCTION
PHYSICAL ACTIVITY/INACTIVITY AND CANCER RISK
NATIONAL PHYSICAL ACTIVITY GUIDELINES
BENEFITS OF PHYSICAL ACTIVITY
OUR RESEARCH

3. DISCLOSURES
I have no financial relationships with ACCME defined
ineligible companies to report.
I will not be discussing any unlabeled or investigational
uses of any pharmaceutical products or medical devices.
I find joy and peace with movement!

5. PHYSICAL
ACTIVITY AND
CANCER RISK

6. SEDENTARY
BEHAVIOR AND
CANCER RISK

8. PHYSICAL ACTIVITY AND CANCER RISK REDUCTION
EXERCISE HAS MANY BIOLOGICAL EFFECTS ON THE BODY,
SOME OF WHICH HAVE BEEN PROPOSED TO EXPLAIN
ASSOCIATIONS WITH SPECIFIC CANCERS.
Lowering the levels of sex hormones and growth factors that have
been associated with cancer development and progression
Preventing high blood levels of insulin this is linked to cancer
development and progression
Reducing inflammation
Improving immune system function
Helping to prevent obesity, which is a risk factor for many cancers
National Cancer Institute: Physical activity and cancer

10. CLASSIFYING PHYSICAL ACTIVITY:
METABOLIC EQUIVALENTS
https://www.sedentarybehaviour.org/what-is-sedentary-behaviour/

11. AMERICAN CANCER SOCIETY GUIDELINES
 Exercise regularly: 150-300 min/week of moderate OR
75-150 min/week of vigorous activity
 Strength training exercises: 2 days/week
 Avoid inactivity: Any activity is beneficial
 Start slow: Slowly increase the length and intensity of
activity
 Consider short sessions: benefits of several 10-minute
segments = 1 longer exercise session
Rock et al. CA Cancer J Clin
2012 www.paulabecker.com

12. CANCER SURVIVORS’ MINUTES OF WEEKLY
MODERATE/VIGOROUS PHYSICAL ACTIVITY
Kwon et al,. J Cancer Surviv 2012

13. BENEFITS OF PHYSICAL ACTIVITY
DURING SURVIVORSHIP
 Physical:
 Heart and lung fitness
 Muscle strength
 Body composition
 Balance
 Reduce risk of second cancer
 Reduce the risk of other chronic
diseases
 Immune system
 Increase appetite
 Mental/emotional:
 Quality of life
 Fatigue
 Psychosocial distress
 Depression
 Anxiety
 Self-esteem
 Sleep
 Brain function
Rock et al. CA Cancer J Clin 2012; www.cancer.org
www.istockphoto.com

14. BRIEF OVERVIEW OF THE
BENEFITS OF YOGA
Numerous!
More from Dr. Harden
Lin KY et al. 2011
Media.istockphoto.com

15. PHYSICAL ACTIVITY DURING TREATMENT
Benefits of aerobic and resistance exercise
 Reduce fatigue
 Preserve cardiorespiratory fitness, physical functioning,
and strength
 For some populations:
 Improve quality of life
 Reduce anxiety & depression
Ligibel JA et al. Journal of Clinical Oncology 2022

16. PHYSICAL ACTIVITY AND SURVIVAL
All gyn cancer survivors: High levels of post-
diagnosis physical activity had 33% lower risk
of all-cause death than those with little
activity
Ovarian cancer survivors: pre-diagnosis
physical activity over 2 hours/ week increased
survival rates compared to physical activity of
< 1 hour/week
Friedenreich CM, et al. JNCI Cancer Spectr. 2020
Moorman PG, et al. Ann Epidemiol. 2011

17. Cancer survivors
reporting NO
physical activity in
their leisure time
Centers for Disease Control and Prevention, National Cancer for Health Statistics March 2021

18. OUR RESEARCH

19. ENDOMETRIAL CANCER: OBESITY AND INACTIVITY
 Most common
gynecologic malignancy1
 Cancer most closely
related to obesity2
 Linear relationship
between obesity and
endometrial cancer risk2
 Physical activity
decreases cancer risk3
1 Reeves et al. 2Ward et al. 2013 3Moore et al. 2010

20. SURVIVORSHIP AND PHYSICAL ACTIVITY LEVELS
88% of survivors did NOT meet the physical
activity guidelines
80% reported no strenuous exercise
54% reported no moderate exercise
Median= 70 of minutes of exercise per week
(including light physical activity)
vonGruenigen et al. 2011
Image Envision 30207

22. Let’s create an
intervention!
timeline for
behavioral interventions to
reach participants

23. OBESITY-RELATED BEHAVIORAL
INTERVENTION TRIALS (ORBIT)
TRANSLATIONAL MODEL

24. Can we improve
the health and
quality o life of
ECS?

25. Can we improve
the health and
quality o life of
ECS?

26. Program
8-week walking program
• Compatible with
Cooperative
Extension
• Weekly newsletters
& Zoom sessions
• Facilitators & online
Group Dynamics
Participating teams
• ‘Team captains” and
family & friends
• Create team name
• Set physical activity
goals
Data
Program ‘miles’
• Actual miles walked,
run, or rolled
• Any 15-minute bout
of moderate intensity
physical activity

28. Can we improve
the health and
quality o life of
ECS?

29. Can we improve
the health and
quality o life of
ECS?

31. Mary Frazier PhD
Candidate
Samantha Harden PhD, 500-YRT Jamie Zoellner PhD, RD Wen You PhD
Brian Ludwin PhD
Katie Brow MD
Brandon Ganjineh
MS4
THANK YOU
NATIONAL INSTITUTE OF HEALTH
ITHRIV
CARILION RESEARCH TEAM
DIVISION OF GYNECOLOGIC
ONCOLOGY
DEPARTMENT OF OB GYN
Our survivors &
support team
members