Benefits of Physical Activities (PA) in Cancer Survivors

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On 4th March 2012, I had the privelege of talking at Asian Breast Cancer Conference. But I wasn't planning on going there and be a yes man.

I took the oncology fraternity to task. If they have known for a long time that exercise and physical activity reduces cancer risk by 25-50% and side effects in survivors from inactivity is as bad as disease itself, then why don't they talk and promote more about it. Only a quarter bring up exercise to their patients. I was looking to get a reaction, whether it be a shoe thrown at me or saying, wow... Let's work together on this... But the audience was very sedated... courtesy the pharmaceutical industry that sponsors conferences like these. There was no response. I finished my talk by saying "my role model is Lance Armstrong, a man who did amazing things in world of sports after he was diagnosed, treated and then survived cancer."

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  • Benefits of Physical Activities (PA) in Cancer Survivors

    1. 1. Role of Physical Activityin Breast Cancer Survivor
    2. 2. Role of Physical Activity in Breast Cancer Survivor Dr Rajat ChauhanSports - Exercise Medicine Physician
    3. 3. Role of Physical Activity in Breast Cancer Survivor Dr Rajat ChauhanSports - Exercise Medicine Physician Asian Breast Cancer Conference Bangalore, 4th March 2012
    4. 4. Where do we fit in?
    5. 5. Where do we fit in?HEALTHCAREINDUSTRY
    6. 6. Where do we fit in?HEALTHCARE FITNESSINDUSTRY INDUSTRY
    7. 7. Where do we fit in?HEALTHCARE FITNESSINDUSTRY INDUSTRY
    8. 8. The Deadly Triad
    9. 9. The Deadly TriadGenetics
    10. 10. The Deadly TriadGenetics Environment
    11. 11. The Deadly TriadGenetics Environment Lifestyle
    12. 12. Side effects / adverse effects of cancer treatment• fatigue • CVD risk• depression • cardiotoxicity• anxiety • bone loss / osteoporosis / fractures• quality of life • physical activity• weight gain
    13. 13. Benefits of increased Physical Activity• Side effects / adverse events of diagnosis, surgery, treatment • fatigue, depression, anxiety • QoL • weight loss / maintenance • CVD risk & Cardiotoxicity • bone loss / fractures
    14. 14. More benefits• Increased chemotherapy completion rates• Increased overall survival• Increased cancer specific survival• Reduced risk of recurrence• Reduced new cancers• Reduced biological markers: reduced BMI, reduced insulin, reduced sex hormones
    15. 15. Objective:To make bodies fuel-efficient
    16. 16. Barriers to increased Physical Activities• PA is not part of cancer treatment plan• Lack of clinical trial data of PA & survival• Reluctance of oncologists to prescribe PA• Lack of prioritization of PA in healthcare setting• Non-availability of insurance coverage for physical activity counseling• Confusion from patients on whether PA increases survival
    17. 17. Strategies to increase Physical Activities• Clinical trials demonstrating PA increases survival & biological markers• PA incorporated into cancer treatment recommendations• Increased opportunity / resources for PA• Increased oncologist knowledge of benefits of PA after a cancer diagnosis• Increased oncologist initiated PA discussion & referral
    18. 18. Challenge is us• 84% Cancer survivors want to receive information for physical activity• 28% oncologists initiated dialogue• 14% survivors initiated• Only 14% referred to specialist • Irwin et al. Physical activity interventions for cancer survivors. Br J Sports Med 2009;43:32-38
    19. 19. Challenge is us• 84% Cancer survivors want to receive information for physical activity• 28% oncologists initiated dialogue• 14% survivors initiated• Only 14% referred to specialist • Irwin et al. Physical activity interventions for cancer survivors. Br J Sports Med 2009;43:32-38
    20. 20. Encourage• PA challenge for healthy people, how then to encourage survivors?• Improves quality of life• Effective way of reducing side effects resulting from inactivity & disease• Inactivity: loss of fitness, strength & mobility, unfavorable weight gain, insulin sensitivity
    21. 21. More Strategies toincrease Physical Activities• Increased insurance coverage for PA counseling• Increased number of exercise trainers certified to counsel / exercise train cancer survivors• Increased tailoring of exercise programs • When to start (during or post-treatment) • Supervised or home based • Group programs or alone • Mail, telephone, or web based approach • Pedometer to increase PA levels
    22. 22. Express your genes
    23. 23. Express your genes• Telomeres (the longer the better) control the lifespan and healthspan of human cells by regulating the expression of age and health related genes
    24. 24. Express your genes• Telomeres (the longer the better) control the lifespan and healthspan of human cells by regulating the expression of age and health related genes• Regular endurance exercise decreases exercise induced inflammation in humans while occasional exercise increases inflammation even more than no exercise does
    25. 25. Express your genes• Telomeres (the longer the better) control the lifespan and healthspan of human cells by regulating the expression of age and health related genes• Regular endurance exercise decreases exercise induced inflammation in humans while occasional exercise increases inflammation even more than no exercise does • Dr William Andrews, An authority in unlocking the molecular mechanisms of aging, President & CEO of Sierra Sciences, a company devoted to finding ways to lengthen telomeres, thus extending human lifespan and healthspan
    26. 26. Recommendation for all doctor consultation rooms• Cover of March 2011 edition of British Journal of Sports Medicine• Had front cover of the book Physical Activity in the Prevention & Treatment of Disease by Swedish National Institute of Public Health• Recommendation: • 1 per consulting room • Use 20-30 times daily• How many of my colleagues even know this book existed, leave alone do as suggested?
    27. 27. Recommendation for all doctor consultation rooms• Cover of March 2011 edition of British Journal of Sports Medicine• Had front cover of the book Physical Activity in the Prevention & Treatment of Disease by Swedish National Institute of Public Health• Recommendation: • 1 per consulting room • Use 20-30 times daily• How many of my colleagues even know this book existed, leave alone do as suggested?
    28. 28. How much exercise• 4 hrs of PA per week, corresponding to 6 METs (i.e. 6 times the oxygen uptake at rest, corresponding to light jog) yields 30-50% reduction of Breast Cancer in postmenopausal women • Thune et al. Physical activity and risk factors of breast cancer. N Engl J Med 1997;336:1269-75 • Moradi et al. Breast cancer risk and lifetime leisure-time and occupational physical activity (Sweden). Cancer causes Control 2000;11:523-31 • Bernstein et al. Lifetime recreational exercise activity and breast cancer risk among black women and white women. J Natl Cancer Institute 2005;97:1671-9
    29. 29. Take home message No matter how slow you go, You are still lapping everybody on the couch.
    30. 30. Excuses
    31. 31. Excuses
    32. 32. +91 11 4656 0339 / info@b2f.co.in / www.b2f.inAll rights reserved. These pages are to be used for selected audience only. Distribution, quotations and duplications — even in the form of extracts — for third parties is only permitted upon prior written consent of Back 2 Fitness.

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