Walking Reduces Cancer Risk and Improves Overall Health

Breast Cancer Prevention and
Exercise
Debra A. Neirinck
Oncology/Hospital Massage Specialist

Agenda
 Risk Factors
 Benign vs Malignant
 Pathophysiology of Cancer
 Estrogen role
 Signs and Symptoms of Cancer
 Deadliest/most aggressive BC
 Exercise Physiology 101

Risk Factors
 Cannot control
 Female
 Over age 50
 Family history
 Personal history of BC
 2 or more 1st degree
relatives
 Known mutations
 Abnormal growth
 DCIS
 LCIS
 Early menarche / late
menopause
 Radiation to chest wall

Risk Factors
 Cannot control
 Genetic links (BRCA1
and BRCA2)

Risk Factors
 Can control
 Oral contraceptives
 Postmenopausal obesity
 Alcohol use
 Obesity and high-fat diet
 Hormone replacement therapy

Facts
 It isn’t the cancer that kills most cancer pts
 Infection (No. 1 killer of cancer patients)
 DVT (No. 2 killer of cancer patients)
 Pneumonia

Pathophysiology of Cancer
 Three things must be present
 Exposure to toxins
 Immunocompromised
 Genetics of cell

 Benign Tumor
 Quiet
 Contact inhibition
 Encapsulated
 Inactive Cancer
 Does not move
 Non-Invasive

 Malignant Tumor
 Disregard normal cell
function
 Invasive
 Fast-moving
 Parasitic
 Vampiric
 Establishes own blood
supply
 Aggressive
 Does not die!!!
http://repairstemcell.wordpress.com

 How is cancer created?
 How does cancer
grow?
 How does cancer
spread?
http://www.alkalizeforhealth.net

http://www.cksinfo.com/clipart/medicine/normal-and-cancer-cells.png

http://www.cancerhelp.org.uk/about-cancer/what-is-cancer/cells/the-cancer-cell#normal

Signs, Symptoms, and Treatment
 Inflammatory Breast Cancer
 Breast Cancer
 Where spreads to
 Signs / Symptoms
 Lymphedema
 Chemotherapy
 Radiation

 Inflammatory Breast Cancer
 Red!!
 Hot to touch
 Larger
 Heavier
 Something like pus coming out of nipple
 Puckered, orange peel skin
 Nipple inverts

 Breast Cancer
 Lump / thickening in breast or under arm or along
breast bone
 Change in breast size, shape, or appearance
 Blood-stained or clear fluid nipple discharge
 Change in skin appearance of breast
 Redness around nipple
 Misshapen areola
 Marble-like hardness under the skin

 Chemotherapy for Breast Cancer
 Beginner combo of drugs (4 treatments)
 “Punch” after pt stabilizes (every 3-4 wks)
 Drug to prevent nausea; vomiting
 Steroid

 Short-term side effects
 Profound fatigue
 Nausea
 Depression
 Anxiety
 Self-esteem
 Physical activity
 Weight control
 Neuropathy in fingers and toes
 Immunosuppression
 Bone marrow suppression
 Anemia
 Fatigue
 Fatigue
 Fatigue

 And . . . .
 Hair loss
 Skin
 Eyes
 Mouth
 Nose
 Stomach
 Intestine

 Keep going ….
 Blood
 Reproductive system
 Cardiac system
 Nervous system
 Brain
 Respiratory system
 Lungs
 Pregnant? Fetal developments

 Long-term side effects
 Reproductive
 Joints
 Organs

 Radiation for Breast Cancer
 Side effects (short-term)
 Organ damage
 Fibrotic tissue
 Burn/damage lymph node
 Reddening/blushing
 Permanently damages lymph vessels
 Sensitive to sun and pressure
 Side effects (long-term)
 Cardiomyopathy
 Skin
 Bones / tissue
 Reduced function of heart and lungs
 Infertility

How Exercise Affects Cancer Tx
 Muscles need oxygen
 Blood carries oxygen and iron to tissues in the
body
 Muscle contractions stimulate lymphatic flow (the
immune system)

How Exercise Prevents Cancer
 Blood turbulence
 ↑ immune system function
 ↑ blood cell production
 ↓ cardiomyopathy

Aerobic Exercise and Cancer Patients
 Reduces premature death
 Reduces premature death from heart disease
 Improved psychological well-being
 Reduces development of high blood pressure
 Reduces depression / anxiety
 Improvement in weight control
 Maintains bone, muscle, and joint health

Exercise Ideas
 Stairs vs. elevator
 Park farther away
 Go down every aisle in grocery store –
whether you need to or not
 Stroll the mall
 Work out in water
 Tai Chi, Qi Gong, or Yoga
 Gardening
 Anything that you enjoy

Statistics
 230 different types of cancers
 Breast cancer – American women
 90% of cancer deaths from spreading
 1 in 8 in this room will be diagnosed
 10% of cancer has a genetic link
 90% environmentally related
 Leading cause of death in ages 1-14

10 Ways to Prevent Cancer
 More fruits and vegetables
 Exercise: 30 minutes x 4x/week
 Sleep 8 hours a night
 Reduce stress
 East organic when possible
 Drink more water and green tea
 Avoid alcohol, sodium and excess fat
 Avoid or reduce exposure to toxins
 Love yourself and those around you
 Communicate clearly, openly and honestly

Final Thoughts
 Cancer doesn’t kill the patient, . . . .
 Keep yourself healthy.
 Exercise has a profound effect on the
prevention of cancer.
Debra A. Neirinck
nad8@chrysler.com

Bibliography
Alfano, Sean. Stop Cancer with ‘Real’ Exercise. CBSNews.com. Sept. 28, 2006.
http://www.cbsnews.com/stories/2006/09/28/health/webmd/main2050251.shtml.
American Cancer Society. Detailed Guide: Breast Cancer Hormone Therapy. 3-2-2009.
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Hormone_Therapy_5.asp?sitearea=
CancerConsultants.com. Exercise and Cancer Overview. Sept 10, 2008.
http://patient.cancerconsultants.com/HealthWellness.aspx?TierId=1334
Cancer Research UK. Your blood, bone marrow and cancer drugs. 10-22-2008.
http://www.cancerhelp.org.uk/help/default.asp?page=314
curetoday.com. During Treatment: Side Effects of Therapy. (date unknown)
http://www.curetoday.com/index.cfm/fuseaction/article.show/id/2/article_id/1005
Drouin, Jacqueline and Pfalzer, Lucinda. Cancer and Exercise. The National Center on Physical
Activity and Disability. Mar 5, 2009.
http://www.ncpad.org/disability/fact_sheet.php?sheet=195
National Cancer Institute. Understanding Cancer Series: Estrogen Receptors/SERMs. 4-27-2006.
http://www.cancer.gov/cancertopics/understandingcancer/estrogenreceptors
Versagi, Charlotte Michael, William Beaumont Hospital School of Allied Health Oncology/Hospital
Massage Program Instructional Manual, Oct. 2008.
Weiss, Marisa, M.D. Stages of Breast Cancer. BreastCancer.org. Aug 7. 2008.
http://www.breastcancer.org/symptoms/diagnosis/staging.jsp
CancerConsultants.com. Adult Weight Change Influences Risk of Breast Cancer. 12-20-2007
http://patient.cancerconsultants.com/CancerTips.aspx?DocumentId=38061

Walking as a Cancer
Preventative
Debra A. Neirinck
Oncology/Hospital Massage Specialist

Agenda
 Risk Factors
 Benign vs Malignant
 Pathophysiology of Cancer
 Signs and Symptoms of Cancer
 Side Effects of Treatment
 Specific Hormonal Influences

Disclaimer
 Smoking and alcohol

Facts
 Cancer deaths in America
 2012
 577,000 Americans died from cancer
 2/3 could have been prevented
 1/3 died from tobacco use
 1/3 died from obesity, poor nutrition, physical inactivity, overweight
 Lung cancer - 1st
 Obesity – 2nd
 Colorectal cancer - 3rd
Source: “Cancer Prevention & Early Detection Facts & Figures 2012” www.cancer.org

Risk Factors – Lung Cancer
 Single largest preventable cause of
cancer deaths in Americans
 443,000 deaths annually
 50,000 are non-smokers

Risk Factors – Lung Cancer
 Can control
 Cigarette smoking
 Occupational exposure to
 Asbestos
 Arsenic
 Coal products
 Etc
 Second hand smoke
Source: A Cancer Source Book for Nurses, Eighth Edition

Risk Factors – Effects of Obesity
 2nd leading cause of cancer deaths in
America
 Obesity
 Physical inactivity
 Poor nutrition

Risk Factors – Colorectal Cancer
 3rd leading cause of cancer death
 Cannot control
 Over age 60
 Family history
 Family genetic syndromes
 Inflammatory bowel conditions

Risk Factors – Colorectal Cancer
 Can control
 Sedentary lifestyle
 High fat diet
 Weight
 Diet low in fruits
 Diet low in vegetables
 Heavy alcohol consumption

Risk Factors – Breast Cancer
 Death rates declining since 1990
 60% diagnosed at a localized state
 Education
 Early detection
 5-year survival rate at 99%

 Cannot control
 Female
 Over age 50
 Family history
 Personal history of BC
 2 or more 1st degree
relatives
 Known mutations
 Abnormal growth
 DCIS
 LCIS
 Early menarche / late
menopause
 Radiation to chest wall

 Cannot control
 Genetic links (BRCA1
and BRCA2)

 Can control
 Oral contraceptives
 Postmenopausal obesity
 Alcohol use
 Obesity and high-fat diet
 Hormone replacement therapy

Risk Factors – Prostate Cancer
 Cannot control
 Male
 Over age 50
 Family history
 African American
 Family history of 1st degree
relatives

Risk Factors – Prostate Cancer
 Can control
 High fat diet

Types of Cancer
 Cancer is a complex condition
 Five major types of cancer
 Carcinomas
 Leukemias
 Myelomas
 Lymphomas
 Sarcomas

 Malignant Tumor
 Disregard normal cell
function
 Invasive
 Fast-reproducing
 Parasitic
 Vampiric
 Establishes own blood
supply
 Aggressive
 Does not die!!!

 Pain
 Not typical in early stages
 Severe enough to alter lifestyle
 40% intermediate stages
 60% advanced stages

 Cancer
 Where spreads to
 Signs / Symptoms
 Lymphedema
 Chemotherapy
 Radiation

 Cancer
 Lump / thickening in tissue (breast/testicles)
 Change in wart or mole
 Change in bowel/bladder habits/appearance
 Persistent cough (even mild)
 Chronic stomach upset (indigestion)

 Diagnosis
 Stage I
 Stage II
 Stage III
 Stage IV

 Chemotherapy
 Beginner combo of drugs (4 treatments)
 “Punch” after pt stabilizes (every 3-4 wks)
 Drug to prevent nausea; vomiting
 Steroid

 Chemotherapy
 Short-term side effects
 Nausea
 Depression
 Anxiety
 Self-esteem
 Physical activity
 Weight control
 Neuropathy in fingers and toes
 Immunosuppression
 Bone marrow suppression
 Anemia
 Fatigue
 Fatigue
 Fatigue

 Chemotherapy
 Long-term side effects
 Reproductive
 Joints
 Organs

 Radiation
 Side effects (short-term)
 Organ damage
 Fibrotic tissue
 Burn/damage lymph node
 Reddening/blushing
 Permanently damages lymph vessels
 Sensitive to sun and pressure
 Side effects (long-term)
 Cardiomyopathy
 Skin
 Bones / tissue
 Reduced function of heart and lungs (if in chest area)
 Infertility

Aerobic Exercise and Cancer
 Reduces premature death
 Reduces premature death from heart disease
 Improved psychological well-being
 Reduces development of high blood pressure
 Reduces depression / anxiety
 Improvement in weight control
 Maintains bone, muscle, and joint health

Hormone & Cholesterol Efficiency
 Cholesterol meds = $26 billion annually
 25.6 million Americans 20+ years of age
diagnosed with Type 2 Diabetes (as of 2011)
 79 million Americans have pre-diabetes
 Epidemic of insufficient sleep

 Hormones
 Estrogen
 Cortisol
 Insulin

 Estrogen
 Fast reproducing cells

 Cortisol

 Insulin

 Cholesterol
 Not just related to heart disease
 What is it, really?
 Do we need it?
 Influential factors
 Diabetes, stress, diet, weight

 Review
 Key hormones and function
 Contribution to development of cancer
 Walking assists optimum function of body

10 Ways to Prevent Cancer
 More fruits and vegetables
 Exercise: 30 minutes x 4x/week
 Sleep 8 hours a night
 Reduce stress
 Eat organic when possible
 Drink more water and green tea
 Avoid alcohol, sodium and excess fat
 Avoid or reduce exposure to toxins
 Love yourself and those around you
 Communicate clearly, openly, and honestly

Final Thoughts
 Brisk walking has a profound effect on the
Debra A. Neirinck
debra.neirinck@gmail.com

Massage for Cancer Patients
Debra A. Neirinck
Oncology & Hospital Massage Specialist

Disclaimer
 What we will discuss
 Cancer
 Treatment
 Side Effects
 What will not be discussed

Agenda
 What is Touch
 Benefits of massage during treatment
 Benefits of massage after treatment
 The Disease
 Mind-Body Connection
 Oncology Massage
 Review of Information

Definitions
 “Touch” (World English Dictionary)
 the state of being in physical contact
 to bring (the hand, finger, etc., or something held)
into contact with something
 the act or an instance of something coming into
contact with the body
www.dictionary.com

Definitions
 Definition of Oncology
1. the branch of medical science dealing
with tumors, including the origin,
development, diagnosis, and treatment of
malignant neoplasms.
2. the study of cancer.
 Definition of Oncology Massage
The adaptation of massage to safely nurture
the body, mind and spirit of anyone
diagnosed with cancer.
Society for Oncology Massage
www.dictionary.com

Oncology Massage: A Recognized
Modality
 Recommended by:
 American Cancer Society
 Society for Integrative Oncology
 LiveStrong
 Offered at many cancer centers:
 William Beaumont Hospitals (Troy & Royal
Oak)
 St. Joseph’s Hospital (Ann Arbor &
Pontiac)

Oncology Massage: A Recognized
Modality
 My personal experiences

Massage Benefits During Tx
 Reduces short-term pain, anxiety, fatigue,
feelings of isolation
 Enhances mood
 Contributes to better rest
 Improves perception of treatment

 What is cancer?
 How does it grow?
 How does it
spread?

 Benign Tumor
 Quiet
 Encapsulated
 Inactive Cancer
 In situ
 Does not move
 Non-Invasive

 Malignant Tumor
 Disregard normal cell function
 Invasive
 Fast-moving
 Parasitic
 Vampiric
 Established own blood supply
 Aggressive
 Does not die!!!

Treatment
 Surgery
 Chemotherapy
 Radiation

Treatment – Surgery (p.63)
 Short-Term Effects
 Risk for blood clots
 Depression of immune system
 Tenderness at incisional site
 Long-Term Effects
 Risk of lymphedema
 Scarring
 Numbness / hypersensitivity
 Body Image
 Unconscious guarding of surgical site

Treatment – Chemotherapy
 Short-term side effects
 Profound fatigue
 Nausea
 Depression
 Anxiety
 Self-esteem
 Physical activity
 Weight control
 Neuropathy in fingers and toes
 Immunosuppression
 Bone marrow suppression
 Anemia
 Fatigue
 Fatigue
 Fatigue
 Profound fatigue

 And . . . .
 Hair loss
 Skin
 Eyes
 Mouth
 Nose
 Stomach
 Intestine

 Keep going ….
 Blood
 Reproductive system
 Cardiac system
 Nervous system
 Brain
 Respiratory system
 Lungs
 Pregnant? Fetal developments

 Long-term side effects
 Reproductive
 Joints
 Organs

Treatment – Radiation (p. 65)
 Side effects (short-term)
 Organ damage
 Fibrotic tissue
 Burn/damage lymph node
 Reddening/blushing
 Permanently damages lymph vessels
 Sensitive to sun and pressure
 Side effects (long-term)
 Cardiomyopathy
 Skin
 Bones / tissue
 Reduced function of heart and lungs
 Infertility

Research Studies and Results
 Safety and Efficacy of Massage Therapy for Patients with
Cancer (2005)
 MEDLINE and CINAHL database study showing strongest evidence for
stress reduction with trends toward pain reduction
 Massage Therapy for Symptom Control: Outcome Study at a
Major Cancer Center
 Memorial Sloan Kettering observational study of 1,290 patients
 Rated symptoms (pain, nausea, fatigue, anxiety, and depression) pre-
and post-massage with immediate reduction in all areas
 Massage Therapy May Have Immediate Positive Effect on Pain
and Mood for Advanced Cancer Patients (2008)
 NIH funded study
 Randomized trial of 380 advanced cancer patients at 15 US hospices
 Improvement in pain and mood following massage compared with simple
touch

Massage Benefits After Tx (p. 41)
 Restores a feeling of wholeness to the body
 Increases range of motion and suppleness to
areas affected by surgery and radiation
 Stress reduction/ restorative rest
 Pain reduction

Massage Benefits after Tx (cont’d)
 Take from S4OM slides and p. 41

Massage for Cancer Patients
 Take from S4OM slides and p. 41

Cancer Patient = Warrior
 Rest, Warrior (by Tracy Walton, LMT, MS)
 Printed in Massage Today, June 2009, Vol. 09,
Issue 06

Massage for Cancer Patients - Final
Thoughts
 Exercise has a profound effect on the

Bibliography
 Alfano, Sean. Stop Cancer with ‘Real’ Exercise. CBSNews.com. Sept. 28, 2006.
 http://www.cbsnews.com/stories/2006/09/28/health/webmd/main2050251.shtml.
 American Cancer Society. Detailed Guide: Breast Cancer Hormone Therapy. 3-2-2009.
 http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Hormone_Therapy_5.asp?sitear
ea=
 CancerConsultants.com. Exercise and Cancer Overview. Sept 10, 2008.
 http://patient.cancerconsultants.com/HealthWellness.aspx?TierId=1334
 Cancer Research UK. Your blood, bone marrow and cancer drugs. 10-22-2008.
 http://www.cancerhelp.org.uk/help/default.asp?page=314
 curetoday.com. During Treatment: Side Effects of Therapy. (date unknown)
 http://www.curetoday.com/index.cfm/fuseaction/article.show/id/2/article_id/1005
 Drouin, Jacqueline and Pfalzer, Lucinda. Cancer and Exercise. The National Center on Physical
Activity and Disability. Mar 5, 2009.
 http://www.ncpad.org/disability/fact_sheet.php?sheet=195
 National Cancer Institute. Understanding Cancer Series: Estrogen Receptors/SERMs. 4-27-2006.
 http://www.cancer.gov/cancertopics/understandingcancer/estrogenreceptors
 Versagi, Charlotte Michael, William Beaumont Hospital School of Allied Health Oncology/Hospital
Massage Program Instructional Manual, Oct. 2008.
 Weiss, Marisa, M.D. Stages of Breast Cancer. BreastCancer.org. Aug 7. 2008.
 http://www.breastcancer.org/symptoms/diagnosis/staging.jsp
 CancerConsultants.com. Adult Weight Change Influences Risk of Breast Cancer. 12-20-2007

Thank You!
Debra A. Neirinck
Oncology & Hospital Massage Specialist
248-770-2298
debra.neirinck@gmail.com

The Silent Disease
Debra A. Neirinck
April 19, 2007

Statistics
1.5 million fractures annually
hip
spine
wrist
Vertebral fractures >50 years
1 in 2 women
1 in 4 men
Future concern
Worldwide
Children

Statistics
U.S. ranks 1st among countries
15 billion gallons sold
53 gallons per year Americans
65 gallons per year teenagers
1970-1997: 118%  soft drinks
23%  in milk
1999-2002: teens 3x more than milk

• Weak / fragile
• Painful
• Lose ability to stand / walk
• Lose height
• Debilitating fractures
• Sometimes fatal
Osteoporosis

Bones
• Living organs
• Hardest and most durable substance
• Support us
• Allow us to move
• Protect heart, lungs, brain
• Store essential minerals

Anatomy
Remodeling
• Continually breakdown
• Continually rebuild
• Matrix of fibers provide
strength
• Hardened with calcium,
phosphorus, minerals

Destruction
• Natural bone loss
• Poor eating habits
• Broken bones
• Calcium leeched from
bones

Calcium
• Muscle contraction (including heartbeat)
• Nerve conduction
• Blood pressure
• Blood clotting
• Enzyme regulation
• Deposited / withdrawn every day

Phosphorus
• Found naturally in some foods
• 85% in bones and teeth
• Assists with muscle contraction
• Kidney function
• Nerve conduction
• Maintains regular heartbeat

Phosphoric Acid
• Preservative added to soft drinks
• Sharpens flavor
• Binds to calcium in gut
• Directly influences bone mineral
density
• Affects parathyroid hormone activity
• Major contributor to osteoporosis

Prevention
• Adequate Calcium
• Adequate Vitamin D
• Exercise
• Don’t smoke
• Reduce alcohol consumption
• Reduce consumption of soft drinks

Get Healthy,
Be Healthy,
Stay Healthy
Debra A. Neirinck
Oncology/Hospital Massage Therapist

 Immune System
 Importance
 Clear infection
 Function
 Collect “trash”
from tissues
 Exchange between
blood and cells
through capillaries
Introduction

Introduction
 Origin of Lymph
 Greek = “pure, clear stream”
 Latin = “clear water”
 Originates as blood plasma
 90% water
 100 different solutes
 Nutrients, gases, hormones, wastes
 Products of cell activity, ions, and
 Proteins

Introduction
 Rob says:
 Protein molecules are picked up by the lymphatic
system, because they are not picked up by the
venous system.
 If the lymphatic system did not pick these up,
you’d die within 24 hours.
Why?
 Regulate cell function
 Regulate immune system

Introduction
 Plasma proteins
 Albumin
 Prevents blood from leaking out of vessels
 Carries molecules for tissue growth and healing
 Osmotic pressure
 Globulin
 Alpha, beta, and gamma types
 Some made by immune system
 Bind with hemoglobin to transport substances to fight
infection

Lymphatic Vessels
http://www.lymphnotes.com/article.php/id/151/

Lymphatic Vessels
http://pennhealth.com/health_info/animationplayer/lymph_nodes.html

Lymph Nodes
• Organs and
tissues of the
immune system
• 2 functions
• Remove
debris from
body
• Activate
immune
system

Lymphocytes
 B Cells
Produce
antibodies

Lymphocytes
 T Cells
Patrol for foreign
invaders

Comparison
Cardiovascular System
(Blood)
Lymphatic System
(Lymph)
 Blood collects and distributes
oxygen and nutrients to tissues
 Blood flows in continuous loop
 Blood is pumped
 Blood transports red and white
cells
 Blood is visible and damage
causes visible signs: bleeding
or bruising
 Blood is filtered by kidneys
 Blood vessel damage or
insufficiency produces swelling
with low-protein fluid
 Lymph collects and removes
waste from tissues
 Lymph flows in open circuit
 Lymph is not pumped
 Lymph that has been filtered is
clear or milky white
 Lymph is invisible and damage is
not known until swelling occurs
 Lymph is filtered by lymph nodes
 Lymphatic vessel damage or
insufficiency produces swelling
with protein-rich fluid
http://www.lymphnotes.com/article.php/id/15
0/

Lymphatic Drainage
 “as gentle as a butterfly’s kiss”
 stimulates flow from one area to another
 encourages formation of new lymph
 increases lymph flow
 extends lymphangion wall
 increases lymphangion function

Lymphatic Drainage
 Improved during exercise
 Lymph is mostly water, so drinking water is a
good thing
 Beneficial for many ailments and diseases
 Chronic swelling
 Multiple sclerosis
 Sinus problems
 Upper respiratory problems
 Erectile dysfunction

Summary
 Vessels and nodes
 B Cells and T Cells
 Manual stimulation
 Stimulates parasympathetic nervous system
 Causes deep relaxation
 Increases lymphatic activity
 Stimulates immune system

How About You?
Maintenance
Protection
Future performance

Word Scramble
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le/Data/2007.12/12849.0.html

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