Physical activity guidelines exist in many EU countries to reduce cancer risk, though only a minority meet them. Research shows physical activity lowers breast, colon, and endometrial cancer risk by 25-30%, and likely other cancers, through mechanisms like reduced body fat and inflammation. Randomized trials show exercise improves outcomes for breast cancer survivors. More research is needed on optimal dose and type of activity. Ongoing studies examine biological mechanisms and effects on recurrence, survival, and quality of life.
Dr Anna Campbell's keynote speech 'The Importance of Staying Active after a Cancer Diagnosis' at the SCPN's 'Be Active Against Cancer' conference, Tuesday 4th February 2014.
Exercise and cancer: How staying active can positively impact your health and...Inspire
In an hour-long webinar, nationally recognized exercise specialist Carol Michaels, MBA, ACE, ACSM discussed how maintaining an exercise program during cancer treatment and recovery can help patients to minimize treatment side effects, increase energy levels, and reduce stress, along with many other benefits. Inspire produced the educational webinar in partnership with the Bladder Cancer Advocacy Network, US TOO International, and ThyCa: Thyroid Cancer Survivors' Association.
Dr Anna Campbell's keynote speech 'The Importance of Staying Active after a Cancer Diagnosis' at the SCPN's 'Be Active Against Cancer' conference, Tuesday 4th February 2014.
Exercise and cancer: How staying active can positively impact your health and...Inspire
In an hour-long webinar, nationally recognized exercise specialist Carol Michaels, MBA, ACE, ACSM discussed how maintaining an exercise program during cancer treatment and recovery can help patients to minimize treatment side effects, increase energy levels, and reduce stress, along with many other benefits. Inspire produced the educational webinar in partnership with the Bladder Cancer Advocacy Network, US TOO International, and ThyCa: Thyroid Cancer Survivors' Association.
A Slide show on the Principles of Management of Cancer by Surgery, having practiced this branch for almost 25 years ,I decided to crystalize this knowledge.
Breast Cancer Prevention with Physical Activity and ExerciseDarryl Edwards
How breast cancer can be prevented through physical activity and exercise.
Breast cancer is the most common cancer globally what can we do to help prevent it? What are the main risk factors? What are the roles of physical activity and exercise in breast cancer prevention?
View the full post at: https://www.primalplay.com/blog/the-benefits-of-physical-activity-for-breast-cancer-prevention
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
A Slide show on the Principles of Management of Cancer by Surgery, having practiced this branch for almost 25 years ,I decided to crystalize this knowledge.
Breast Cancer Prevention with Physical Activity and ExerciseDarryl Edwards
How breast cancer can be prevented through physical activity and exercise.
Breast cancer is the most common cancer globally what can we do to help prevent it? What are the main risk factors? What are the roles of physical activity and exercise in breast cancer prevention?
View the full post at: https://www.primalplay.com/blog/the-benefits-of-physical-activity-for-breast-cancer-prevention
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
I am doing physical excercise many times a week. New toys gives nice opportunities to collect excercise data beyond traditional excercise log. So I did six months deep dive to world of quantified self. With help of couple of Trackers I collected data and did cross analysis of the data sets. In this presentation you can find summary of the findings.
Ohio State's ASH Review 2017 - Myeloproliferative DisordersOSUCCC - James
Katherine Walsh, MD
Assistant Professor of Clinical Internal Medicine
The Ohio State University Comprehensive Cancer Center -
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Happiness, joy and peace are linked to exercise. The body is the connection between the mind and the soul. It is of paramount importance that we take care of our bodies. The more we exercise the easier it is for us to realize the purposes in our soul for which we were placed on this earth.
Movement and Healing: Learn and Experience the Benefits of Movement During GY...bkling
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!
Jeffrey A. Meyerhardt, MD, MPH
Associate Professor of Medicine, Harvard Medical School Active Medical Staff, Medical Oncology, Dana-Farber Cancer Institute - speaker for Tuesday Call-on Congress 2012
Systematic review and meta-analysis | Research process | Meta-analysis researchPubrica
According to the study, higher levels of physical activity are linked to a decreased risk of various health consequences, and the risk reduction increases as physical activity level increases. Based on these findings, the authors recommend that public health policies and interventions focus on promoting physical activity to reduce the risk of these diseases.
Read more @ https://pubrica.com/academy/meta-analysis/critical-review-of-meta-analysis-conducted-in-this-paper/
Visit us @ https://pubrica.com/services/research-services/systematic-review/
Cancer is not all about what we inherit-- it's also about what we eat, how much we move and even how we stay connected. This is good news! This talk reviews the evidence for how we can reduce our risk of cancer through simple lifestyle changes.
Plasma 25-Hydroxyvitamin D Concentration, VDR polymorphisms and their Interac...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Plasma 25-Hydroxyvitamin D Concentration, VDR polymorphisms and their Interaction are Associated with Survival in Colorectal Cancer Patients - Lina Zgaga
The International Classification of Functioning (ICF) Core Set for breast can...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
The International Classification of Functioning (ICF) Core Set for breast cancer – a prospective surveillance tool to identify rehabilitation needs - Marese Cooney
Developing a national strategy for research into cancer survivorship in the U...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Developing a national strategy for research into cancer survivorship in the UK - Dr Jim Elliott (UK NCRI)
Physical and psychological side-effects following prostate cancer treatments ...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Physical and psychological side-effects following prostate cancer treatments - Heather Kinnear
Cancer Survivorship: longer term issues and the role of primary care - Prof E...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Cancer Survivorship: longer term issues and the role of primary care - Prof Eila Watson (Oxford Brookes University).
Quality of Life of Head and Neck Cancer Survivors in Urban and Rural Ireland ...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Quality of Life of Head and Neck Cancer Survivors in Urban and Rural Ireland - Audrey Thomas
Markers of low socio-economic status and lack of social support are associate...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Alan O'Ceallachair, Linda Sharp, Eamonn O’Leary, Mairead Skally, Paul Hanly
Markers of low socio-economic status and lack of social support are associated with low health-related quality-of-life in colorectal cancer survivors
Developing a cancer survivorship research agenda - Prof Patricia GanzIrish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Developing a cancer survivorship research agenda: challenges & opportunities - Prof Patricia Ganz, UCLA Fielding School of Public Health
Professor Sir Michael Marmot's Charles Cully Lecture on health inequalities a...Irish Cancer Society
The Irish Cancer Society hosts the annual Charles Cully Lecture in memory of one of the Society's founding members. Professor Sir Michael Marmot, one of the world's leading international experts on health inequalities, was the recipient of the Charles Cully Medal and gave the 2013 lecture on health inequalities and cancer.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Physical Activity and Cancer, a review of innovative current research. Dr. Niamh Murphy, Waterford Institute of Technology
1. Physical Activity and Cancer-a
review of innovative current
research and future directions
Dr Niamh Murphy, Centre for Health Behaviour Research,
Department of Health Sport and Exercise Science, WIT, Waterford
Official Conference for the European Week Against Cancer 2013
AVIVA Stadium Dublin
29-30 May 2013
2. Purpose of workshop
• Examine the state of current knowledge on
physical activity and cancer prevention and
treatment
• What we know, what we still need to know
• What are the research and policy implications
for Ireland and the EU?
6. What are the PA guidelines for cancer
prevention (and post cancer)?
ACSM Consensus statement and American Cancer Society-same as Irish PA guidelines, i.e.
-a minimum of 150 minutes of moderate to vigorous PA per week or 75
minutes/week of vigorous exercise
-Strength training 2-3 times/week
• Avoid Inactivity!!!
• Return to normal daily activities as quickly as possible
• Continue normal daily activities and exercise as much as possible during and after non-surgical
treatments
There is a clear list of contraindications/special considerations
• ACSM/ACS Certification:Cancer Exercise Trainer
Most recently (2012), WCRF/AICR conducted a comprehensive review of current
evidence and recommended that adults aim to participate in at least 60 minutes
of moderate activity or 30 minutes or more of vigorous activity daily as a means of
reducing cancer risk.
7. Meeting PA guidelines??
In Ireland, 3 out of every 4 Irish adults DO NOT MEET the Department
of Health and Children’s National Physical Activity Guideline for
maintaining and improving their current and future health.
“Current national guidelines may not be sufficient for cancer
prevention, nor for weight management.”( Aparicio-Ting et al, 2012).
Amongst adults aged 35-65 years participating in the Tomorrow
Project (49% of those eligible) in Alberta, Canada an estimated 55% of
participants met CSEP guidelines, and 23% met WCRF/AICR guidelines,
respectively. Women are less likely to meet guidelines than men, and
being obese was correlated with not meeting guidelines (Aparicio-Ting
et al, 2012).
8. Physical activity in female
adolescents
Age (Years) % Males meeting
guidelines
% Females
meeting
guidelines
10-12 27 13
12-13 24 13
14-15 16 8
16-18 7 6
CSPPA Study, 2010: Table shows the % of primary and post-
primary boys and girls who meet national minimum physical
activity guidelines (Woods et al, 2010).
(National sample of 1275 primary and 4122 post primary students.
Measurement tool: physical activity questionnaire)
35% of primary pupils and 10% of post-primary
pupils received the Department of Education
and Skills recommended minimum minutes of
physical education per week.
9. What does the evidence tell us about
the link between physical activity and
cancer?
10. Mechanisms
• The evidence for a role of PA in cancer etiology is now
• considered to be fairly strong, consistent and biologically
plausible (Aparicio-Ting et al, 2012).
Includes an effect of activity on
• levels of body fat,
• insulin resistance,
• inflammation,
• metabolic and growth hormones,
• endogenous sex steroid hormones,
• immune function and
• oxidative stress.
11. What we know
• Since 1985….epidemiologic evidence has been
accumulating that physical activity reduces the
risk of developing cancer
• Since 2005… evidence that increased activity
levels can improve survival after cancer.
• The risk of colon, breast and endometrial cancers
is reduced by 25% to 30% in physically active
individuals, and evidence for a beneficial effect of
PA in reducing prostate, ovarian, lung and other
gastrointestinal cancers is emerging (Wolin et al,
2009; Cust, 2011; Monninkhof et al, 2007)
12. Physical activity is effective!-What we
know...
Breast cancer
• Engaging in moderate intensity PA reduces the risk of breast cancer by 15%.
• More is better-up to 28% reduction w 14 hours/ week PA (Lynch,Neilson and
Friedenreich, 2011).
• Most benefit for lean women. No effect of family history.
Breast cancer survivors
• Exercise is effective in treating many side effects in breast cancer survivors
(fatigue, lymphoedema, improved functional status and upper body range of
movement ; Speck et al, 2010)
Colon cancer
86 studies have been conducted worldwide.
• 72 of 86 studies found a positive effect for physical activity.
• Type, dose and timing. All types of activity equally effective. Sedentary behaviour
may increase the risk. Consistent effects across BMI groups-benefit equal for men
and women
Endometrial cancer
• Consistent evidence of relationship with physical activity. A 33% decrease in risk in
physically active individuals.
13. RCTs and impact on breast cancer
biomarkers
• Three year-long RCTs have been conducted to date.
ALPHA trial, PATH trial, SHAPE trial
• ALPHA trial (Alberta Physical Activity and Breast Cancer Prevention Trial)
• 220 postmenopausal women, year long prog, 5 days/week, 45
mins/session 93 supervised, 2 unsupervised). Excellent adherence to trial,
very little dropout. All inactive before trial. Statistically sig change in PA
levels from baseline to 12 months. Increased VO2max.
• Sig decrease in estradial,
• CT and DEXA scans to measure body fat-very strong effects on adiposity.
With increased adherence, body fat reductions were greater.
• Decreases in insulin and leptin.
Greatest changes in those who did most exercise.
• (Friedenrich 2012 )
14. The effects of physical activity on cancer have been examined in nine
meta-analyses, with three focusing on breast cancer and six on any type of
cancer.
• Fong et al. Physical activity for cancer survivors: meta-analysis of
randomised controlled trials BMJ 2012;344:e70
• 34 randomised controlled trials, of which 22 (65%) focused on patients
with breast cancer. Twenty two studies assessed aerobic exercise, and four
also included resistance or strength training. The median duration of
physical activity was 13 weeks (range 3-60 weeks). Most control groups
were considered sedentary or were assigned no exercise
• Physical activity has positive effects on physiology, body composition,
physical functions, psychological outcomes, and quality of life in patients
after treatment for breast cancer. When patients with cancer other than
breast cancer were also included, physical activity was associated with
reduced BMI and body weight, increased peak oxygen consumption and
peak power output, and improved quality of life.
15. Physical activity (PA) and health-related fitness
(HRF) are essential for the health of any
population but they appear to be particularly
important for breast cancer survivors.
22. What do we still need to know about
PA and cancer?
• the exact type, timing, dose of activity needed for optimal
cancer risk reduction and improved coping, rehabilitation,
quality of life and survival after cancer.
• further understand the underlying biologic mechanisms
involved in the association between physical activity and
cancer risk as well as survival.
• In breast cancer survivors studies are limited because none
were designed with a primary focus on PA or fitness and
there is a reliance on self-report measures with no
objective assessment. Studies don’t generally assess
lifetime PA and other important domains of PA (e.g.,
occupational), or sedentary behavior
23. AMBER Study-role of PA and fitness in treatment
completion, side effects, recovery, quality of life,disease
24. What is new about the AMBER study?
Examining the exact biologic mechanisms by which PA and fitness influence
breast cancer recurrence and survival
-Will recruit a total of 1500 breast cancer survivors (recruitment will take 5
years).
-Seven years of follow-up to 2022
-What are the independent and interactive associations of objective
measures of physical activity (at work, at home, and for recreation and
transportation), health-related fitness, and sedentary behaviour with....
- disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall
survival)
-treatment completion rates, symptoms and side effects (e.g., pain,
lymphedema, fatigue, neuropathy), quality of life,
-psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness), (
2) What are the determinants, mechanisms, and moderators of physical
activity and health-related fitness in breast cancer survivors?
25. Trial of Combined Aerobic and Resistance
Exercise in Breast Cancer Survivors (CARE)
Prospective, three-armed, randomized controlled trial conducted
in Edmonton, Ottawa, and Vancouver with breast cancer survivors receiving
chemotherapy. Completion date January 2014
• Combined aerobic and resistance exercise program (1,000 kcal/week; COMB)
• Standard moderate volume of aerobic exercise (500 kcal/week; STAN)
• High volume of aerobic exercise (1,000 kcal/week; HIGH)
All exercising 3 days/week
Outcome measures:
• Cardiorespiratory fitness (maximal treadmill test)
• muscular strength (8 repetition maximum tests)
• muscular endurance (standard load test at 50% of estimated baseline maximum)
• body composition (DEXA scans)
• psychological distress, sleep quality, exercise adherence, and chemotherapy
completion rates.
26. The Colon Health and Life-Long
Exercise Change (CHALLENGE) trial
• Courneya KS et al
• Just started-will take 3 years to recruit people.
• Colon cancer survivors (N=962) in Canada and
Australia randomly assigned to a 3 year
structured PA intervention (behavioral support
program and supervised PA sessions)or general
health education materials. The primary endpoint
is disease-free survival. Important secondary
endpoints include multiple patient-reported
outcomes, objective physical functioning, biologic
correlative markers, and an economic analysis.
27. Scotland: RCT
Mutrie et al (BMJ, 2007) and 5 year follow up(Mutrie et al, J
Cancer Surviv, 2012)
• 12 week supervised group exercise programme (2 supervised 45 min
exercise sessions/ week plus one home based session) during treatment
for early stage breast cancer, with six month follow-up.
• 203 women entered the study; 86% completion rate.
• Control group: usual care.
• Functional and psychological benefit after a 12 week intervention and six
months later.
• Did gains persist 18 and 60 months later?
• 44 % of women lost to follow up at 18 months and 58% at 60 months
• At 5 years, the intervention group achieved on average around 200 min of
activity each week more than the control group
• Irrespective of original group allocation, women who were more active
consistently reported lower levels of depression and increased quality of
life compared to those who were less active.
• Benefits may be caused by the exercise itself, by the group experience, or
by a combination of both.
28. Ireland...
15 week walking and resistance training programme with
48 breast cancer survivors in Dublin yielded positive results
(Grant, Murphy, Cotter and Vance, 2011)
“The next challenge for the Irish Cancer Society is to make the programme
available on a wide reaching basis across the country.”
Physical activity research? Opportunities to share today!
29. Policy implications
Elements of a successful
population-based
approach to physical activity
• High-level (political) commitment
• Resources / funding
• Integration in national policy
context and with other agendas in
related sectors
• Support from stakeholders
• Leadership and coordination
• Workforce; skilled, with capacity
30. Big gaps
• Surveillance
• Systematic, timely evaluation of programmes
• Co-ordination, sharing, non-duplication
• Changes in policy, changes to the environment, to
structures, to ways of working are less commonplace
than programmes, and are rarely evaluated
• Physical activity is everyone’s job-and no-one’s!
• Physical activity is the poor relation of nutrition
We need to focus on environments and policies and not
just on lots of (often) unconnected behaviour change
programmes
31. One e.g…Cancer prevention, and physical activity
involvement needs to begin in youth so...
It’s not OK for our schools to have...
• inadequate PE provision
• no indoor sports facilities
• large (unwalkable) distances from towns
• no footpaths or unsafe roads
• unhealthy food on offer
• overemphasis on competition and winning....
• overreliance on outside agency delivery of
programmes
..or for Government to fund sport
that is not accessible/affordable for all