Physical Activity – Frantic Shanti

Exercise Trumps Genes for Longevity

By now I’m probably sounding like a broken record about how important exercise is to all aspects of your life, but here I go again…

Although this is not specifically about cancer, an article recently published in the Journal of Aging and Physical Activity (Posis et al., 2022) scored another point for the benefits of maintaining an active lifestyle.

This study was conducted at the Herbert Wertheim School of Public Health and Human Longevity Science (University of California, San Diego), where the researchers examined the effect of physical activity/sedentary time on longevity in women. The 5400+ study participants spanned the entire range of genetic predispositions for longer or shorter lives. You can read a synopsis of the research here.

The results of this prospective study (2012-2020), while not surprising in the grand scheme of things, can be considered a wake-up call.

Regardless of their genetic predisposition, women who engaged in higher levels of activity had a lower mortality risk and those who were more sedentary had a higher risk. This is important, because it’s tempting to think that if your family members are long-lived, you will be too. However, your own activity levels do matter.

In addition, being physically active was effective in extending the lifespans even of those women whose genetics suggested a shorter life.

This can be considered promising news: you do have some control over your lifespan. Even when you’ve been dealt what may seem like a losing hand in terms of longevity or disease, providing your body with the supportive behaviors that it needs and deserves still makes things better.

It’s easy to forget this when we focus on the negatives in life. And while we do need to acknowledge our hardships and allow ourselves time to grieve for our losses, making choices that benefit our bodies and minds is a sign of respect for ourselves.

So go ahead, soak those tootsies…then get back outside for a walk. And don’t stop.

Unlike a glass of wine or a rich dessert, commonly considered an “indulgence”, self-care in the form of moving ourselves, step by step, day by day, closer to a healthier lifestyle is the kindest, most loving indulgent act you can ever do for yourself.

What one little thing can you do today that you didn’t offer to yourself yesterday that will move the needle further towards a more active life?

~~~~~~~~~~~~~~~~~~~~~~

References:

“Physical Activity May Have a Stronger Role than Genes in Longevity” by Yadira Galindo, UC San Diego News Center, August 24, 2022, https://ucsdnews.ucsd.edu/pressrelease/physical-activity-may-have-a-stronger-role-than-genes-in-longevity.

Posis et al., (2022) Associations of Accelerometer-Measured Physical Activity and Sedentary Time With All-Cause Mortality by Genetic Predisposition for Longevity, J Aging Phys Act, https://doi.org/10.1123/japa.2022-0067.

The Benefits of Physical Activity During Cancer Treatment and How to Begin

While this isn’t exclusively an exercise blog, if you’ve perused my posts you’ve probably noticed that I’m a huge proponent of exercise for both cancer patients and survivors (well, actually for everyone; but see my important message at the bottom of this post).

The best way to achieve this is to start exercising right now, if you are not yet, no matter what stage of the cancer experience you’re in.

There is a growing body of research that shows the benefits of exercise for cancer folk (I’ve written about it here). But the fact is that only about 17-37% of cancer survivors meet the minimum physical activity guidelines set out by the American Cancer Society (Hirschey et al., 2017, Cancer Nurs) even though doing so reduces the risk of cancer recurrence by 55%, not to mention the improvement in quality of life (Cannioto et al., 2021, J Natl Cancer Inst).

Exercise, the Cancer Fighter. In the not too distant future, your oncologist might hand you an exercise prescription as part of your cancer treatment.

Now, there is a call to include exercise as an adjuvant therapy for cancer for those who are currently undergoing chemotherapy. During the Oncology session of the 7th International Congress of the Spanish Society of Precision Health (SESAP) that took place in Spring 2022, Adrián Castillo García, a researcher at the Barcelona Biomedical Research Institute (IIBB) of the Spanish National Research Council (CSIC), reviewed recent studies regarding the benefits of exercise during cancer treatment, including the potential role that it had in “modulating the tumor microenvironment and immune function.”

You can read a synopsis of his statements here in the section entitled “Exercise as Oncological Therapy” (starting towards the bottom of page 2). Castillo states that physical exercise “has been shown to have the ability to modulate the tumor environment… . This modulating effect translates into an improvement in the efficacy of chemotherapy and other oncological treatments.”

Castillo goes on to say that “prescribing doses of physical activity at an established intensity and volume can be very decisive in combating the tumor microenvironment, but this preliminary evidence must be confirmed in trials on humans to ratify the role of exercise as a treatment capable of improving the efficacy of the main therapies.” (All quotes from the aforementioned synopsis.)

With such promising results, it’s quite possible that future cancer treatments may be a combination of medicine and physical activity.

Ok, so say that you are not an avid exerciser, but motivated by these studies you’re willing to give regular exercise a go. What do you do when you’re already feeling fatigued from treatments?

I wrote about this here, but in a nutshell, the idea is that you need to decide what the right starting point is for you, and this will depend on your previous experiences, both physical and emotional, with a physical activity program. It will also depend on what you can manage at any given time in your treatment.

Starting an exercise program? Make it something that you can do and enjoy, and it will become a life-long habit.

Ask yourself, “what is reasonable for me?” But don’t respond to that with a t-shirt slogan-type answer (“Exercise? I thought you said extra fries?!?”) that immediately shuts down the idea. Admittedly, there may be times during treatment that getting yourself to the toilet without help is a momumental achievement. But that will pass. And exercise will make you feel more in control of your health and better overall.

IMPORTANT: Find what you can do and then do it as consistently as you can.

This may mean starting very simply [always get your doctor’s okay first!]. Choose an activity, duration and frequency, say, brisk walking for 20 minutes a day, three days a week. Follow that pattern for two weeks, then add to it–perhaps another 10 minutes–not to overwhelm yourself, but simply to push the edge a bit (you can always ease off if you need to, give it a week and increase again). If possible, increase some aspect of your program every couple of weeks, as it suits your condition. In the example of walking, incorporate a flight of stairs and gradual upper body movements: first pumping the arms, then hand weights, eventually strength training for both upper and lower body.

The timing is up to you.

If a walking program feels too easy for you, train at a higher level, but remember that the same concepts still apply: (1) consistency, (2) progression, (3) balance in your activities. If you’re interested, read my post about my three “pillars” of fitness.

Most importantly, start, progress gradually and keep it up for the rest of your life.

If your starting point is a standstill, this will take patience. But I PROMISE you, no matter what you can muster, it will still be better than doing nothing.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

I know I already said this, but it bears repeating, especially for cancer patients and survivors: do not start any exercise program without consulting with your medical team first. While I feel that improving your physical fitness is one of the best things you can do for yourself, every body is different and every cancer situation is different. Talk to your doctor and let them know what you’re planning to do.

Making Mondays Bearable

As 2022 approaches and we face the prospect of having another twelve months speed by us again, I’ve found it useful to sit down and take stock of where I was last January, what changed over the past year, and with what attitude I will enter into the next 12 months.

One thing that has caused a great deal of anxiety for me has been work, even with having one of the greatest bosses in the world and a flexible work situation.

My work situation is quite positive, but anxiety has left me with emotional claustrophobia.

Why? Because my job has also been associated with some of the most wrenching anxiety that I have ever experienced, including being diagnosed with cancer.

What’s resulted is that even in a supportive and stimulating environment (although not my passion, admittedly), I’ve felt trapped, like an animal trying to scratch my way out of my cage.

This past year, I came up with a tactic to at least partially relieve this feeling.

Now, I actually look forward to Mondays, because I’ve set up a beautiful association for the first day of the workweek with something very indulgent.

First, I work from home on Monday. This softens the dread that I’ve historically felt on Sunday nights, knowing that the weekend is over. The transition to the office is gentler.

Second, with some changes in my kids’ school schedules (one in college living at home and the other in high school), I start my workday an hour later. This has given the entire family reprieve from the stress of waking very early and starting the week sleep-deprived.

It also gives me to time to enjoy a cup or two of decaf in the morning.

Third, when the rest of the family leaves for school and work, I have 45 minutes before my own workday starts. I set up my rower for a 30-minute row, facing the tv/computer monitor in the living room…

Great exercise + fun videos = an amazing start to Monday!

…and put on a half-hour YouTube video of something I really enjoy that I might not have time to watch otherwise. For me now? It’s an episode of “BuzzFeed Unsolved–Supernatural”. Pure 100% indulgent entertainment.

Because it’s a timed row, when the 30 minutes are over, I stop. No pressure to hit a certain speed or distance. No matter what, it ends up being a decent workout because I enjoy the exercise.

That leaves 15 minutes before I start work. Chemo left me with short hair that allows for a five-minute shower.

By the time my workday begins, I am completely refreshed and the day’s workout is done. I feel like I’ve been given a huge treat–almost like I’m cheating, but I know I’m not. That 30 minutes of physical activity tied with watching a fun video re-sets my attitude and I’m ready to take on the week.

I love Mondays!

~~~~~~~~~~~~~~~~~

Can you create your own positive association with the toughest day of the week or anything else that causes you grief?

Working Out the Brain Fog

So if you needed yet another reason to exercise before, during and after your breast cancer treatments, I’ve got one for you.

A recent study in the Journal of Clinical Oncology (Salerno et al., 2021) found that early stage (I-III) breast cancer patients who were meeting the US minimum physical activity guidelines both before and during their chemotherapy displayed better cognitive function then did those patients who did not, and the effects were apparent both at the time of chemo and also six months after its completion.

Cognitive impairment is a relatively common complaint of breast cancer survivors–and can be improved with exercise.

This follows along the lines of other things we already know about exercise and cancer, such as increased survival rates and reduced rates of recurrence. It’s not a big stretch to say that exercise (and for the purposes of this post, I’m referring to the US national guidelines) is possibly one of the best things you can do for yourself, whether you are already a cancer patient or don’t want to become one (again).

What are these guidelines?

It’s suggested that adults do (1) at least 150-300 minutes per week of moderate-intensity or 75-150 minutes per week of vigorous-intensity aerobic physical activity, or some combination of the two intensities, the more the better; and (2) strength training activity involving all the major muscle groups at least two days a week at moderate or greater intensity (see specifics at Physical Activity Guidelines for Americans, 2nd edition).

Notably, similar guidelines hold across age groups and health conditions, with some modifications, although what exactly constitutes moderate to high intensity for different people will vary according to their conditioning and abilities. Take home message: If you can’t meet the guidelines, do what you can. It will still benefit you. The worst thing you can do is nothing.

The benefits of exercise for cancer survivors have been well-documented.

While there’s been a considerable amount of research done on the benefits of exercise as a whole, we’re only now beginning to focus on cancer patients and survivors as the test subjects. And new research is being conducted on different aspects of exercise to learn what effects they might have on cognition.

I’m going to be watching for the results of two clinical studies regarding exercise and cognition of cancer survivors. Both are currently recruiting participants.

The first, being conducted by the University of California, San Diego, is entitled “I Can! Improving Cognition After Cancer” and will be a randomized trial that examines whether physical activity improves cognitive function. You can read about it here: A randomized trial of physical activity for cognitive functioning in breast cancer survivors: Rationale and study design of I Can! Improving Cognition After Cancer, funded by the National Cancer Institute. Want to learn more? Go to https://clinicaltrials.gov/ct2/show/NCT04049695.

The second, conducted by the University of Pittsburgh and entitled, “Aerobic Exercise in Improving Cognitive Function in Patients with Stage 0-IIIA Breast Cancer”, will explore the effects of aerobic exercise specifically and will involve neuroimaging and the examination of pro-inflammatory biomarkers. You can read about it here: https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCT02793921&r=1. Again this is funded by the National Cancer Institute. Interested in learning more? Go to https://clinicaltrials.gov/ct2/show/NCT02793921.

If you’re not exercising yet, the important thing is not what physical activity to choose, it’s to make the decision to begin.

If you have any interest in participating in either of these studies, contact info for the research project is available above in the posted clinical trial links.

So you might be thinking, “I can barely deal with the diagnosis…and you want me to EXERCISE???” I promise you, physical movement will only make you feel better. However, if you don’t have an established exercise routine and don’t particularly enjoy the experience, consider what you can manage.

We’re not talking about training for a marathon or a powerlifting competition. But if you can do something, ANYTHING, you will still see greater improvements in your cognition–and quite frankly, many other aspects of your physical and mental state–than if you hadn’t done any activity at all.

It is worth it and you are worth it. So lace up your shoes and give it a go.