University of Washington Schools of Public Health and Medicine
Fred Hutchinson Cancer Research Center
Presentation Abstract
Exercise Before and During Cancer Treatment
The 2018 U.S. Physical Activity Guidelines Advisory Committee found moderate-grade evidence of associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with risk reductions ranging from 38 to 48 percent. However, these studies did not control for confounding effects of treatments received, and included studies of patients regardless of timing of exercise after diagnosis. Most research on prognosis outcomes has focused on individuals who have completed primary therapy, but there is increasing interest in understanding the effects of exercise during treatment, or in the time period between diagnosis and onset of therapy (“prehab”). Such research has focused on short-term health effects such as physical functioning, cardiorespiratory fitness, fatigue, primary treatment adherence, and quality of life. Much of this research has used randomized controlled trials of short duration (typically 8-12 weeks), with the intervention consisting of an aerobic exercise program. Most studies focused on the most common cancer types—breast, prostate, or colorectal cancer. Typically, the interventions were center-based, individualized exercise prescriptions based on current fitness level. Gaps in research include: optimal mode, frequency, and intensity of exercise; need for exercise specialist guidance; effects of exercise in diverse race/ethnic populations, in specific age groups; in children and young adults; in patients with treatment-related side effects that hinder exercise ability; and in the social, financial, and personal constraints faced by patients under treatment that affect opportunities to exercise. This talk will present an overview of the state of research on health effects of exercise before and during cancer treatment, including types of exercise, cancer sites, particular populations, and groups for whom risk of adverse effects of exercise during therapy may be increased.
About Dr. McTiernan
Anne McTiernan, M.D., Ph.D., is a Professor at the Fred Hutchinson Cancer Center and a Research Professor at University of Washington Schools of Medicine (Gerontology & Geriatric Medicine) and Public Health (Epidemiology) in Seattle. Dr. McTiernan’s research focuses on identifying ways to prevent new or recurrent cancer with physical activity, obesity prevention and treatment, and chemoprevention. She is the Principal Investigator (PI) of several clinical trials and cohort studies investigating the effects of exercise, diet, weight, hormones, and chemoprevention agents on cancer incidence and prognosis. She was the PI of the National Cancer Institute (NCI)-funded (U54) Seattle Transdisciplinary Research on Energetics and Cancer program that investigated obesity prevention and mechanisms linking overweight, obesity, and sedentary lifestyles with cancer. She is a Breast Cancer Research Foundation grantee, and has received funding from the National Institutes of Health, NCI, Komen, and other government agencies and foundations.
Dr. McTiernan is an elected Fellow in the American College of Sports Medicine, the Obesity Society, and the American College of Epidemiology. She has published more than 400 scientific manuscripts in major medical journals and is lead author of the book, “Breast Fitness” (St. Martin’s Press, 2000). She is editor of two academic texts: “Cancer Prevention and Management through Exercise and Weight Control” (CRC Press LLC, 2005) and “Physical Activity, Dietary Calorie Restriction, and Cancer” (Springer, 2010). She has served on national and international health advisory boards and working groups including the International Agency for Research on Cancer, the American Cancer Society, the U.S. Department of Health & Human Services Physical Activity Guidelines Advisory Committee, the World Cancer Research Foundation, and the Susan G. Komen for the Cure Scientific Advisory Council.
Dr. McTiernan authored two memoirs: “Starved: A Nutrition Doctor’s Journey from Empty to Full” (Central Recovery Press, 2016) and “Cured: A Doctor’s Journey from Panic to Peace” (Central Recovery Press, 2020).
Dr. McTiernan disclosed the following conflicts of interest for this workshop: Benesol stock options (UVB light technology to produce vitamin D); World Cancer Research Fund Continuous Update Project Advisory Panel.