Scanxiety. But also, research about exercise | Dec 2 2023

T-minus 14 days until the quarterly glow-in-the-dark refresher and that dang cancer dread scrabbles like mice at the back of my mind. Each cough in the chilly fall air, each feeling of tiredness is a sign that the cancer in my lungs is recurring, and, certainly, a momentary stumble over my own feet indicates there’s a tumor growing in my brain. And what is there to do? Nothing, really, except note it, recall the pace of research and feel a measure of confidence that other treatment lines exist, meditate, and focus on something I enjoy.

That’s why I want to tell you about an article a wonderful blog reader shared with me: Exercise is the prescription that every cancer patient deserves – and one they’re in control of. In it, the author, an Australian oncologist, discusses the findings of a recent study, Pan-cancer analysis of postdiagnosis exercise and mortality. That report is behind a paywall, so I spent time on a companion piece in the Journal of Clinical Oncology, Meeting exercise recommendations is beneficial for cancer survivors. 

The study analyzed surveys of about 12,000 participants who did moderate-intensity exercise 4 or more days per week for an average of 30 minutes or more, and/or strenuous exercise 2 or more days per week, averaging 20+ minutes. (This amount of exercise is roughly what the 2018 Physical Activity Guidelines for Americans [PAGA] recommends.)

Here are the top points I walk away with.

1. Increasingly, exercise is seen as an important part of cancer treatment and recovery. In Meeting exercise recommendations…, authors Kenfield & Chan write, “The latest American Cancer Society guidelines recommend that physical activity assessment and counseling begin as soon as possible after diagnosis [italics in original]….” Both the American College of Sports Medicine and ASCO (American Society of Clinical Oncology) echo this advice.
2. “Meeting vs. not meeting the guidelines was associated with a 25% reduced risk of… mortality for cancer survivors.” 
3. The more exercise a survivor did, the more significant the reduction of their mortality risk.
4. In head and neck cancers, and renal cancers, exercise had an even more significant reduction of cancer-specific mortality.

It’s gobsmacking news.

This says to me that exercise must be part of any patient’s treatment plan.

Given how long it takes to receive results of genomic testing of lung tissue (and probably any other, but I only know about lungs), exercise assessment and planning could slide right into the time when the patient’s fretting about having to wait so damned long to get treatment started. With an exercise prescription in hand, a patient could immediately feel a semblance of control in a world that’s been ripped out of its orbit.

Look, we’re not talking about running marathons here (or riding to Multnomah Falls either.) PAGA’s key guidelines for adults are as follows:

• Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
• For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week.
• Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
• Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.
• When older adults or adults with chronic conditions or disabilities are not able to meet the above key guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity.

It’s good to have these recommendations in writing. It’s better to review them periodically and make adjustments. I’ll be honest, since the outside air has gotten too chilly for my lungs and I’m back on the indoor bike, I’m meeting only the minimum recommendations for cardio, and I’m not doing any strength work. Obvs, it’s the right time to make a new plan of action for the next couple of months.

Because, come June, DH and I are heading off to a boat-bicycling adventure on the Danube River. In addition to the mileage, the first day of riding involves <gulp> 2300 feet of elevation gain.

See? I’ve told you about such interesting stuff that the thought of scans is far away.

And in case all this talk of exercise is making you uncomfortable, here’s a tidbit from a recent Hidden Brain newsletter.

Happy happy, joy joy. If an apple a day keeps the doctor away, what does a daily moment of joy do for your health? New research from the Greater Good Science Center at the University of California, Berkeley found that people who engage in daily “micro-acts” of joy are 25 percent happier over the course of a week. In what researchers are calling the BIG JOY project, study volunteers took surveys about their emotions, stress levels and social habits. Then, for a week, they committed to daily “micro-acts” of joy, such as meditation, gratitude lists, and random acts of kindness. Not only were people happier after the week-long intervention, but some volunteers felt they had stronger relationships. They also felt more in control of their happiness. “We’re really excited,” said Emiliana Simon-Thomas, science director of the Greater Good Science Center. “What we’re really focused on is understanding impact and the potential for change in people’s lives.”

Thanks for reading. Here’s hoping you aren’t sick of the relentless positivity that’s overtaken these recent posts and that you are resting in a small pocket of joy.