Advertisement

Cancer Causes & Control

, 20:225 | Cite as

The impact of physical activity on all-cause mortality in men and women after a cancer diagnosis

  • Mark Hamer
  • Emmanuel Stamatakis
  • John M. Saxton
Original Paper

Abstract

Objective

Existing information regarding the impact of physical activity after a cancer diagnosis on all-cause mortality is limited. We examined the association between different types of physical activity (domestic, walking, sports) and mortality in 293 participants (65.5% women) with a cancer registration prior to the baseline assessment.

Methods

Participants were drawn from the Scottish Health Surveys (1995, 1998, 2003) that were linked to a national database of cancer registrations and deaths. The main outcome was all-cause mortality during a mean follow-up period of 5.9 ± 3.2 years. Cox proportional hazards models were used to estimate the risk of all-cause mortality by levels of physical activity.

Results

There were 78 deaths during follow-up. The lowest risks for all-cause mortality were seen in sports activity groups [multivariable-adjusted hazard ratio (HR) for any compared with groups of no sports: 0.47, 95% CI 0.23–0.96, p = 0.039] although light and moderate activity such as domestic activity (HR = 1.04, 0.60–1.80) and regular walking (HR = 0.95, 0.57–1.56) did not confer protection.

Conclusion

Participation in an average of more than three sessions of vigorous exercise per week for at least 20 min/session was associated with the lowest risks of all-cause mortality following a cancer diagnosis. Vigorous physical activity could therefore be a more important determinant of survival than duration or total volume of exercise in cancer survivors.

Keywords

Exercise Cancer Mortality Survival Epidemiology 

Notes

Acknowledgments

The authors received grant funding from the British Heart Foundation, UK (MH), and the National Institute for Health Research, UK (ES). The Scottish Health Survey is funded by the Scottish Executive. The views expressed in this article are those of the authors and not necessarily of the funding bodies. We declare that the funders played no role in the concept and design of the study, analysis or interpretation of data, or drafting and critical revision of the manuscript.

Contributors

All authors were responsible for the study concept and design, interpretation of data, and drafting and critical revision of the manuscript. ES was responsible for the acquisition of the data. Statistical analysis and preparation of the data was performed by MH and ES. All authors approved the final version of the article. MH is the guarantor.

References

  1. 1.
    Cancer Research UK. UK Cancer incidence statistics. http://info.cancerresearchuk.org/cancerstats. Accessed Feb 2008
  2. 2.
    Information Services Division. Cancer in Scotland (2007) NHS National Services Scotland. http://www.isdscotland.org/isd/5323.html. Accessed Feb 2008
  3. 3.
    Yancik R, Ries LA (2000) Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am 14:17–23. doi: 10.1016/S0889-8588(05)70275-6 PubMedCrossRefGoogle Scholar
  4. 4.
    Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G (2005) Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 23:3830–3842. doi: 10.1200/JCO.2005.02.148 PubMedCrossRefGoogle Scholar
  5. 5.
    Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 14:1588–1595. doi: 10.1158/1055-9965.EPI-04-0703 PubMedCrossRefGoogle Scholar
  6. 6.
    McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175:34–41. doi: 10.1503/cmaj.051073 PubMedGoogle Scholar
  7. 7.
    Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, McTiernan A, Rock CL, Thompson C, Gansler T, Andrews KS, The 2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 56:323–353PubMedCrossRefGoogle Scholar
  8. 8.
    Department of Health (2004) At least five a week: evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical OfficerGoogle Scholar
  9. 9.
    Holmes MD, Chen WY, Feskanich D et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486. doi: 10.1001/jama.293.20.2479 PubMedCrossRefGoogle Scholar
  10. 10.
    Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ, Baron JA, Egan KM, Willett WC (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386. doi: 10.1158/1055-9965.EPI-07-0771 PubMedCrossRefGoogle Scholar
  11. 11.
    Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541. doi: 10.1200/JCO.2006.06.0863 PubMedCrossRefGoogle Scholar
  12. 12.
    Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534. doi: 10.1200/JCO.2006.06.0855 PubMedCrossRefGoogle Scholar
  13. 13.
    Haydon AM, Macinnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55:62–67. doi: 10.1136/gut.2005.068189 PubMedCrossRefGoogle Scholar
  14. 14.
    The Scottish Government Statistics. Scottish Health Survey Publications. http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-healthsurvey/Publications. Accessed Nov 2007
  15. 15.
    Giovannucci EL, Liu Y, Leitzmann MF, Stampfer MJ, Willett WC (2005) A prospective study of physical activity and incident and fatal prostate cancer. Arch Intern Med 165:1005–1010. doi: 10.1001/archinte.165.9.1005 PubMedCrossRefGoogle Scholar
  16. 16.
    Patel AV, Rodriguez C, Jacobs EJ, Solomon L, Thun MJ, Calle EE (2005) Recreational physical activity and risk of prostate cancer in a large cohort of U.S. men. Cancer Epidemiol Biomarkers Prev 14:275–279. doi: 10.1158/1055-9965.EPI-04-0583 PubMedCrossRefGoogle Scholar
  17. 17.
    Campbell KL, McTiernan A (2007) Exercise and biomarkers for cancer prevention studies. J Nutr 137:161S–169SPubMedGoogle Scholar
  18. 18.
    Saxton JM (2006) Diet, physical activity and energy balance and their impact on breast and prostate cancers. Nutr Res Rev 19:197–215. doi: 10.1017/S095442240720294X PubMedCrossRefGoogle Scholar
  19. 19.
    Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain and survival after breast cancer. J Clin Oncol 23:1370–1378. doi: 10.1200/JCO.2005.01.079 PubMedCrossRefGoogle Scholar
  20. 20.
    Bastarrachea J, Hortobagyi GN, Smith TL, Kau SW, Buzdar AU (1994) Obesity as an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer. Ann Intern Med 120:18–25PubMedGoogle Scholar
  21. 21.
    Obermair A, Kurz C, Hanzal E et al (1995) The influence of obesity on the disease-free survival in primary breast cancer. Anticancer Res 15:2265–2269PubMedGoogle Scholar
  22. 22.
    Bassett WW, Cooperberg MR, Sadetsky N, Silva S, DuChane J, Pasta DJ, Chan JM, Anast JW, Carroll PR, Kane CJ (2005) Impact of obesity on prostate cancer recurrence after radical prostatectomy: data from CaPSURE. Urology 66:1060–1065. doi: 10.1016/j.urology.2005.05.040 PubMedCrossRefGoogle Scholar
  23. 23.
    McTiernan A, Rajan KB, Tworoger SS, Irwin M, Bernstein L, Baumgartner R, Gilliland F, Stanczyk FZ, Yasui Y, Ballard-Barbash R (2003) Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 21:1961–1966. doi: 10.1200/JCO.2003.07.057 PubMedCrossRefGoogle Scholar
  24. 24.
    Visser A, Bouter LM, McQuillan GM, Wener MH, Harris TB (1999) Elevated C-reactive protein levels in overweight and obese adults. JAMA 282:2131–2135. doi: 10.1001/jama.282.22.2131 PubMedCrossRefGoogle Scholar
  25. 25.
    Hamer M (2007) The relative influences of fitness and fatness on inflammatory factors. Prev Med 44:3–11. doi: 10.1016/j.ypmed.2006.09.005 PubMedCrossRefGoogle Scholar
  26. 26.
    Manson JE, Greenland P, LaCroix AZ, Stefanick ML, Mouton CP, Oberman A, Perri MG, Sheps DS, Pettinger MB, Siscovick DS (2002) Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 347:716–725. doi: 10.1056/NEJMoa021067 PubMedCrossRefGoogle Scholar
  27. 27.
    Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB (2002) Exercise type and intensity in relation to coronary heart disease in men. JAMA 288:1994–2000. doi: 10.1001/jama.288.16.1994 PubMedCrossRefGoogle Scholar
  28. 28.
    Tsai HK, D’Amico AV, Sadetsky N, Chen MH, Carroll PR (2007) Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 99:1516–1524. doi: 10.1093/jnci/djm168 PubMedCrossRefGoogle Scholar
  29. 29.
    Hutnick NA, Williams NI, Kraemer WJ, Orsega-Smith E, Dixon RH, Bleznak AD, Mastro AM (2005) Exercise and lymphocyte activation following chemotherapy for breast cancer. Med Sci Sports Exerc 37:1827–1835. doi: 10.1249/01.mss.0000175857.84936.1a PubMedCrossRefGoogle Scholar
  30. 30.
    Meijer EP, Goris AH, van Dongen JL, Bast A, Westerterp KR (2002) Exercise-induced oxidative stress in older adults as a function of habitual activity level. J Am Geriatr Soc 50:349–353. doi: 10.1046/j.1532-5415.2002.50069.x PubMedCrossRefGoogle Scholar
  31. 31.
    Campbell KL, McTiernan A, Li SS, Sorensen BE, Yasui Y, Lampe JW, King IB, Ulrich CM, Rudolph RE, Irwin ML, Surawicz C, Ayub K, Potter JD, Lampe PD (2007) Effect of a 12-month exercise intervention on the apoptotic regulating proteins Bax and Bcl-2 in colon crypts: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev 16:1767–1774. doi: 10.1158/1055-9965.EPI-07-0291 PubMedCrossRefGoogle Scholar
  32. 32.
    Leung PS, Aronson WJ, Ngo TH, Golding LA, Barnard RJ (2004) Exercise alters the IGF axis in vivo and increases p53 protein in prostate tumor cells in vitro. J Appl Physiol 96:450–454. doi: 10.1152/japplphysiol.00871.2003 PubMedCrossRefGoogle Scholar
  33. 33.
    McTiernan A (2008) Mechanisms linking physical activity with cancer. Nat Rev Cancer 8:205–211. doi: 10.1038/nrc2325 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Mark Hamer
    • 1
  • Emmanuel Stamatakis
    • 1
  • John M. Saxton
    • 2
  1. 1.Department of Epidemiology and Public HealthUniversity College LondonLondonUK
  2. 2.Centre for Sport and Exercise ScienceSheffield Hallam UniversitySheffieldUK

Personalised recommendations