Moderate, vigorous physical activity improves OS for patients with 10 cancer types
Key takeaways:
- Engaging in recommended amounts of physical activity after a cancer diagnosis was linked to lower mortality risk for survivors of 10 cancer types.
- Any amount of activity appeared related to longer survival.
Participating in moderate to vigorous physical activity after a cancer diagnosis appeared to improve survival for patients with specific cancer types, according to research published in Journal of the National Cancer Institute.
Cancer types included bladder, breast, colon, endometrial, kidney, lung, oral, prostate, rectal and respiratory, findings showed.
“Prior research has shown that physical activity is linked to a lower risk of developing at least seven types of cancer, but it is unclear if physical activity after a cancer diagnosis is related to better survival,” Erika Rees-Punia, PhD, MPH, FACSM, senior principal scientist at the American Cancer Society, told Healio. “We wanted to understand if being active after a cancer diagnosis might be linked to survival.”
Rees-Punia and colleagues pooled data from six U.S.-based cohort studies that included 90,844 cancer survivors (mean age at diagnosis, 67 years; 55% women). The population included survivors of all cancer types combined and survivors of individual cancer types, including bladder, endometrial, kidney, lung, oral cavity, other respiratory, ovarian, breast, colon, rectal and prostate cancers.
Participants in the studies regularly self-reported recreational exercise or leisure-time physical activity for at least 1 year after cancer diagnosis.
The researchers classified leisure-time activities as moderate (3-5.9 metabolic equivalent [MET] hours/week) or vigorous ( 6 MET hours/week) intensity to calculate total volume of moderate to vigorous intensity physical activity (MVPA).
At mean follow-up of 10.9 years, 45,477 participants had died.
Two-thirds (66%) of participants reported having met or exceeding MVPA guidelines, most of whom were men and former smokers.
Inactive participants were older at diagnosis and more likely to be current smokers, have a higher BMI and be diagnosed with advanced stage disease. They also were closer to their diagnosis at the time of self-reporting.
Results showed that engaging in recommended MVPA (7.5-14.9 MET hours/week) vs. no MVPA appeared associated with improved OS for survivors of 10 specific cancer types, including oral (HR = 0.44; 95% CI, 0.27-0.73), endometrial (HR = 0.5; 95% CI, 0.34-0.76), lung (HR = 0.51; 95% CI, 0.38-0.68), rectal (HR = 0.51; 95% CI, 0.36-0.71), respiratory (HR = 0.51; 95% CI, 0.29-0.72), bladder (HR = 0.53; 95% CI, 0.4-0.72), kidney (HR = 0.53; 95% CI, 0.37-0.77), prostate (HR = 0.6; 95% CI, 0.49-0.74), colon (HR = 0.61; 95% CI, 0.5-0.76) or breast (HR = 0.67; 95% CI, 0.55-0.81) cancers.
The researchers also found that for all cancer survivors combined engaging in up to 7.5 MET-hours per week compared with no MVPA appeared associated with reduced risk for mortality (HR = 0.71; 95% CI, 0.66-0.76). Additional benefit was observed among those engaging in the recommended amount (7.5-14.9 MET-hours/week; HR = 0.58; 95% CI, 0.53-0.63).
Notably, the observed inverse associations between MVPA and mortality remained for eight of the 10 cancer types after excluding patients who died within 2 years of follow-up.
“This evidence for improved survival associated with physical activity behaviors postdiagnosis may be empowering for people living with and beyond cancer, and may motivate clinicians to better equip themselves to promote physical activity to cancer patients,” Rees-Punia said. “Meeting aerobic physical activity guidelines — 150 to 300 minutes per week of moderate intensity exercise or 75 to 150 minutes per week of vigorous intensity exercise, or some equivalent combination of moderate and vigorous exercise — is ideal.
“However, doing some exercise after a cancer diagnosis is better than doing none,” she added.
The researchers acknowledged study limitations, including relying on self-reported physical activity data and the potential for immortal time bias due to delay from cancer diagnosis to assessment of MVPA.
“Our ongoing work is evaluating relationships between postdiagnosis physical activity with cause-specific mortality — for example, cancer mortality and cardiovascular disease mortality — in participants with a history of cancer by type,” Rees-Punia told Healio. “We are also working to describe prediagnostic to postdiagnostic physical activity patterns that may be associated with better survival.”
For more information:
Erika Rees-Punia, PhD, MPH, FACSM, can be reached at erika.rees-punia@cancer.org.
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