PHYSICAL ACTIVITY AND CANCERLINDA BAULDOCTOBER 8TH 2015

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Outline

• PHYSICAL INACTIVITY AND CANCER• EFFECTS OF ACTIVITY ON CANCER RISK• PHYSICAL ACTIVITY FOR CANCER PATIENTS• WHAT NEXT?

PHYSICAL INACTIVITY

AND CANCER

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Physical inactivity versus sedentary behaviour

• PHYSICAL INACTIVITY MEANS A LACK OF PHYSICAL ACTIVITY• SEDENTARY BEHAVIOUR IS TIME SPENT LYING OR SITTING

DOWN (E.G. AT HOME, AT WORK, WHEN COMMUTING)• SOMEONE WHO IS SEDENTARY (E.G. AT WORK) MAY STILL BE

PHYSICALLY ACTIVE IN THEIR SPARE TIME• THIS MAKES THESE CONCEPTS DIFFICULT TO DISENTANGLE IN

RESEARCH STUDIES

• PHYSICAL INACTIVITY AND SEDENTARY BEHAVIOUR ARE NOT THE SAME, ALTHOUGH BOTH IMPACT ON HEALTH

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Physical inactivity is linked to cancer

• APPROXIMATELY 1% OF ALL CANCERS IN THE UK EACH YEAR ARE DIRECTLY LINKED TO PHYSICAL INACTIVITY

• 3% of bowel cancers• 4% of womb cancers• 3% of breast cancers

• IT ALSO LEADS TO A GREATER RISK OF BEING OVERWEIGHT OR OBESE, WHICH IS IN TURN LINKED TO UP TO TEN TYPES OF CANCER

Parkin D M, 2011. Cancers attributable to consumption of alcohol in the UK in 2010. British Journal of Cancer: 105(S2); S14-S18. Cancer Research UK 2015 http://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/preventable-cancers#heading-Ten

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1,700

1,400

300

Cancer Research UK 2014

Physical inactivity is directly linked to approx. 3,400 cancers per year in the UK

EFFECTS OF ACTIVITY ON CANCER RISK

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Physical activity prevents cancer

• KEEPING PHYSICALLY ACTIVE HELPS PREVENT CANCERS LINKED TO INACTIVITY

• PREVENTION IS DUE TO ACTIVE REDUCTION IN RISK

• THIS REDUCTION IS INDEPENDENT FROM EFFECTS ON FITNESS OR WEIGHT THAT COULD CONFER ADDITIONAL BENEFITS

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Mechanisms behind cancer risk reduction

• PHYSICAL ACTIVITY SUPPORTS THE MOVEMENT OF FOOD THROUGH THE BOWEL AND REDUCES INFLAMMATION IN THE BOWEL, REDUCING THE RISK OF BOWEL CANCER

• PHYSICAL ACTIVITY REDUCES LEVELS OF HORMONES (INCL. OESTROGEN AND INSULIN) THAT ARE LINKED TO A RANGE OF CANCERS

• REGULAR PHYSICAL ACTIVITY CAN ALSO HELP TO REACH AND MAINTAIN A HEALTHY WEIGHT, WHICH HAS AN INDIRECT EFFECT ON SEVERAL CANCERS LINKED TO OBESITY

WCRF and AICR. Food, nutrition, physical activity and the prevention of cancer: A global perspective. 2007, Washington: American Institute for Cancer ResearchIARC, Weight Control and Physical Activity. IARC Handbooks of Cancer Prevention, ed. H. Vainio and F. Bianchini. Vol. 6. 2002, Lyon: IARC

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How big is the effect on cancer risk?

• PEOPLE WHO DO THE MOST PHYSICAL ACTIVITY CAN CUT THEIR BOWEL CANCER RISK BY UP TO A QUARTER

• FOR EVERY TWO HOURS/WEEK OF MODERATE TO VIGOROUS EXERCISE, A WOMAN REDUCES HER BREAST CANCER RISK BY 5%

• BEING PHYSICALLY ACTIVE CAN REDUCE A WOMAN’S RISK OF ENDOMETRIAL CANCER BY UP TO 30%

Robsahm, T.E., et al. Body mass index, physical activity, and colorectal cancer by anatomical subsites: a systematic review and meta-analysis of cohort studies. Eur J Cancer Prev, 2013Wu, Y., et al. Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res, 2013. 137(3): p. 869-82Moore, S.C, et al. Physical activity, sedentary behaviours, and the prevention of endometrial cancer. Br J Cancer 2010. 103 (7): 933-8

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More activity = lower risk

• THERE IS A DOSE-RESPONSE OF DECREASING RISK WITH INCREASED ACTIVITY, I.E. THE MORE PHYSICALLY ACTIVE SOMEONE IS, THE BETTER

•BUT GETTING INACTIVE PEOPLE TO START BEING ACTIVE IS A CRUCIAL STEP

Friendenreich, C.M. et al. State of the epidemiological evidence on physical activity and cancer prevention. European Journal of Cancer 2010, 46:2593-2604

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Physical activity recommendations

• GOVERNMENT RECOMMENDATIONS SUGGEST A MINIMUM OF 2.5 HOURS OF MODERATE ACTIVITY PER WEEK FOR ADULTS•MODERATE OR VIGOROUS PHYSICAL ACTIVITY INCLUDES:• Cycling and brisk walking• Running or jogging• Team sports (football, rugby etc.)• Dancing• Heavy gardening • Household tasks• Active family games (e.g. tag)

Department of Health 2011 Physical activity guidelines https://www.gov.uk/government/publications/uk-physical-activity-guidelines

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Where to start?

• THE GOVERNMENT’S 2.5 HOURS OF MODERATE ACTIVITY PER WEEK CAN BE SPLIT, E.G.:• 30 minutes 5 days a week• 10 minute chunks

• INTEGRATING ACTIVITIES IN DAILY ROUTINES CAN BE HELPFUL:• For shorter journeys walk rather than drive• Take the stairs instead of the lift• Go for a short walk at lunch time• Have regular family fun days in the park

Department of Health 2011 Physical activity guidelines https://www.gov.uk/government/publications/uk-physical-activity-guidelines

EFFECTS OF ACTIVITY FOR

CANCER PATIENTS

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Physical activity helps cancer patients

• PHYSICAL ACTIVITY REDUCES TIREDNESS AND IMPROVES FITNESS IN THOSE UNDERGOING CANCER TREATMENT AND IN CANCER SURVIVORS•WELL-BEING AND QUALITY OF LIFE IS IMPROVED IN CANCER

SURVIVORS WHO DO REGULAR EXERCISE

• EVIDENCE IS ALSO EMERGING THAT PHYSICAL ACTIVITY COULD POSITIVELY AFFECT CANCER RECURRENCE AND MORTALITY

• In breast cancer• In bowel cancer

Speck, R.M, et al. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surv 2010. 4(2):87-100Fong, D. et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ 2012. 344 e70.Ibrahim, E.M, et al. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol 2011. 28(3):753-765Meyerhardt J.A, et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 2006. 24:3527-3534

WHAT’S NEXT?

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Physical Activity and CRUK

• PREVENTION KEY FOCUS IN CRUK STRATEGY- AIM TO ADDRESS THE 4 IN 10 PREVENTABLE INCIDENCES OF CANCER• POLICY RESEARCH CENTRE FOR CANCER PREVENTION (PRCP) • CANCER PREVENTION FELLOWSHIPS• INNOVATION WORKSHOPS • RENEWED FOCUS ON BEHAVIOURAL RESEARCH FOR CANCER

PREVENTION THROUGH EXISTING FUNDING COMMITTEES•WELCOME NEW PROPOSALS FOCUSSING ON PHYSICAL

ACTIVITY / EXERCISE AND CANCER• INFORMATION PROVISION FOR THE PUBLIC

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Race For Life

• PRIMARILY A FUNDRAISING EVENT, BUT COULD ALSO HELP GET PEOPLE ACTIVE

• IN 2015, R4L INTERVENTION WAS TRIALLED DESIGNED TO HELP PARTICIPANTS CONTINUE BEING ACTIVE AFTER THE EVENT• Built on feeling of success at

having completed their Race• Provided tools to plan regular

activity over the next year• Pledging

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Race For Life

The biggest breakthroughs oftencome from two very simple principles:

(FROM JAMES PATTERSON)

•GIVE PEOPLE ENOUGH INFORMATION TO MAKE INFORMED DECISIONS•GIVE THEM THE ABILITY TO ACT ON THAT INFORMATION

Let’s beat cancer sooner

Professor Linda BauldCancer Research UK

Contact : Linda.Bauld@cancer.org.uk

cruk.org