Even Modest Exercise Extends Thyroid Cancer Survival

With Rikki Cannioto, PhD, EdD, and Andrea Leonard, CPT

Sure you know that getting more exercise will improve your physical and mental wellbeing but now there is solid evidence that anyone with cancer, including thyroid cancer, can extend their survival just by exercising even a modest amount.1

Rikki Cannioto, PhD, EdD, assistant professor of oncology at the Roswell Park Comprehensive Cancer Center in Buffalo, New York and colleagues, looked at the association between people who were physically active before and after receiving a diagnosis of cancer and then they followed long these individuals lived.1

Taking a walk is an easy way to get enough exercise to extend your life even with cancer.Need some help to take that walk? Find a willing companion to go around the block with you. Photo: 123rf

In all, the researchers followed more than 5,807 patients with a variety of cancers at multiple stages; the study results are published in the journal, Cancer Causes & Control.

Some Activity Is Sufficient to Extend Life in Those with Cancer

The researchers sought to determine whether patients were physically active before diagnosis or not, and if they changed their activity level‑becoming more or less active—after receiving a diagnosis of cancer.1 Patients who were active before learning that they had some form of cancer and maintained the same level of physical activity after being diagnosed had a 39% lower risk of dying from complications of their cancer as compared with individuals who were inactive. More notable, this group of always active individuals also had an even lower likelihood of dying from any cause—reduced by 40%.1

The benefits gained by exercising regularly remained despite the frequency—whether the activity is done three to four times a week, or just one or two times a week. Interestingly, there was no significant advantage in longevity from being physically active for five or more times a week; in fact, these daily exercisers had similar benefits as those who were active for just two to three day a week.1

Even patients who were not active before diagnosis but began to move more, even walk, after they were diagnosed with cancer, saw a 28% decrease in their mortality rate from any cause. More notable—it didn’t matter if the patients had obesity, or they smoked cigarettes—there was a benefit to adding some exercise. And although those diagnosed with stage 4 disease didn’t get as much benefit as those with less advanced stages of cancer, physical activity still helped extend their lives beyond the expected survival.

Dr. Cannioto and her team had anticipated that there would be a positive effect from exercise among those who were already active. But the reduction in mortality among those who were overweight or obese, who were smokers, and those with advanced stage diagnoses were surprising. 

Even Modest Activity Offers Health Benefits Despite Other Medical Concerns

“Another surprising finding was that patients who reported being completely inactive in the decade prior to a cancer diagnosis, but who began exercising sometime within the year after being diagnosed, experienced a 25-28% increased survival advantage in comparison to patients who remained inactive,” Dr. Cannioto tells EndocrineWeb.

Many cancer survivors say that the experience changed their lives for the better—it seems to act as a wake-up call. That dose of reality, if you will, actually delivers a positive impact by presenting people with a need to evaluate what is important, and to set new goals, starting with eating better, and moving more.

The news that even occasional exercise is beneficial was another pleasant surprise, Dr. Cannioto says. “This is good news for patients who can be overwhelmed by daily physical activity recommendations in the current guidelines,” she says. “You don’t have to exercise every day or even most every day for your survivability to improve. In fact, patients who reported exercising 1-2 times per week, or 3-4 times per week before or after diagnosis were the patients who had the best survival experience”

This isn’t the end of their research on this topic. Dr. Cannioto says patients need to be followed throughout treatment and then long-term “to understand the association between physical activity patterns using objective assessment tools, like fitness trackers and research grade accelerometers, and to evaluate differences in cancer outcomes for individuals with more rare tumors. We also need to learn more about the underlying biological mechanisms that are responsible for the association between physical activity and improved survival.”

Researchers also don’t know what kind of activity works best–aerobic or resistance training—or if the types of exercise matter and what intensity is best, she says.

While It May Seem Counterintuitive, Dig Deep and Get Up and Move  

Recognizing the toll that cancer treatment, be it surgery, chemotherapy, radiation, or other treatments can have on you physically, not to mention the emotional impact, experts offer some suggestions to help patients increase their activity level.

Start with a brief walk.Try taking even a five-minute walk, or try to walk up and down the stairs a few times during the day, says Andrea Leonard, CPT, president and founder of the Cancer Exercise Training Institute in Portland, Oregon. “Any movement is better than nothing as the study findings suggest; whether it’s 10 minutes a few times a day, or finding a half hour to move all at once, it will help improve treatment tolerance and fatigue in particular.”

Patients are likely to feel lousy during treatment, but stretching, doing some gentle yoga, or taking a stroll around the block will leave you feeling better, Dr. Leonard says because you will increase the production of endorphins that make the effort to get up and going worth it.

“Your motivation may be that you feel a bit better in the short term, or it may be that known that by pushing yourself to move will both help to extend your life and improve the quality of your life,” Dr. Leonard tells EndocrineWeb.

If that doesn’t get you out of bed or off the couch, call on your support team to help you get some exercise, even it’s walking the aisles of the grocery store, or going out to pick up the mail. “The positive impact of every step is cumulative. You will feel better and better, the more you move,” she says.

Some of the issues cancer patients may face—like lymphedema, reduced range of motion, unequal post-surgical muscle mass, or extreme fatigue from radiation—might require professional help in designing a program that works. Dr. Leonard suggests seeking out a certified personal trainer or a physical therapist who specializes in cancer recovery to create a personalized exercise plan for you. Others may find YouTube videos and online exercise programs that suit your personal just what is needed to help you up your activity.

Dr. Leonard’s cancer institute, which certifies trainers, has a list of professionals who have gone through the courses aimed to address physical limits and challenges facing anyone undergoing cancer treatment. Some of these exercise specialists will even work over Skype or FaceTime, or use other online tools. She says that they are skilled to focus on the individual, tailoring the exercise plan to consider side effects of specific treatments, to select the  types of activity that both meet the comfort of the individual as well as to suggest what will work best for the patient, and what they can safely manage in their particular case.

Few cancer patients’ exercise and many physicians will recommend that patients rest, Dr. Leonard says. But she knows from her own cancer journey, and a similar experience with her mother (now facing her third bout with the disease) that being active makes recovery easier. “We have data now to support what I’ve been seeing,” Dr. Leonard says. “For people who are newly diagnosed, it’s a matter of acting on it.”

Dr. Cannioto agrees, and adds a statement long stated but now borne out by data: “It’s really never too late to start increasing your activity.”


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