Exercise provides therapeutic benefits, such as easing fatigue during radiation treatments

Doctors have known for quite awhile that exercise plays a role in preventing some cancers. But in a new twist, a researcher at the James C. Wilmot Cancer Center is studying whether exercise provides therapeutic benefits, such as easing fatigue during radiation treatments.

Exploring the link between exercise and adult cancer survivorship is a relatively new area of medicine. It began attracting more attention this spring, when results from the well-known national Nurses Health study showed that exercise seemed to boost the survival rates among the most active of 2,167 women with breast cancer. The American Association for Cancer Research presented the study at its March 2004 annual meeting.

“Cancer patients historically were told, and often still are told, to go home, relax, don’t overdo it,” explains Karen Mustian, Ph.D., one of the few scientifically trained exercise psychologists with a specialty in cancer in the United States. “However, we are beginning to see that change, just as it did years ago in cardiology. Individuals who suffer heart attacks today are placed into a formal exercise rehabilitation program as part of their recovery. I think we will find that exercise also helps improve the physical and mental well-being of cancer survivors, and in fact an exercise program for cancer survivors may become the norm of the future.”

Mustian joined the faculty of the University of Rochester Medical Center late last year, as a research assistant professor in Radiation Oncology. She has just launched a pilot study to find out if moderate exercise helps alleviate the fatigue common among individuals with breast and prostate cancer, while they are receiving radiation treatments. Participants agree to wear a pedometer to measure walking distance and some engage in resistance training at home with elastic bands. She plans to enroll 30 volunteers who are scheduled to receive at least 30 radiation treatments. This initial study is expected to close by September, and Mustian hopes to use the results to launch a larger study later.

In addition, Mustian is working with Wilmot Cancer Center doctors to explore ways to use exercise as therapy for metastatic breast cancer patients. During informal focus group sessions with 40 breast cancer survivors, the women told Mustian that the more active they were, the faster their lives returned to normal and the better they felt about themselves.

Finally, in a previous study that Mustian conducted at the University of North Carolina, Greensboro, she discovered that Tai Chi participation was better than attending a support group at helping 21 patients recover physically and emotionally from cancer diagnosis and treatment.

“Indeed, this type of mild to moderate exercise program seemed to improve strength, flexibility and heart and lung function, in addition to reducing fatigue and improving mood, self-esteem and quality of life,” she says.

Mustian has dedicated her career to understanding the mind-body connection. She believes that some of the common symptoms and side effects of cancer treatment may be associated with a deconditioning of the body.

However, hurdles still exist in the field of oncology. For example, it is not clear if exercise is safe for all cancer patients, how exercise may affect treatment, what types of exercises are appropriate and how much exercise is needed. Preliminary scientific literature is beginning to answer some of these questions, Mustian says. Studies have already shown, for example, that moderate exercise is safe for some cancer patients and that exercise might help problems such as lymphodema, the arm swelling and pain that many women experience after breast surgery.

“Scientific advances in cancer treatment have moved medicine to the point that more patients can expect to survive for longer periods of time. And that’s very exciting,” Mustian says. “So now researchers must work to make sure that cancer treatment includes methods that will help patients return to a life that is active, normal and full of the quality that everyone deserves. I am thrilled to be part of this important new wave of research in cancer control and survivorship, which is focused on relieving the side effects of treatment and improving long-term recovery.”

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