Weight Lifting May Help Breast Cancer Survivors

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First, there was the news that weightlifting may help breast cancer survivors who already have the common – and painful – condition called lymphedema. Now the same team of researchers has found that weightlifting may play a key role in preventing the condition.

The research is a big deal because traditionally, breast cancer survivors at risk of lymphedema were advised to avoid weight-bearing exercises or even carrying children or heavy bags in the fear they would get the condition. But avoiding weightlifting means women can not reap the many benefits of weight-lifting exercises and it may keep them from exercise in general, which research suggests can prevent recurrence and improve survival.

The study was published online in the Journal of the American Medical Association. Here is the abstract.

The lead researcher of the study was Kathryn H. Schmitz, PhD, MPH of the University of Pennsylvania, who was one of the presenters at AICR’s Annual Research Conference in 2009. At the conference Dr. Schmitz spoke about strategies to promote physical activity among cancer survivors.

In this brief video clip from the AICR conference, Dr. Schmitz offers direction and resources for survivors at risk of lymphedema or women who already have it.

For the JAMA study, Dr. Schmitz and her colleagues randomly split 154 breast cancer survivors without lymphedema into two groups: one group lifted weights and the other did not. The weight lifters were supervised for the first 13 weeks of the study. At the end of one year, fewer women in the weightlifting regimen developed the condition compared to the non-weight lifters (11% and 17%, respectively).

Among women who had five or more lymph nodes removed during surgery, the impact of the weightlifting intervention was even more.

Lymphedema occurs when the normal flow of lymph fluid becomes blocked and causes limbs to swell. During treatment for breast cancer, the lymph nodes (which carry the fluid) are harmed or removed. You can find out more about lymphedema at the the National Lymphedema Network.

Vitamin D and Breast Cancer

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Dr. Pam Goodwin, oncologist at Mt. Sinai Hospital in Toronto, CA  presented Thursday afternoon on breast cancer and vitamin D, a very hot topic.

There’s lots of interest in this connection because there are studies showing an association between vitamin D blood levels and breast cancer risk:  Lower levels show increased risk.

However, Dr. Goodwin pointed out that this association is only observed when blood was drawn after diagnosis.  When data was analyzed looking at blood drawn before diagnosis, there was no association.  She reported that the strongest studies do not show an association vitamin D and breast cancer risk.

What about for survivors?

For women with diagnosed breast cancer, many studies show low levels of vitamin D status at diagnosis.  However, two very recent studies show vitamin D deficiency to be more uncommon, though  present in 10-20% of these women.  This may be because more women are taking vitamin D supplements.

Some data show an association between vitamin D deficiency and shorter survival, but a randomized clinica trial did not show any association.

With all these conflicting results, what is the take-away message?

Dr. Goodwin’s take:

  1.  The evidence thus far is not convincing that there is a causal association between vitamin D status and breast cancer risk or for prognosis.
  2. Regardless of the vitamin D and breast cancer association, there are other health problems associated with D deficiency, so it is reasonable to use vitamin D supplementation to obtain sufficient blood levels.
  3. It will also be important to study, using preclinical studies, what the effects are of higher levels (above sufficient levels) of nutrients, such as vitamin D. 

 

Finally, Dr. Goodwin advises breast cancer patients on chemotherapy to use the standard dose of vitamin D supplement until we know more about chemotherapy and vitamin D.

Cautious Optimism for Survivorship Findings at AICR Afternoon Session

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Moving more every day in any way is an important component to cancer survival.

At the Diet, Physical Activity and Survivorship session of AICR’s annual meeting, leading researchers pointed to the latest developments in lifestyle changes that might affect risk and death from major cancers. Catherine M. Alfano of the National Cancer Institute stressed the desire of cancer survivors, now numbering more than 12 million in the US, to “take control and actively participate” in beating cancer.

In breast cancer, physical activity has been studied most and found to have an impact on preventing recurrence and improving quality of life, as well as reducing negative side-effects of treatment.

Human trials looking at the impact of physical activity, diet and obesity on other kinds of cancers are sorely needed — as borne out by evidence presented by Jeffrey Meyerhardt, Ph.D, of Dana-Farber Cancer Institute in Boston, who noted that studies linking physical activity with preventing colon cancer have shown clear results, but design of studies on survivors have varied.

Finding evidence on recurrence and mortality is more complex, Dr. Meyerhardt said, such as in looking into the various stages of colon cancer diagnosis, so these studies must be large and long-term, accumulating data over decades.

Prostate cancer and physical activity also has not been adequately studied, although presenter Edward Giovanucci, MD, of Harvard University said that being active before diagnosis is best, and that vigorous activity seemed to help survivors in the later stages of prostate cancer. He noted that brisk walking (3 miles an hour or more) for at least 7 hours per week did seem to have a positive effect in a small study of prostate cancer survivors. As for obesity, studies so far do not show an effect on survival from prostate cancer, but they may affect screening and treatment effectiveness, which may in turn affect survival of this cancer. A low-fat diet also seems to help survival rates.

The presenters emphasized the many health benefits of a physically active and prudent-diet lifestyle besides the likely cancer prevention and survival benefits, including lower risk for diabetes, heart disease and other chronic health problems — in other words it’s smart to make healthy changes while we are still healthy so that even after a cancer diagnosis, we are more likely to survive.