Archive for July 5th, 2010

“What’s the one thing I should Start doing NOW as it relates to Exercise for Cancer?”

“What’s the one thing I should Start doing NOW as it relates to Exercise for Cancer?” How to Exercise for Cancer Exercise programming for cancer may mirror the growth in the US in alternative medicine and self help. A report in Alternative Therapies Journal by Van deCreek et al suggests that exercise is second only to prayer as the top forms of complimentary therapies that breast cancer survivors have interest in (prayer=84%, exercise=76%) and actually participate in as part of their recovery (prayer=76%, exercise=38%). Secondly, the passage of the Balanced Budget Act in 1998 has curtailed many acute rehabilitation programs in the US. Therefore, many therapists are looking for programs to provide to their patients to expand their level of clinical services. In 1996, the publication of the US Surgeon General’s Report on Physical Activity put into perspective the importance of regular exercise in maintaining and improving one’s physical health. Lastly, health centers in the US and abroad are moving in the direction of new and innovative programming. Many health clubs want to forge stronger relationships with their community medical facilities. All of these elements make for an attractive fit to provide exercise for persons with cancer. Therefore, exercise may stand on its own as the premier form of complimentary medicine for cancer survivors. Benefits of Exercise Why would a cancer survivor who has recently undergone chemotherapy or radiation wish to participate in an exercise program? In essence, patients feel better when they are in good shape. Not only are they better able to tolerate their medications, but their quality of life improves. This section details some of the major sports medicine reports that lend support to participating in exercise as a preventive approach to cancer but (according to some oncology sources) also to improve the odds for survival after diagnosis. The Epidemiology of Exercise and Cancer In the mid 1980s, Dr. Rose Frisch detailed a report that stated that former collage athletes had a marked reduction in the incidence of certain types of cancer, some by up to 45% less than their sedentary counterparts. In the late 1980s, a report from Stanford stated that persons who engage in more than three hours of physical activity per week have a reduction in certain cancers (such as colon cancer) by about 15%. These were the first epidemiological reports that looked at physical activity in cancer prevention. It wasn’t until five years later that USC Professor Dr. Leslie Bernstein showed a 60% reduction in breast cancer incidence in premenopausal women who engaged in regular exercise each day. Three years later, Dr. Ingar Thune published a Swedish study on physical activity and breast cancer incidence in 25,000 women. Her results mirrored the work at USC and showed a reduction in incidence rates by over 25%. This is impressive based on the large sample size interviewed. In general, the consensus of epidemiology reports lend a tremendous amount of statistical power to inclusion of exercise into a cancer-prevention regime. Improved Immune System Reports from the early 1990s by Dr. David Nieman confirmed that exercise enhanced natural killer (NK) cell activity. This immune system component has effects on chemoprotection. However, the criticism in the immunology community is that changes in the immune system are transient, and it is hard to pinpoint whether or not regular exercise stimulates these cells enough to produce a long-term effect. In a conversation with Dr. Nieman early in 1999, his response to this was for physiologists and physicians to understand the concept of immunoenhancement – the sum of change in the immune system over time. This changing pattern over time may improve the protective status of the immune system without being detected on a random blood draw. Nonetheless, this may explain why some persons who exercise regularly may have a reduced incidence rate of certain types of cancers. Hormonal Changes Some theories recently published by Dr. Ann McTiernan state that improving the hormone state will have a tremendous impact on cancer development. It seems as though components such as insulin and insulin-like growth factor (IG-F) have an effect on tumor development. Modulating these hormones (along with cortisol and sex hormones) may reduce the ability of tumor cells to grow and proliferate. Other Physiological Mechanisms There are other hypotheses that may indeed have an impact on tumor cell development and proliferation. Like the new angiogenesis inhibitors that are being tested in the cancer field, exercise redistributes blood flow. This redistribution may have an impact on blood supply to the developing tumor cell. Exercise also increases body core temperature, changes body pH and increases the amount of lactate produced metabolically. These changes, although not currently tested in cancer, may also have an impact on tumor cell growth. We can only speculate as to the true mechanisms of why those who exercise may be at a reduced risk for development. Quality of Life Changes The past 10 years of behavioral research has given quite a bit of information as to the power of support groups and positive thinking on cancer survivorship. Recent behavioral reports have shown that persons with metastatic cancer who are involved in group support live longer than their non-support group counterparts. In the behavioral aspects of exercise, what we do know for certain is that physical activity enhances the quality of life for all of its participants. There are more reports coming out each year on the effects of exercise on quality of life issues. A 1997 report by Dr. Bernadine Pinto stated that 16 breast cancer survivors who participated in regular aerobic exercise had improved profile of mood scores than their sedentary controls. A 1998 report by Michelle Segar from the University of Michigan stated that 24 breast cancer survivors who performed regular aerobic conditioning had improved self efficacy scores and less anxiety than their controls. A 1999 review of over 20 behavioral reports by Dr. Kerry Courneya from Canada states that 75% of these reports show positive effects of exercise on cancer survivorship. A paper presented at 1999 by the HealthEmotions Research Institute states that 41 women with breast cancer who underwent a 16-week group exercise program improved blood pressure, body weight and well-being scores. This is some of the most profound research available on the benefits of exercise for cancer survivors. The ability to enjoy life and participate more fully in daily activities is shown through regular exercise at even a low level of training. Current Clinical Studies One of the first publications on therapeutic exercise for cancer patients was published by Rosenbaum in 1979. This guidebook may have been years ahead of its time in terms of its practical application to acute exercise programming for cancer survivors. However, in the 1990s, there are more reviews on the subject of exercise in terms of its application to the rehabilitation profession. A recent report from Dimeo states that patients who are on high dose chemotherapy and stem cell transplantation can improve physical measures such as hemoglobin and physical performance. This report details how even patients receiving large amounts of medication can derive exercise benefits. Winningham introduced the concept of the WAIT protocol, which uses interval aerobic conditioning to improve the fitness level of participants. Durak has used moderate to heavy progressive resistance strength training to improve overall function and quality of life scores in stage I and II cancer survivors. This program has also looked at health status over five years for participants who are continually exercising. Most of them (90% of 18 interviewed) still exercise and take nutritional supplements daily as part of their recovery process. A summary of the epidemiological and clinical benefits of exercise and cancer is listed in Table 1 below. Programming for Exercise and Cancer Most programs for cancer survivors use aerobic training (walking or stationary bike protocols) to improve function and quality of life scores for patients. The Cancer Well-Fit Program in Santa Barbara, California uses a four component approach for exercise. This model concentrates on progressive resistance strength training as the primary training regime. Patients select stations that fit their initial fitness level and medical concerns and progress to higher weight levels and additional stations as pain free fitness levels and strength improves. Aerobic training concentrates on machines (so patients can check improvement in Watts and MET values from computer readouts), step classes and group walking. The important aspect about training in a community health club environment is that patients can select from a variety of classes (designed for them) and aerobic machines to improve their aerobic capacity during their initial 10 weeks of supervised exercise. The third component is range of motion and flexibility. This concentrates on working out scar tissue deficits and balancing general musculature. The last component is mind/body fitness, which consists of breathing, relaxation, one to two yoga classes within the 10 weeks and some meditation programs. All of these are part of the health club programming. They are offered to cancer participants along with water exercise, NIA training and other club programs. This model is one that many health clubs and clinics are looking to emulate because, over the past five years, programs in Southern California, Colorado and Illinois have trained hundreds of cancer survivors using this model, and outcomes have been published on many of these participants with regards to increases in strength (over 45%), aerobic capacity (30%) and a multitude of quality of life improvements (in general over 29%). Over five years of recovery, over 90% of participants continue to exercise either self paced or in a club, and the same percentage take supplements on a daily basis. Their level of vigor is over 80% (on a 100 scale), and almost all use some type of complimentary therapy to enhance their recovery process. Future Directions in the Field Exercise and cancer is slowly making its presence felt in the sports medicine community. For now, personal trainers, therapists and oncology nurses have the resources to provide exercise programs for cancer survivors in a safe and supervised environment. Personal trainers will play a critical role in the development of long-term health outcomes for cancer survivors. As we have seen in our recent national survey of personal trainers, fitness instructors can help cancer survivors with their orthopedic concerns (after referrals from PT), psycho-social needs through group exercise and improvement in self efficacy and can inform them on topics of health education, nutrition and mind-body fitness. Health clubs will also play a role in cancer wellness through the developing of programs in their facilities and working with local medical agencies (physical therapy, nursing and oncology) to facilitate the growth of such programs for all types of cancer survivors. If cancer and exercise is to reach the status of cardiac rehabilitation in this decade, then it is essential we increase our awareness and knowledge of dealing with cancer survivors (some of whom already exercise in the health club setting) and improve our communication with oncologists and therapists to ensure a smoother referral network into these exercise programs. Exercise professionals are going to lead the change in this area of health care, and they will do it in a big way. This article is dedicated to the memory of Dr. Maryl Winningham, who pioneered the use of exercise for cancer patients. She lost her battle with breast cancer in February of 2001, but her spirit remains. References: 1. Bernstein, L., Henderson, BE, Hanisch, R., Halley, JS, Ross, E. Physical exercise and reduced risk of breast cancer in young women. J. Nat. Cancer Inst. 86;18:1403-08, 1994. 2. Courneya, KS, Friedenreich, SM. Physical exercise and quality of life following cancer diagnosis: A literature review. Ann. Behav. Med. 21;2:1-10, 1999. 3. Dimeo, R.C., Tilmann, M.H.M., Bertz, H., Kanz, L., Mertelsmann, R., Keul, JR. Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation. Cancer. 79:1717-22, 1997. 4. Durak, E.P, Lilly, P.C. The Application of a Total Conditioning Program with Cancer Patients: Effects on Strength and Endurance. J. Str. Condit. Res.. 12;1:3-6, 1998. 5. Durak, EP, Lilly, PC. A five year follow up survey on health and exercise habits in women breast cancer survivors. Br. Cancer Res. Treat. 57;1:92 (abstract), 1999. 6. Durak, EP, MSc, Harris, JM, Ceriale, SM. The Effects of Exercise on Quality of Life Changes in Cancer Survivors: The Results of a National Survey. Submitted to Cancer, September, 2000 7. Frisch, R.E., Wyshak, G., Albright, N.L., Albright, T.E., Schiff, I., Witschi, J.,Marguglio, M. Lower lifetime occurrence of breast cancer and cancers of the reproductive system among former college athletes. Am. J. Clin. Nutr. 45:328-35, 1987. 8. Kolden, G, Staruman, T., Woods, T., Schneider, K, et al. Exercise is associated with improved physical and mental health in women with breast cancer. Br. Cancer Res. Treat. 57:1:131 (abstract), 1999. 9. McTiernan, A, Ulrich, CM, Yancey, D, Stalte, S., et al. The Physical Activity for Total Health (PATH) Study: Rationale and design. Med. Sci. Sports Ex. 31;9:1307-12, 1999. 10. Nieman, DC, Nehlsen-Cannarella, SL. Exercise and infection. In: Exercise and Disease. R.R. Watson, ed. CRC Press, Boca Raton, FL pp. 121-148, 1992. 11. Pinto, B., Maruyama, N., Thebarge, R. Exercise participation in breast cancer patients. (abstract). Psycho-Oncol. 1996; 5;3:S-3:3, 1996. 12. Rosenbaum, E.R., Rosenbaum, I. Rehabilitation Exercises for the Cancer Patient. Bull Publishing, Palo Alto, CA, 1980. 13. Segar, M., Katch, V.L., Garcia, A., Haslanger, S., Wilkens, E. Aerobic exercise reduces depression, and anxiety, and increases self-esteem among breast cancer survivors. Oncol. Nur. Forum. 20:317-21, 1998. 14. Shephard, R.J. Physical activity and cancer. Int. J. Sports Med. 11:413-20, 1990. 15. Spiegal, D., Bloom, J., Kraemer, H, et al. Effect of psychological treatment on survival of patients with metastatic breast cancer. Lancet 14 (October): 888-91, 1989. 16. Thune, I., Brenn, T., Lund, E., Gaard, M. Physical activity and the risk of breast cancer. The New Engl. J. Med. 336;18:1269-75, 1997. 17. Van deCreek, Rogers, E, Lester, J. Use of alternative therapies among breast cancer outpatients compared with the general population. Alt. Ther. Health Med. 5;1:71-77, 1999 18. Winningham, M.L., MacVicar, M.G. The effect of aerobic exercise on patient reports of nausea. Oncol. Nurs. Forum. 15;4:447-50, 1988. 19. Erik Durak

Male Breast Cancer? Uncommon but Serious

At 41, Brian Place found a lump near his left nipple and dismissed it as a sort of injury from the rough games he had been involved with for most of his life.  He thought that the lump was probably a result of a collision with another rugby player.  Though his doctor didn’t think much of the lump either, nevertheless, he advised Place to get a mammogram test.  When the ultrasound of the breast and a biopsy came out, the diagnosis shocked Place and his colleagues from the Royal Air Force in Britain where he works as a Communications Technician: breast cancer.
Staff at his local breast clinic even assumed that Place was accompanying a female patient during his check up. The confusion is understandable. Only about less than 1% of breast cancers diagnosed occur in men. The rarity of breast cancer in men leaves so much room for research regarding the condition.   According to Dr. Larissa Korde, staff clinician at the National Cancer Institute’s clinical genetics branch, “In women, we have studies based on hundreds of thousands of patients.”  However, there are no studies of that scale in men. “Though much can be extrapolated from research in women,” said Korde, ” it’s a little bit harder to make recommendations for men based on evidence.”
One of the surest risk factors to consider is family medical history, that is, for both men and women.  At the time of Place’s diagnosis, two female relatives of his had died of breast cancer and a third of ovarian cancer.  However, several genes may contribute to breast cancer, such as mutations which are known to increase the possibilities of both breast and ovarian cancers. Although most men might never even meet a man with breast cancer, those who have several relatives diagnosed with breast cancer should be wary for signs of their own breast tumors. Based on studies, certain populations with an unusually high proportion of people carrying BRCA2 mutations may have a higher incidence rate of breast cancer in men, such as in Sweden, Hungary, Iceland, and among Ashkenazi Jews.
There are similarities in the survival rates for men and women as they adjust in the stage of the disease at diagnosis.  But since men do not undergo a regular screening like women do, they are more likely to be diagnosed at a later stage.  The lumps may not always be detected by medical scanning equipment.

Medical treatment usually includes surgery, to be followed by some combination of radiotherapy and chemotherapy.  With men, an additional hormone treatment is necessary because almost all men with breast cancer have tumors characterized as hormone-receptor-positive.
After two years of medical treatment and therapy, Place is now doing well.  Two years after his diagnosis, Place is well enough to play contact sports. The mastectomy was successful, and Place has decided to discontinue his hormone treatment due to its side effects like hot flashes which he found to be very unpleasant.
Brian Place is now an active participant in online discussions and support group communities for cancer patients.  He tries to answer questions regarding male breast-cancer conditions.  Place also gives talks to people who contact him through the U.K. nonprofit Breast Cancer Care. Although there are women who are not yet accustomed to men with breast cancer condition, time and awareness can help address the issue.

Celgene Acquires Abraxis for $2.9 Billion

Celgene Acquires Abraxis for $2.9 Billion
Celgene’s purchase expands the company into the solid tumor cancer drug market.

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A Breast Cancer Survivor’s Story-Patty Rich

It’s not a death sentence. That’s the message many breast cancer survivors want to share with others who just learned they have the disease. Its been a short time since Patty Rich got the devastating news. She shares with us the drastic measure she took to keep the cancer from coming back, who helped her through her ordeal, and advice for women just starting their fight against the disease. Here’s Pattys story as only she can tell it.

When is a drug too risky to stay on the market?

When is a drug too risky to stay on the market?
By MARILYNN MARCHIONE AP Medical Writer The arthritis pill Vioxx was withdrawn but menopause hormones were not, even though both were tied to heart risks. A multiple sclerosis medicine was pulled and later…

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Novartis, Myriad May Get Shield for Diagnostic Tests After High Court Case

Novartis, Myriad May Get Shield for Diagnostic Tests After High Court Case
Myriad Genetics Inc. , Genomic Health Inc. and the rest of the burgeoning industry for personalized medicine stand to gain from yesterday’s landmark U.S. Supreme Court decision on patenting business methods.

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Mammograms and Breast Cancer: A Research Documentary V. 1 part 2

Hello, my name is Doctor Calvin Ross and I am a certified X-ray technician and I am very concerned about women continuing to receive annual Mammograms for breast cancer screening. This is video 1 of 3

Tricia’s Experience with an Alternative Breast Cancer Treatment

Visit www.euro-med.us for more videos. Tricia shares her story of an alternative breast cancer treatment with Insulin Potentiation Therapy (IPT).

Ipsogen Map Quant Dx for breast cancer profiling

Ipsogen’s MapQuant Dx system enables pathologists, laboratories and oncologists to get a comprehensive view of tumor biology. Proprietary computation of the tumor expression profile allows the identification of key characteristics of the tumor and subsequently guides therapeutic decisions. This video clip illustrates how the system relates to breast cancer screening.

Stop Living in Fear of Cancer

When the FDA uses the phrase “may reduce the risk of certain cancers,” it is nearly impossible to imagine they are talking about anything other than a new costly prescription pill. Then following said claim usually includes a fine print warning or commercials with the “speed talker” warning us of the numerous side effects which may occur while taking the prescription.

Proponets of mainstream medicine in the U.S. seem content to leave things as they are, shuffling the countless off to the surgical ward, concerned more with slicing and dicing than actually improving your quality of life. Major pharmaceutical companies refuse to acknowledge anything natural because only chemicals can be patented. Drug companies then try to replicate
the components but it just isn’t quite working out. So, what are we left with? What are our choices?

Currently, conventional medicine is basically telling us the way to treat cancer is to cut, poison and burn. Diagnosed with breast cancer, just cut it off. Chemotherapy is poison, it makes people very sick and this most popular drug for breast cancer causes uterine cancer. Use radiation to burn then, but medical studies show that the results between people with cancer who were treated with radiation and those who were not treated showed no difference.

Don’t be naive, cancer equals big money and we have been beyond “awareness” for many years now. In fact, the drug companies have already made 12.5 billion on diabetes so far in 2008 and this is not intended to come across as unsympathetic for those who currently have cancer and those who have lost friends and loved ones to this disease. Au contraire, it especially breaks my heart when I think how hard it must be on a young boy or girl who has a form of cancer and the toll it brings on their families.

My question is why the medical profession and big pharma will not give consideration to treating cancer naturally or at least incorporate natural supplements and not just close the door. Sadly it seems the love of the almighty dollar has distorted things just a bit.

Do not be surprised when in the not to distant future we will be unable to purchase vitamins in the U.S., such as vitamin c for example, without a prescribtion. CODEX is already controlling a lot of this internationally and it’s just a matter of time until those dollar signs trigger a new era in the U.S. which is already a signatory but it is not enforced…yet.

Sure we are all familar with the saying “an ounce of prevention is worth a pound of cure,” and this is so very true, especially concerning cancer. It is much easier to prevent a disease than to cure it and cancer is no exception. All the processed food out there full of preservatives is not only void of nutrients but in many cases is harmful. Companies advertise we can our daily dose of certain vitamins and minerals with their product so we think it’s healthy. Certain fast foods should least have warnings on the wrapper/box that read “this may cause bad things.” Organic foods are great option for a nutricious lifestyle if one can afford it.

We need to focus on what we can do to prevent cancer. Just as it is wise to use preventative measures in other areas of our life, this isn’t any different. This is not meant to bring doom and gloom but don’t fall into the trap of “this will never happen to me.”

Without going into a big dissertation about cancer but very simply, cancer starts at the cellular level. Our immune system plays a vital role in preventing cancer by destroying invading pathogen’s. With this in mind it makes sense to make sure our cells have the nutrients needed, be oxygenated and our immune system is balanced so that the antibodies hit the right target to wipe out the invader.

There are a number of natural supplements available that help make sure this happens, to make any weak links strong. Like most things, there are the good, the bad and the ugly in the natural supplement arena. This article is not intended to tell you what or what not to buy, but to let you know there are options that work which you will never hear about from mainstream medicine. Do some investigation but keep in mind that mainstream, conventional medicine is quick to use the term “quackery” that which does not fit neatly in their protocol.