The findings don’t prove exercise itself boosts a person’s survival chances, researchers said. But the pattern held even after the study team took into account how advanced patients’ cancers were, their age and other aspects of their diet, lifestyle and health. “Any activity is better than none,” including walking, stretching and gardening, said Peter Campbell, the lead researcher on the study from the American Cancer Society. “Five to ten minutes at a time is fine, and the type of activity we’re talking about here, this isn’t marathon running or climbing the Alps.” Campbell’s analysis included about 2,300 people who developed colon cancer out of an initial pool of 184,000 volunteers in a cancer prevention and nutrition study launched in 1992. Over an average of eight years after their diagnosis, 846 people with colon cancer died – including 379 from cancer. The researchers found that study participants who exercised the most – equal to two and half hours of walking per week or more – both before and after being diagnosed were 28 to 42 percent less likely to die during the follow-up period than those who barely exercised at all. Spending six or more hours of leisure time on the couch daily before diagnosis, compared to less than three hours, was tied to a 36 percent higher chance of dying. Being sedentary after a cancer diagnosis was linked to a 27 percent increased risk of death – although that particular finding could have been due to chance, the researchers noted this week in the Journal of Clinical Oncology. To account for the fact that very sick people can’t exercise, Campbell and his colleagues excluded anyone who died within two years of their last survey, and found similar results. Researchers have known for a while that obesity and exercise affect a person’s risk of getting colon cancer in the first place, said Dr. Jeffrey Meyerhardt from the Dana-Farber Cancer Institute in Boston, who has also studied exercise and colon cancer survival. “The question when you’re a patient with colorectal cancer is, Do those things matter once I get the disease? Are there things I can do in addition to standard treatment to reduce my risk of recurrence?'” he told Reuters Health. Researchers said there are a couple of possible explanations for why exercise, both pre- and post-diagnosis, might benefit people with cancer. “What we think is at least part of what is happening is, people are going into surgery and adjuvant treatment in a more fit state,” Campbell told Reuters Health. In addition, he said, “If you’re active both before and after diagnosis, there are a lot of changes that occur in your blood,” such as in levels of insulin and other hormones.
Aspirin helps survival from colorectal cancer
It is thought that the impact of aspirin may come through its inhibition of the enzyme cyclooxygenase-2 (COX-2) which is overexpressed in many colorectal cancers. A team at Massachusetts General Hospital and Harvard Medical School has shown that aspirin also helps survival in patients who have already got colorectal cancer and, indeed, also reduces overall mortality. They looked at the long-running Health Professionals Follow-up Study and also the Nurses Health Study, identifying a group of 1,279 men and women who had colorectal cancer and provided information on aspirin use. Follow up was around 12 years, during which time there were 193 total deaths (35%) and 81 (15%) deaths from colorectal cancer among those who used aspirin regularly after their cancer diagnosis. The figures for those who did not use aspirin were 287 total deaths (39%) and 141 (19%) deaths from colorectal cancer. Five year survival for aspirin users was 88% and 83% for non-aspirin users. At ten years, these rates were 74% and 69%. Regular use of aspirin after diagnosis was linked to 29% lower risk of death from colorectal cancer overall, with an even higher reduction in those with grade II or grade III cancer, which carry a bigger risk. The benefit, however, was confined to those whose tumors overexpressed COX-2, where aspirin acts, and to those who took up aspirin after cancer was diagnosed. The study is not suggesting that all those who have colorectal cancer should now start on aspirin further, well-designed prospective studies are needed before this can be recommended. The study opens up the possibility of tailoring aspirin use to those whose colorectal tumors are positive for COX-2 overexpression.
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