Move & Thrive with Siya_K
Move & Thrive with Siya_K is the podcast for active people who want to move better, train smarter, and stay healthy for life - without burnout and without avoidable injuries. Hosted by Dr Siyabonga Kunene, a sports physiotherapist, coach, endurance runner, and cyclist, the show blends science, performance insight, and practical strategies to help you optimise your health and athletic potential.
Move & Thrive with Siya_K
Exercise & Cancer: Moving Through Prevention, Treatment & Survivorship
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Can exercise help prevent cancer?
Can it reduce cancer-related fatigue and support recovery during and after treatment?
Join me (Dr Siyabonga Kunene) and renowned oncology rehabilitation expert Prof Mary Lou Galantino (USA) as we explore the powerful role of exercise in cancer care, recovery and survivorship.
Movement is more than exercise. It can be part of the journey toward better health and quality of life.
Listen to the full conversation on the Move & Thrive Podcast.
#MoveAndThrive #ExerciseAndCancer #CancerRehabilitation #ExerciseMedicine #CancerSurvivorship #ExerciseIsMedicine
Extremely important to be able to think about prevention of various cancers that certainly can have a role to play alongside of during cancer treatment and survivorship. I come here today as both a clinician, uh academician, um, as well as a cancer survivor.
SPEAKER_04Welcome to another episode of Move and Thrive with me, Dr. Siawong Agunene. Thank you so much for tuning in. Today we are going to look at exercise and cancer. I am joined by Professor Meliru from USA. Thank you so much for joining me. How are you doing, Professor Calentino?
SPEAKER_12Well, I got my exercise in before I arrived today. So that's firstly.
SPEAKER_01That's the most important feature.
SPEAKER_12Uh and uh I'm doing well and honored to be here to have this conversation. You are a professor in USA.
SPEAKER_04You've worked in oncologize rehabilitation for over 30 years now.
SPEAKER_12Well over 30 years. I had the good fortune to uh decide to go into cancer rehabilitation, and I trained at MD Anderson Cancer System Center, which is in Texas in the United States. At that time, we had a very small group of a rehabilitation department that really helped cancer survivors. My entry into that, however, was interestingly enough HIV. Okay. Because our patients with HIV in the 1980s had to Coposi sarcoma, which, when the immune system decreases, the vulnerability of cancers for people living with HIV actually increases. So that led me on my pathway to doing research in the area of the benefits of exercise for cancer survivors alongside of HIV individuals who are struggling with comorbidities with HIV and cancer and perhaps other types of non-communicable diseases.
SPEAKER_04Wonderful. And we've seen the work you've done. You've published over a hundred papers, and we really appreciate the contribution that you have made even in our setting in South Africa. You are a visiting professor here at Vent University. We're really happy to have you. You've helped us a lot with curriculum development. What kind of research are you currently working on right now?
SPEAKER_12Right now, uh, my area of focus for cancer survivors and individuals with HIV is a condition that causes pain in the hands and the feet due to in the case of HIV, anti-retroviral therapy, or in the case of chemotherapies, they can cause pain and tingling and numbness in the hands and feet. So, as part of my continuum of research looking at the benefits of exercise for individuals with cancer and HIV, and my research team for HIV is at Rutgers University. And then I'm doing work at the University of Pennsylvania within our team looking at integrative therapies for both of these neuropathies in these two diagnoses. Specifically, I did my postdoc work at the University of Pennsylvania looking at integrative therapies, incorporating the use of meditation and yoga and tai chi if individuals aren't able to be functional enough to do a full-on exercise program. So those are the precursors. So I'm looking at can we get similar benefits from some of these mindful movement exercises as we get with traditional exercises?
SPEAKER_04Prof, I want us to start from the beginning. What is cancer? For somebody who may not know what is cancer.
SPEAKER_12Well, let's just start off that with the fact that we have incredibly powerful immune systems. We know that when we get the common cold, our immune systems are the essence of keep of keeping pathogens and cells that just aren't multiplying optimally. The immune system keeps it in check. Unfortunately, when it comes to a cell that is not replicating normally, that cell can get out of control. And since the immune system in some individuals might the quality of that immune system might decline because we have natural killer cells in our system. And subsequently, if there is any compromise of the immune system, the opportunity for an opportunistic cancer can develop in individuals. Now, cancer is quite complex because it could be genetic.
SPEAKER_08Okay.
SPEAKER_12We could have multifactorial lifestyle behaviors, including smoking, obesity, type 2 diabetes, and then we have the environmental component as well. Being exposed to carcinogens in the environment, uh, in addition to lifestyle nutrition on healthy eating and bringing in not so great nutritious elements in our bodies that could be the recipe for a cell to grow and either stay locally if we're lucky to get an early diagnosis or can spread throughout the body and create metastasis. Wow, wow.
SPEAKER_04So you you are linking cancer with lifestyle. Indeed. So would we say cancer is one of the lifestyle diseases? Absolutely.
SPEAKER_12We must appreciate that there's the epigenetic components as well. So if I have a family history of BRCA1, two, BRCA1 or BRCA2, that genetic history may indeed portend that I may get breast cancer andor ovarian cancer. However, um that is a smaller percentage of us, and even with that, we did university at the University of Pennsylvania, we did research with Dr. Schmitz, Catherine Schmitz, and she really led a study that looked at those women who actually had the BRCA1-2 gene to see if we could change the underpinning of the hormonal levels to reduce the likelihood of getting breast cancer. So indeed, we can look at the lifestyle factors and work to prevent colon cancer, breast cancer, many of the esophageal cancers, lung cancer, and these are cancers that indeed may be preventable with exercise, because exercise has a potent effect on the immune system, up-regulating the protective aspects of our cellular replication as well as overall reduction in inflammation.
SPEAKER_04Okay, so you're saying it cancer could be prevented with lifestyle change? Yes. Okay. So if it's a lifestyle disease, it means the solution is lifestyle as well. Precisely. So now tell me, you mentioned colon cancer, you mentioned breast cancer. Who is affected by cancer? What type of cancers do we see in men? What type of cancers do we see in women?
SPEAKER_12So typically in women, we see uh both pre- and post-menopausal women uh with uh breast cancer diagnosis, most assuredly. Uh we also see the gynecologic cancers, which can include ovarian, uterine, and cervical cancer. We know that in women who are vaccinated against HPV early on in puberty with the three vaccinations, we can actually see reductions in cervical cancer because cancer can be virally mediated. So if we can have those vaccinations, that would maybe a way to prevent. Okay. In men, we typically see uh prostate cancer, testicular cancer. And again, these types of cancers are hormonally regulated for the most part. I see, I see.
SPEAKER_04And then you colon cancer, are you read that men are mostly affected by colon cancer? Is there a reason why men would be more prone to colon cancer?
SPEAKER_12I would say that uh it depends on again on one's body mass index and the level of obesity. If we have that central adiposity, that central obesity and metabolic syndrome, that is a situation where inflammation is everywhere. With inflammation, it is not a good recipe for our cells to replicate healthily. So whether there's a predilection for more males than females is based on region of the globe. It's also based on other comorbidities, and specifically, obesity is a predictor for colon cancer, alongside of poor nutrition and sedentariness. Sure.
SPEAKER_04The reason why I'm I'm asking about colon cancer, I'm in a habit of doing regular checks twice twice a year, just to do full checks. And there was a point where I felt discomfort, some ulcers in my stomach, and I asked doctors to just put a camera there inside and check what is happening with and then doctors found some three or four polyps inside my colon and they obviously removed them. Now, my question is does that mean that I'm now exposed to cancer? Does it mean my chances of cancer are increased? What does it mean? Those polyps, could they develop cancer?
SPEAKER_12Well, firstly, thank you for actually getting checked. Because now what you've done is prevent an incidence of colon cancer because they can be precancerous.
SPEAKER_07Okay.
SPEAKER_12And so the goal to have a colonoscopy is to be able to take that camera and check that your intestines are clear of those polyps. So indeed, um, being able to have early surveillance, and typically males should, again, it depends on every country, it has its own cutoff, age cutoff. For males, if you have a family history of colon cancer, that is important for you to have earlier surveillance. So, congratulations.
SPEAKER_05For taking up.
SPEAKER_12Yes, uh, I commend you and I commend all of our listeners uh for being able to number one say, Do I have a family history? If so, then early surveillance is essential. And therein lies seeing your primary care physician, and especially if you are having symptoms because you're healthy.
SPEAKER_06Yeah.
SPEAKER_12I didn't feel yeah right, you didn't feel anything. You just had maybe some discomfort. What's interesting is oftentimes people will go, oops, is it cancer? Or it could just be indigestion because you're stressed. Stress can also increase inflammation, uh, and yet get getting that confirmation, you are to be commended for that.
SPEAKER_04Yeah, testing is very important knowing because cancer is a sudden killer. You could live with cancer without knowing. Exactly. So checking is important. Why would why are we afraid of checking? I know men don't want to go to check.
SPEAKER_12Well, especially as it relates to prostate cancer, who wants a rectal exam? No one needs to be No one wants to have invasive procedures, and yet it actually is a reliever of stress when you know you don't have it. Okay. So if you're thinking, could I possibly have cancer? The only way to get an answer is to have a diagnostic. Let me give you an example. One of the most important features for women is seven days after their menstrual cycle, the ability to check their breasts.
SPEAKER_14Okay.
SPEAKER_12And it is important to be able to notice and appreciate your body as it is in its normal, healthy state. If I feel something unusual in my breast, it might be painless, it might have no symptoms, but if it's palpable, we could be getting early stage cancer removed. I think what we're afraid of, and we have to change the narrative, honestly, we are, if we're afraid of cancer, cancer does not equal death.
SPEAKER_09Yes.
SPEAKER_12If we could change that narrative, we could change it only if our audience actually notices that something is not quite right and then says, I'm gonna follow up with my physician. That way we have an early surveillance with removal.
SPEAKER_04And um, coming back to the issue of prevention, yes, because you mentioned that it can be prevented. So take me through why how is exercise a recipe for preventing? I know exercise alone may not be enough. There is a comprehensive approach to preventing diseases, which include diet, which include many other lifestyle-related issues. What is medicine about exercise that can prevent cancer?
SPEAKER_12Well, firstly, I think there are a number of really great research and evidence to point out that when an individual exercises, we firstly are creating a sense of stress relief. What we know with exercise, for all our audience participants uh that uh will join us in exercising after this podcast, we know that the ability to feel good after exercising is the endogenous uh endorphins and enkehlins that have us feel good about our bodies. One of the most important features around that feeling good is the regulation of that, the the endorphins that occur alongside of hormonal regulation. Okay. And as we mentioned, the gynecologic uh female and breast cancers, and similarly prostate cancer, those are regulated by our hormonal system. So when we regulate through exercise a homeostasis of the hypothalamic, pituitary, adrenal cortical systems, that's when the fight flight comes into play. When we are under stress, that actually fosters cortisol in our body. Cortisol isn't great to have. And when we exercise, we can reduce that inflammation and not have the environment of the human host system to allow a cell that is aberrant or not cycling adequately to not replicate in our bodies. So it is a prevention because the lymphatic system of our body will simply clean it up. So everyone, all of our listeners today, our immune system right now is keeping any type of cell that's not normal adequately cleaned up. The only caveat to that is we have good hydration, good nutrition alongside of exercise. Okay. Exercise is movement, movement is life. Okay, movement is life.
SPEAKER_04What I hear you're saying, exercise does contribute in boosting our immune system. And with immune system being boosted, then you are able to fight these cancerous uh cells or the disease in our bodies. How else can exercise be medicine for cancer? Do you want to go deeper into the science of exercise being medicine for cancer, for prevention of cancer?
SPEAKER_12I would be delighted, and I would like to give credit to all of the great researchers that are really publishing the evidence. There was a study by Zoo and colleagues just recently looking at exercise in cancer prevention and anti-cancer therapy. So we're thinking about anti-cancer therapy before it develops. And these effects and molecular mechanisms are really important to underpin. But firstly, let me say and echo once again: modifiable lifestyle factors are the strongest determinants and major preventable causes of most types of cancers. And so what we know is that exercise actually reduces the incidence of cancer and it affects the types of cancer when they are in development. Because what we have here is that there is a regulation of the intratumoral angiogenesis. Cancer cells love blood supplies. Exercise can help reduce that. It also has the regulation of myokines and adipokines alongside of their associated pathways. So cancer metabolism is altered via exercise. So that is why it's important there can be anti-cancer immunity. And that is so important because it really supports the prescription of exercise for cancer prevention to really sensitize cancer to anti-cancer therapy as well and manage the symptoms of chemotherapy and radiation. So I think what is important also, Wang et al. looked at cancer prevention and treatment, and we want to add the other domains of looking at not just the scientific underpinning as it relates to the immune system, the metabolism, the endocrine system, but also when we look at the autonomic nervous system, we can appreciate that if I get a diagnosis of cancer, what happens to my mood? If I get a diagnosis, does cancer mean that I don't move anymore? Quite the opposite. Because depression and anxiety also affects our immune systems.
SPEAKER_04Yes, you did touch on that. And exercise you mentioned that it gives you that calmness. Yes. And it controls stress in a way. You bet. And also, in a way, controls inflammation. Because you said with cancer comes inflammation and with stress comes inflammation and all of that. Yeah.
SPEAKER_12The other feature is that inhibiting that cell proliferation, that abnormal cell proliferation, induces apoptosis. And it regulates the metabolism and the immune environment, to our points here. And I think that's really important. And those are the main mechanisms as it relates to physical exercise in cancer prevention and then treatment. And subsequent to that, to this discussion around the mental health well-being, when we are depressed or have anxiety, once again, exercise can combat that. And by doing so, we endeavor to enhance our endogenous opioids and the enkephalins and the endorphins to be able to mitigate that and reduce inflammation. So even as we think about that surveillance and early diagnosis, even before, and if there is a confirmation of a cancer diagnosis, even with that, we want to be preventing the next steps as we move through the cancer trajectory by doing exercise through the cancer treatment trajectory.
SPEAKER_04Wow, wow. I appreciate the you sharing that deep science. A basic message here is that there is medicine in exercise, as you are telling us now, that exercise can work to prevent cancer. Exactly. Can it also help in managing cancer? Let's say you already have cancer. Can exercise work in during the treatment of cancer?
SPEAKER_12Well, just last year, to your point, um, colleagues, actually, uh doctors Albiney and colleagues uh really looked at just physical activity and exercise health benefits, not just cancer prevention, interception and survival. And uh they really uh talked about the fact that the overall benefits uh include reduction in all-cause mortality, that's very important, and death, morbidity and mortality, weight control, improved quality of life, improved bone health. And we know that accompanying cancer treatment with chemotherapy, everyone gets steroid injections because the impact of chemo is it's inflammatory, but the goal is to get at the targeted cancer cells. It's important because that then affects our bone health. So weight-bearing exercises are important, and if individuals have chemotoxic peripheral neuropathy, exercise can actually be facilitating fall prevention. That is really important. Uh the other feature with chemotherapy is that it does cause chemo brain, where there's a fogginess in the brain primarily from the treatment of chemotherapy. That indeed can be a factor, and so exercise can also help with that. Furthermore, by exercising, it can reduce depression and anxiety during the cancer treatment trajectory. But let's step back for just a moment because many individuals may receive chemotherapy to shrink the tumor first, then undergo surgery, remove all the tumor, or they may receive surgery first and then have chemotherapy and radiation. Or an individual may receive radiation to shrink the tumor, chemotherapy, then have tumor removal. Again, it depends on the tumor type, the tumor advancement, right, whether it's stage one, two, three, or four, and then the nature of the pathology report. So that's important to consider. And that is Reason why going into surgery, if that's the first line of treatment, what we want to make sure is that individuals actually have the strength and the power and the endurance to endure surgery. And that is the reason why there's been quite a bit of evidence to show that individuals that exercise pre-surgery through prehabilitation have better surgical outcomes. And that is extremely exciting. That's good news to hear. Indeed. And this is latest research you are quoting. That is the latest research. And especially if there are other comorbidities of type 2 diabetes, obesity, depression, uh sedentariness, one's ability to recover from surgery not be may not be as robust as individuals who go into surgery healthy.
SPEAKER_06Well.
SPEAKER_12So that's important to know.
SPEAKER_06That's powerful. That's powerful.
SPEAKER_04So, prof, um, now we know that exercise is medicine, but you know medicine, we have to prescribe it correctly. You can't just take and take. It might be harmful if you keep taking without proper prescription. What is adequate for prevention and for treatment?
SPEAKER_12This is a wonderful question. I'm gonna answer the first one very specifically.
SPEAKER_14Okay.
SPEAKER_12Um, the National Cancer Care Network is the are the guidelines along with the American College of Sports Medicine, ACSM. There have been cancer round tables that have really worked diligently to say what is the right dosage for the best cancer prevention. And those are the cancers that obviously aren't genetic based. So let's let's address that. So, most importantly, the physical activity includes a moderate to vigorous intensity of exercise. Every individual should do at least 150 minutes of moderate to the vigorous intensity exercise with an ultimate goal of 300 minutes. So we're not resting on 150. That's baseline.
SPEAKER_04So it's 150 to 300 minutes.
SPEAKER_12That's correct. So that's at least two and a half to five hours a week to interpret that hour-wise to put in your schedule.
SPEAKER_04Which is doable, I believe.
SPEAKER_12It is. You have to put it in the schedule though, don't we? Um, if you choose, if an individual chooses to do vigorous intensity exercise, like high intensity interval training, then 75 minutes a week will be recommended. Okay. Okay?
SPEAKER_04That's the minimum, right?
SPEAKER_12That's the minimum, right? Then you could do a mix of moderate and vigorous intensity activity spread out over the course of the week. And of course, we need to also add two days of strength training to improve muscle physiology alongside of flexibility. So, indeed, we need to be able to not just take a saunter walk alone, like just an easy walk. It has to be a walk if we don't have access to a gym or don't have access to any equipment where we're using our body weight for strengthening to do a plank on the floor for core, or press ups even up against the wall, or get up from your desk and um stretch and then do little bent presses in front of your desk. It is important that these general goals of physical activity for prevention is essential. Okay. Those same amounts of exercise are important once one is going through the cancer treatment, but they may need to be modified because of the intensity of treatment, or an individual needs to be referred to physiotherapy, occupational therapy, or speech therapy to address the post-operative limitations of movement. So if I can't move my arm because I had a mastectomy, I will need to have that restored adequately in order to be able to then do my weight training exercises. So the precursor to meeting those minimum requirements includes an adequate assessment by a rehabilitation specialist to be able to get back to pre-surgery functioning and then return to the dosage of both aerobic and strength training. So I think what's important to note is that within each of the different types of cancer, based on the trajectory of treatment, because both chemotherapy as well as radiation therapy cause cancer-related fatigue. So when one is fatigued, you don't feel like exercising. This is the most important aspect. Exercise is essential to reduce the fatigue. And it's counterintuitive. It doesn't make sense. I just want to sleep. And if you think about this, we're radiating tissue, we're giving chemotherapy, which creates inflammation. So if we could mitigate that with aerobic exercise and strength training, even in the face of cancer-related fatigue, based on the treatment trajectory, that can actually improve cancer-related fatigue. Which also is important if, again, the fatigue is very complex in the cancer survivorship journey. And so, what is important to note is the fact that sleep is a key factor. So individuals need that minimum of six to nine hours of sleep, quality of sleep. It's important again if it depends on where the cancer is to get proper nutrition in. If someone has head and neck cancer, they may have difficulty swallowing. So making sure whether they have an alternative route for caloric intake, that they have enough caloric intake to sustain exercise. And then the other feature that's very important to note is the fact that there are chemotherapeutic agents that are cardio toxic. I see. Why is that important to note? Because individuals can have side effects 20 to 30 years later due to the doses of drugs such as adriaomycin for breast cancer. So I think that's what's important to realize that once a cancer diagnosis is rendered, there may be immediate and then long-term side effects. So it may require, especially with comorbidities like diabetes and obesity and sedentariness, is there a cardiovascular risk that requires clearance by a cardiologist before proceeding to get an exercise prescription? And that is the reason why when we think about exercising during treatment, we know that it has anti-inflammatory effects. Number one, you get the gut microbiome that really has a modulatory effect. You get antioxidants that happen during exercise with good nutrition. You actually reduce your cholesterol levels, and you have improvement in autophagy, right? The autophagy as well, induction. And then finally, it has anti-proliferative and anti and pro apoptosis effects. And this is all in this wonderful model here that was published by Khalifa and colleagues, and they did a summary of the potential mechanisms using diet and exercise, specifically the Mediterranean diet, which does increase in the levels and biological processes and uh really improves the holistic approach to treating.
SPEAKER_04Welcome to another episode of Move and Thrive with me, Dr. Sia Bonagunene. Thank you so much for tuning in. We are continuing with our series where we are looking at exercise as medicine. Today we are going to look at exercise and cancer. I am joined by Professor Meliru from USA. Thank you so much for joining me. How are you doing, Professor Calentino?
SPEAKER_12Well, I got my exercise in before I arrived today.
SPEAKER_01So that's firstly, that's the most important feature.
SPEAKER_12And uh I'm doing well and honored to be here to have this conversation. It's uh extremely important to be able to think about prevention uh uh of various cancers that certainly can have a role to play alongside of during cancer treatment and survivorship. Uh so I come here today as both a clinician, uh academician, um, as well as a cancer survivor.
SPEAKER_04You are a professor in USA. You've worked in on college rehabilitation for over 30 years now.
SPEAKER_12Well, over 30 years. I had the good fortune to uh decide to go into cancer rehabilitation, and I trained at MD Anderson Cancer System Center, which is in Texas in the United States. At that time, we had a very small group of a rehabilitation department that really helped cancer survivors. My entry into that, however, was interestingly enough HIV. Okay. Because our patients with HIV in the 1980s had to Caposi sarcoma, which when the immune system decreases, the vulnerability of cancers for people living with HIV actually increases. So that led me on my pathway to doing research in the area of the benefits of exercise for cancer survivors alongside of HIV individuals who are struggling with comorbidities with HIV and cancer and perhaps other types of non-communicable diseases.
SPEAKER_04Wonderful. And we've seen the work you've done. You've published over a hundred papers, and we really appreciate the contribution that you have made even in our setting in South Africa. You are a visiting professor here at Vets University. We're really happy to have you. You've helped us a lot with curriculum development, and you are busy with what kind of research are you currently working on right now?
SPEAKER_12Right now, uh, my area of focus for cancer survivors and individuals with HIV is a condition that causes pain in the hands and the feet due to in the case of HIV, anti-retroviral therapy, or in the case of chemotherapies, they can cause pain and tingling and numbness in the hands and feet. So, as part of my continuum of research looking at the benefits of exercise for individuals with cancer and HIV, and my research team for HIV is at Rutgers University. And then I'm doing work at the University of Pennsylvania within our team looking at integrative therapies for both of these neuropathies in these two diagnoses. Specifically, I did my postdoc work at the University of Pennsylvania looking at integrative therapies, incorporating the use of meditation and yoga and tai chi if individuals aren't able to be functional enough to do a full-on exercise program. So those are the precursors. So I'm looking at can we get similar benefits from some of these mindful movement exercises as we get with traditional exercises?
SPEAKER_04Wonderful, wonderful. That's powerful. As you can see, Prof Galantino is the right person that can talk about exercise and cancer. So we're gonna unpack this topic. Prof, I want us to start from the beginning. What is cancer? For somebody who may not know what is cancer?
SPEAKER_12Well, let's just start off that with the fact that we have incredibly powerful immune systems. We know that when we get the common cold, our immune systems are the essence of keep of keeping pathogens and cells that just aren't multiplying optimally, the immune system keeps it in check. Unfortunately, when it comes to a cell that is not replicating normally, that cell can get out of control. And since the immune system in some individuals might the quality of that immune system might decline because we have natural killer cells in our system. And subsequently, if there is any compromise of the immune system, the opportunity for an opportunistic cancer can develop in individuals. Now, cancer is quite complex because it could be genetic. Okay, we could have multifactorial lifestyle behaviors, including smoking, obesity, type 2 diabetes, and then we have the environmental component as well. Being exposed to carcinogens in the environment, uh, and addition to lifestyle nutrition on healthy eating and bringing in not so great nutritious elements in our bodies that could be the recipe for a cell to grow and either stay locally if we're lucky to get an early diagnosis or can spread throughout the body and create metastasis. Wow, wow.
SPEAKER_04So you you are linking cancer with lifestyle. Indeed. So would we say cancer is one of the lifestyle diseases? Absolutely.
SPEAKER_12We must appreciate that there is the epigenetic components as well. So if I have a family history of BRCA1-2, BRCA1 or BRCA2, that genetic history may indeed portend that I may get breast cancer andor ovarian cancer.
unknownOkay.
SPEAKER_12However, um, that is a smaller percentage of us, and even with that, we did university at the University of Pennsylvania, we did research with Dr. Schmitz, Catherine Schmitz, and she really led a study that looked at those women who actually had the BRCA1-2 gene to see if we could change the underpinning of the hormonal levels to reduce the likelihood of getting breast cancer. So indeed, we can look at the lifestyle factors and work to prevent colon cancer, breast cancer, many of the esophageal cancers, lung cancer, and these are cancers that indeed may be preventable with exercise, because exercise has a potent effect on the immune system, up-regulating the protective aspects of our cellular replication as well as overall reduction in inflammation.
SPEAKER_04Okay, so you're saying it cancer could be prevented with lifestyle change? Yes. Okay. So if it's a lifestyle disease, it means the solution is lifestyle as well. Precisely. So now tell me, you mentioned colon cancer, you mentioned breast cancer. Who is affected by cancer? What type of cancers do we see in men? What type of cancers do we see in women?
SPEAKER_12So typically in women, we see uh both pre- and post-menopausal women uh with uh breast cancer diagnosis, most assuredly. Uh we also see the gynecologic cancers, which can include ovarian, uterine, and cervical cancer. We know that in women who are vaccinated against HPV early on in puberty with a three vaccinations, we can actually see reductions in cervical cancer because cancer can be virally mediated. So if we can have those vaccinations, that may be a way to prevent in men, we typically see uh prostate cancer, testicular cancer. And again, these types of cancers are hormonally regulated for the most part.
SPEAKER_04I see, I see. And then you colon cancer, are you read that men are mostly affected by colon cancer? Is there a reason why men would be more prone to colon cancer?
SPEAKER_12I would say that uh it depends on again on one's body mass index and the level of obesity. If we have that central adiposity, that central obesity and metabolic syndrome, that is a situation where inflammation is everywhere. With inflammation, it is not a good recipe for our cells to replicate healthily. So whether there's a predilection for more males than females is based on region of the globe. It's also based on other comorbidities, and specifically, obesity is a predictor for colon cancer alongside of poor nutrition and sedentariness.
SPEAKER_04The reason why I'm asking about colon cancer, I'm in a habit of doing regular checks twice twice a year, just to do full checks. And there was a point where I felt discomfort, some ulcers in my stomach, and I asked doctors to just put a camera there inside and check what is happening with and then doctors found some three or four polyps inside my colon and they obviously removed them. Now, my question is does that mean that I'm now exposed to cancer? Does it mean my chances of cancer are increased? What does it mean? Those polyps, could they develop to cancer?
SPEAKER_12Well, firstly, thank you for actually getting checked. Because now what you've done is prevent an incidence of colon cancer because they can be precancerous.
SPEAKER_07Okay.
SPEAKER_12And so the goal to have a colonoscopy is to be able to take that camera and check that your intestines are clear of those polyps. So indeed, um, being able to have early surveillance, and typically males should, again, it depends on every country, it has its own cutoff, age cutoff. For males, if you have a family history of colon cancer, that is important for you to have earlier surveillance. So, congratulations.
SPEAKER_05For taking up.
SPEAKER_12Yes, uh, I commend you and I commend all of our listeners uh for being able to number one say, Do I have a family history?
unknownYeah.
SPEAKER_12If so, then early surveillance is essential. And therein lies seeing your primary care physician, and especially if you are having symptoms because you're healthy.
SPEAKER_06Yeah. I didn't feel yeah, right?
SPEAKER_12You didn't feel anything. You just had maybe some discomfort. What's interesting is oftentimes people will go, oops, is it cancer? Or it could just be indigestion because you're stressed. Stress can also increase inflammation and yet get getting that confirmation, you are to be convinced for that.
SPEAKER_04Yeah, testing is very important. Essential. Knowing because cancer is a sudden killer. You could live with cancer without knowing. Exactly. So checking is important. Why would why are we afraid of checking? I know men don't want to go to check.
SPEAKER_12Well, especially as it relates to prostate cancer, who wants a rectal exam? No one needs to be no one wants to have invasive procedures. And yet, it actually is a reliever of stress when you know you don't have it. So if you're thinking, could I possibly have cancer? The only way to get an answer is to have a diagnostic. Let me give you an example. One of the most important features for women is seven days after their menstrual cycle, the ability to check their breasts. And it is important to be able to notice and appreciate your body as it is in its normal, healthy state. If I feel something unusual in my breast, it might be painless, it might have no symptoms, but if it's palpable, we could be getting early stage cancer removed. I think what we're afraid of, and we have to change the narrative, honestly, we are if we're afraid of cancer, cancer does not equal death.
SPEAKER_09Yes.
SPEAKER_12If we could change that narrative, we could change it only if our audience actually notices that something is not quite right and then says, I'm gonna follow up with my physician. That way we have an early surveillance with removal.
SPEAKER_04And um, coming back to the issue of prevention, yes, because you mentioned that it can be prevented. So take me through why how is exercise a recipe for preventing? I know exercise alone may not be enough. There is a comprehensive approach to preventing diseases, which include diet, which include many other lifestyle-related issues. What is medicine about exercise that can prevent cancer?
SPEAKER_12Well, firstly, I think there are a number of really great research and evidence to point out that when an individual exercises, we firstly are creating a sense of stress relief. What we know with exercise for all our audience participants uh that uh will join us in exercising after this podcast.