Part 1: Physical Exercise and Breast Cancer

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Breast cancer is the most commonly occurring cancer among women. It is estimated that 1 million cases of breast cancer are diagnosed worldwide every year. Chances are someone you know or someone you love has been inflicted with breast cancer. The good news is that over the past 15 years, the number of deaths has declined 2.3% per year.

Risk Factors
There are many risk factors for breast cancer including age, geographic location, socioeconomic status, reproductive events and lifestyle factors, to name a few. The age of a person along with where someone lives can increase or decrease one’s chances of getting the disease. Early age menarche and delayed menopause can increase the risk of breast cancer. Modifying lifestyle factors such as one’s level of physical activity can have a tremendous protective effect on the development of breast cancer. Physical activity can modulate the production and metabolism of many reproductive sex hormones such as estradiol and progesterone which are implicated in the causes of breast cancer.

There are so many things in the world that we cannot directly control or modify. Exercise is not one of them. The amount of exercise you do not only shapes your physiological and psychological health, it also protects against the development of many cancers, including breast cancer.

What Type of Exercise is Best?
All types of exercise whether they be leisure-type activities such as walking the dog or gardening, occupational activities that require lifting, dragging or climbing stairs and structured activities that include a mixture of aerobic and resistance exercise can protect against the development of breast cancer.

Studies focusing on leisure and occupational physical activity have reported a 30% reduction in breast cancer risk in pri-menopausal, peri-menopausal and post-menopausal women. There appears to be a favourable correlation between breast cancer risk and total physical activity. In general, as total exercise activity in hours per week increases, breast cancer risk decreases. Most studies report at least four hours of leisure or occupational activity per week at a moderate intensity level for best protective results. The main message is that exercise, whether structured or unstructured, is required daily and serves as a modifiable risk factor. How much you move, how much you eat and your overall body fatness has a direct impact on your risk of developing breast cancer.

Body Fatness, BMI and Total Food Intake
The negative impact that high body fatness and BMI have on many other diseases apply to the development of breast cancer as well. Obesity and weight gain increase the amount of fat on the body and provide a storage area for estrogen and other sex hormones which increase risk. Studies have shown that for every 5 kilograms of weight gain since a women’s lowest adult weight, breast cancer risk increases by 8%.

A study conducted in Cancer Epidemiological Biomarkers Prevention (2005) tested the hypothesis that women who participated in less overall exercise and/or sporting events and had a high BMI or energy intake would have an increased risk for developing breast cancer. Participants were classified into two groups: the breast cancer cases (1459 women) group and 1559 apparently healthy age-matched controls. All participants completed in-person interviews and provided information about breast cancer risk factors, dietary strategies, exercise patterns, etc.

The results showed that in general, women with lower exercise levels, higher BMI or higher energy intake had an increased risk (approx. 1.5 to almost two times the risk) of developing breast cancer compared to women who reported more regular exercise, had lower BMI and ate less. The study results show that lifestyle or behaviour modifications such as regular exercise and total food intake decrease the risk of developing breast cancer. This decreased risk starts early in life as many studies have reported a protective effect as high as 20% into the adult years for young girls who are relatively active between 12 to 24 years of age.

Why Aren’t We Getting It?
Maybe we are getting it. The prevalence of breast cancer has decreased over the past 15 years due to a number of reasons including early detection, treatment protocols and possibly lifestyle modifications. However, with obesity, weight gain, insulin-resistance and diabetes on the rise (conditions that are modifiable through behaviour changes) it doesn’t seem as though the majority of the population is getting it. The research is conclusive: regular exercise and moderate food intake do not provide guarantees, but they do provide much needed protection. If you are not already following a regular exercise program and eating to live versus living to eat, start today.

What Can you Do?
Start a walking program three to four days per week; walk faster or up a hill for a challenge. When you are ready, purchase some small dumbbells or rubber tubing and start some toning exercises. Take the stairs as often as you can and begin to feel and see how your precious body was intended to function. Positive lifestyle choices decrease the risk of developing breast cancer.

The question remains: Once you are diagnosed with breast cancer, can regular exercise and/or quality and quantity of food intake improve survival? Part 2 of this article series will shed some light on this question. For now, start moving even if it means getting up from your office chair and walking around the office.

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