Lecture 14 - Recurrence & Survival Flashcards
Lecture 14:
What do most studies show about overweight & survival of breast cancer patients?
Overweight breast cancer survivors shown to have poorer survival rates
Lecture 14:
What are some reasons why overweight breast cancer survivors have poorer survival rates?
1.) higher estrogen & androgen concentrations
2.) Later stage of diagnosis & larger tumour sizes
3.) Correlation with socio-economic status (eg; less access to screening/treatments)
4.) Other factors (eg; increased insulin, IGF, decreased sex hormone-bonding globulin, etc)
Lecture 14:
What are 3 reasons why chemotherapy can cause weight gain in breast cancer survivors?
1.) Increased hunger levels
2.) Drugs used
3.) Reduced activity levels
Lecture 14:
What are a few potential mechanisms that outline the correlation between obesity, PA, & breast cancer prognosis?
- more inflammation
- increased estrogen, insulin, & glucose levels
- increased angiogenesis
- decreased PA & increased adiposity in response
Lecture 14:
What was studied in Kroenke et al’s 2005 study?
Studied 5,204 nurses’ from 1976 to 2002
- 533 breast cancer deaths & 681 recurrences
Lecture 14:
What were the results of Kroenke et al’s 2005 study of nurses?
Weight gain of 2.0kg/m^2 (BMI) occurred after diagnosis & associated with;
- elevated risk of recurrence (53% increase)
- elevated risk of breast cancer mortality (64% increase)
- all-cause mortality (59% increase)
Lecture 14:
What did Meyerhardt et al’s study in 2006 study?
- how many participants
Studied impact of PA on colon cancer recurrence & mortality
- 832 stage 3 colon cancer survivors studied after surgery & chemotherapy
Lecture 14:
What were the results of Meyerhardt et al’s study in 2006 study?
Those who engaged in more than 18 MET hours/week of PA (equivalent to walking 6+hrs/week at average pace) saw 47% improvement in disease free survival compared to inactive participants
Lecture 14:
What is physical activity associated with after a colon cancer diagnosis?
- reduced risk of recurrence
- reduced risk of colon cancer mortality
Lecture 14:
What are colon cancer survivors who increase activity levels following diagnosis at lowest risk of?
- colon cancer mortality
- all cause mortality
Lecture 14:
What does increased PA after diagnosis help with?
May decreases recurrence or other diagnosis that are risk factors
Lecture 14:
What happens to mortality risk when PA is increased?
Mortality risk decreases with increased amount of Physical Activity
Lecture 14:
What are some mechanisms that potentially reduce cancer mortality and recurrence?
- Physical Activity (lower levels of circulating ovarian hormones {specifically estrogen & breast cancer)
- Decreased circulating insulin & IGF-1 levels
- Altered prostaglandin synthesis
- Altered bile acid secretion
Lecture 14:
How is inflammation a risk factor for chronic disease?
Risk of chronic diseases of all kinds tied to low grade systemic inflammation
Lecture 14:
What types of patients are low grade systemic inflammation levels higher in?
Obese & sedentary individuals
Lecture 14:
What does inflammation create in cancer patients?
Creates a favourable tumour micro environment
Lecture 14:
In cancer patients, what does inflammation predict?
Inflammation predicts prognosis
Lecture 14:
What do high vs low markers of inflammation indicate in cancer patients?
In cancer patients, high markers of inflammation = poor prognosis & low markers = good prognosis
Lecture 14:
How does PA impact inflammation?
Possible that physical activity can reduce inflammation in cancer survivors
Lecture 14:
How many studies have been done on the impact of PA & reduced inflammation, & how did they study it?
- only 1 study to date
- studied 12 lung cancer patients under a 4-6 week pre-operative aerobic training program
- saw reductions in markers of inflammation
Lecture 14:
What is the purpose of PA in lung cancer patients?
To het fitness up enough so that you can actually give them surgery
Lecture 14:
What 2 cancer types can physical activity after diagnosis reduce the risk of recurrence & mortality in?
Breast & colon cancer survivors
- saw a direct, dose-response relationship
