Exercise and Cancer Survivorship: Impact on Health Outcomes and Quality of Life Saxton, John ISBN-13: 9781441911728 Table of Contents CHAPTER 1: Introduction John Saxton and Amanda Daley 1.1 Abstract 1.2 The burden of cancer 1.3 Stages of the cancer experience 1.4 Exercise and the cancer survivor 1.4.1 Cancer as a ‘Teachable moment’ 1.4.2 Health benefits of exercise 1.4.3 Exercise terminology 1.4.4 Exercise guidelines for cancer survivors 1.5 Levels of evidence 1.5.1 General overview 1.5.2 Observational studies 1.5.3 Qualitative studies 1.5.4 Randomized controlled trials 1.6 Dose-response issues 1.7 Aims of this book 1.8 References CHAPTER 2: Exercise and cancer-related fatigue syndrome Margaret L McNeely and Kerry S Courneya 2.1 Abstract 2.2 Introduction 2.2.1 Incidence of CRF 2.2.2 Etiology of CRF 2.2.3 Conceptual framework for the study of CRF 2.3 Assessment of CRF 2.3.1 Clinical syndrome of CRF 2.3.2 CRF-specific measurement instruments 2.4 Management strategies for CRF 2.4.1 Pharmacological interventions 2.4.2 Psychosocial interventions 2.4.3 Exercise interventions 2.4.3.1 Breast cancer 2.4.3.2 Prostate cancer 2.4.3.3 Hematopoietic stem cell transplantation 2.4.3.4 Advanced cancer 2.4.4.5 Combined interventions for CRF 2.5 Special considerations for exercise testing and programming 2.5.1 Screening for exercise participation 2.5.2 Exercise testing 2.5.3 Exercise programming 2.5.3.1 Prescription considerations for patients with poor functional capacity 2.5.3.2 Intermittent or interval exercise training 2.5.3.3 Muscular fitness training 2.5.3.4 The training index 2.5.3.5 Pacing 2.6 Summary and conclusions 2.7 References CHAPTER 3: Exercise as an intervention during breast cancer treatment Martina Markes 3.1 Abstrac 3.2 Introduction 3.2.1 Impact of breast cancer treatment 3.2.2 Physical activity behaviours 3.3 The evidence base for exercise: a systematic review 3.3.1 Methods of the systematic review 3.3.2 Description of studies 3.3.3 Effects 3.3.3.1 Physical and mental health 3.3.3.2 Adverse effects 3.3.4 Exercise adherence and maintenance 3.3.5 Quality of the evidence 3.3.6 Applicability of the evidence to the breast cancer population 3.3.7 Implications for research 3.4 Implementation and dissemination 3.5 Summary 3.6 References CHAPTER 4: Exercise after treatment for breast cancer: effects on quality of life Helen Crank and Amanda Daley 4.1 Abstract 4.2 Introduction 4.2.1 Incidence and survival from breast cancer 4.2.2 Consequences of breast cancer 4.2.3 Psychosocial and psychosocial interventions 4.3 The potential role of exercise after treatment for breast cancer 4.4 Chapter overview 4.5 Is exercise an effective quality of life intervention after treatment for breast cancer? Summary of the evidence 4.5.1 Setting the scene: early intervention studies 4.5.2 The ’boom’ years 4.5.2.1 Trials of supervised aerobic exercise 4.5.2.2 Weight-training and resistance exercise interventions 4.5.2.3 Combined aerobic exercise and resistance training interventions 4.5.2.4 Pragmatic home-based exercise interventions 4.5.2.5 Alternative modes of exercise 4.5.2.6 Exercise versus other quality of life interventions 4.6 Reviews and meta-analyses 4.7 ‘What’s it like?’ Cancer survivor experiences of exercise 4.8 What next? 4.9 Summary and conclusions 4.10 References CHAPTER 5: The importance of controlling body weight after a diagnosis of breast cancer: the role of diet and exercise in breast cancer patient management Michelle Harvie 5.1 Abstract 5.2 Trends in breast cancer incidence and mortality 5.3 Current recommended treatments 5.4 The problem of excess body weight in breast cancer patients 5.4.1 Prevalence of overweight and obesity amongst breast cancer patients 5.4.2 Weight gain after a diagnosis of breast cancer 5.4.3 Impact of obesity and weight gain on breast cancer recurrence and breast cancer specific mortality 5.4.4 The effects of weight gain and weight loss after diagnosis 5.4.5 Effects of obesity on prognosis in women receiving adjuvant endocrine therap Effects of obesity on prognosis in women receiving adjuvant chemotherapy Effects of obesity on prognosis in women receiving adjuvant chemotherapy 5.4.8 Obesity and contra- lateral breast cancer 5.4.9 The effect of central obesity and insulin resistance on prognosis 5.5 Body weight and lymphedema 5.6 Obesity related co-morbidities in breast cancer patients 5.7 Interventions for weight control amongst breast cancer patients 5.7.1 Diet and exercise interventions 5.7.2 Diet and exercise recommendations for breast cancer patients 5.7.3 Delivery of weight-management programs for breast cancer patients 5.7.4 Pharmacotherapy 5.7.5 Monitoring patients in weight loss interventions 5.8 Weight loss and bone health 5.9 Weight loss and quality of life 5.10 What advice do patients want about diet and weight control? 5.11 Health care professional survey: Current roles and attitudes to delivering diet, exercise and weight control advice to early breast cancer patients 5.11.1 Current practice 5.11.2 Beliefs 5.12 Summary and conclusions 5.13 References CHAPTER 6: The biological mechanisms by which physical activity might have an impact on outcome/prognosis after a breast cancer diagnosis Melinda L Irwin 6.1 Abstract 6.2 Introduction 6.3 Physical activity and breast cancer survival 6.4 Biological mechanisms by which physical activity may impact upon breast cancer survival 6.4.1 Obesity and Weight Gain 6.4.2 Fasting Insulin and IGF Levels 6.4.3 Sex Hormones 6.4.4 Adipokines 6.4.5 Inflammation 6.5 Other potential mechanisms mediating an effect between physical activity and breast cancer survival 6.6 Summary and conclusions 6.7 References CHAPTER 7: Exercise after prostate cancer diagnosis Daniel Santa Mina, Paul Ritvo, Roanne Segal, N Culos-Reed and Shabbir Alibhai 7.1 Abstract 7.2 Introduction 7.2.1 Screening 7.2.2 TNM staging 7.2.3 Histopathological grading 7.2.4 Treatment 7.3 Exercise and prostate cancer prevention 7.3.1 Mechanisms of prevention 7.4 Exercise post diagnosis of prostate cancer 7.4.1 Exercise for early stage, localized disease 7.4.1.1 Radical prostatectomy 7.4.1.2 Radiation therapy 7.4.2 Exercise for locally advanced and hormone sensitive metastatic disease 7.4.3 Exercise for hormone refractory metastatic disease 7.5 Limitations of current research 7.6 Future directions for exercise and prostate cancer research 7.7 Exercise recommendations 7.8 Summary and conclusions 7.9 References CHAPTER 8: Exercise for prevention & treatment of prostate cancer: cellular mechanisms R James Barnard and William J Aronson Abstract 8.2 Introduction 8.3 Possible mechanisms for the value of exercise 8.3.1 Tumor growth and apoptosis 8.3.2 Changes in serum factors induced by diet and exercise 8.3.3 Diet versus exercise 8.3.4 Serum IGF-I, tumor growth and apoptosis 8.3.5 Prostate cancer patients 8.3.6 Angiogenisis, invasion and metastasis 8.4 Summary and conclusions 8.5 References CHAPTER 9: Physical Activity Before and After Diagnosis of Colorectal Cancer David J Harriss, N Tim Cable, Keith George, Thomas Reilly, Andrew G Renehan