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Fitness & Exercise for Senior Citizens
Colon Cancer Risk Significantly Reduced in Men by
Regular Aerobic Exercise
Women in clinical
trial did not have the same positive results
 September
13, 2006 Men who are up for at least four hours of moderate-to-vigorous
aerobic exercise a week can significantly reduce their risk of colon
cancer, says a report from the first randomized clinical trial to test
the effect of exercise on colon-cancer biomarkers in colon tissue. The
results for women were less certain. Senior citizens are the most
vulnerable to this disease, with nine of ten cases found in people age
50 and older.
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This exercise reduces a risk factor rapid
cellular proliferation - associated with the formation of colon polyps
and colon cancer in men, according to the study led by researchers at
Fred Hutchinson Cancer Research Center and published in the September
issue of Cancer Epidemiology, Biomarkers and Prevention.
"In men who met the study's exercise prescription
of an hour of aerobic activity per day, six days a week for a year, we
saw a substantial decrease in the amount of cellular proliferation in
the areas of the colon that are most vulnerable to colon cancer," said
lead author Anne McTiernan, M.D., Ph.D., an internist and epidemiologist
who directs the Hutchinson Center's Prevention Center.
"However, we found that even four hours or more of
exercise weekly was enough to produce a significant benefit," she said.
Specifically, the researchers saw a decrease in the
number of actively dividing cells, or cellular proliferation, within the
colonic crypts tiny tube-like indentations in the lining of the colon,
or epithelium, which help regulate the absorption of water and
nutrients.
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Read more about
colorectal cancer, the third most common cancer found in men and
women in this country, below this news story. |
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"A certain amount of cellular proliferation at the
bottom part of the crypt is normal. But when these cells start dividing
too quickly, they can migrate up the sides of the crypt to the surface
and eventually form a polyp," she said. While most polyps are benign,
over time some types can become malignant.
The researchers found an inverse relationship
between the amount and intensity of exercise and the levels of cellular
proliferation, as measured by how far the migrating cells traveled from
the base of the crypt and up the sides toward the surface of the
epithelium.
A significant decline in cellular proliferation was
observed among men who worked out an average of four hours a week or
more and in those whose cardiopulmonary fitness was most robust. The
greatest decrease in cellular proliferation was seen in men who
exercised more than five hours a week. No such decrease was seen among
sedentary men or those who exercised infrequently.
"Proliferation in the upper section of the colon
crypt decreased among those exercising for a mean 250 minutes per week
or greater, which is important because this pattern of proliferation is
most associated with risk for colon cancer," the researchers reported.
Body weight did not appear to have an impact on the
effect of exercise on cellular proliferation. "These effects were
independent of weight. Vigorous exercise was helpful for men of any
size, as long as they worked out nearly every day," said McTiernan, a
member of the Public Health Sciences Division at the Hutchinson Center
and a faculty member at the University of Washington.
Women do not show same results
So while men of all shapes and sizes seemed to
benefit from frequent, vigorous workouts of at least four hours a week,
the investigators saw no notable changes in markers of cellular
proliferation in their female counterparts.
"This finding supports previous epidemiological
studies that also have suggested that regular exercise reduces the risk
of colon cancer in men more than in women," McTiernan said. "It's not a
finding that we really wanted to see, but at least our results are
consistent with those of previous population-based, epidemiological
studies."
The mechanism behind the null effect in female
exercisers is unknown. Possible explanations, the researchers
hypothesize, include the fact that exercise lowers the level of
naturally occurring estrogen, a hormone that protects the colon. Another
possible explanation is that the men worked out more vigorously and more
often than did the women.
"On average, the men in the study met their
physical-activity goal of an hour a day, six days a week, whereas the
women met about 80 percent of their goal. Also, the men spent more time
jogging or running compared to the women," McTiernan said. "The women
still did very well in this exercise intervention, but it may not have
been enough to protect the colon."
The study, which was funded by the National Cancer
Institute and the National Institutes of Health, involved 202 healthy,
sedentary Seattle-area men and women between the ages of 40 and 75. All
had undergone a colonoscopy within three years of participating in the
year-long intervention to confirm the absence of colon cancer.
Before and after completion of the study, the
participants also underwent a flexible sigmoidoscopy, a procedure that
allows for visual inspection of the rectum and lower colon, and the
collection of tissue samples from the mucosal lining of the colon.
Half of the participants were randomly assigned to
an exercise group and half were randomly assigned to a comparison, or
control group. The exercisers were asked to engage in moderate to
vigorous activity six days a week for a year, both on their own and at a
one of several exercise facilities (including one located at the
Hutchinson Center). They were also asked to maintain their regular
eating habits for the duration of the study.
Those in the control group were asked to maintain
their current activity level and diet for a year, after which they had
an opportunity to exercise for two months at no cost with a personal
trainer at one of several study facilities. The Seattle Foundation and
Precor Inc. of Bothell donated exercise equipment for the
state-of-the-art Hutchinson Center exercise facility.
Adherence to the program was excellent, as
indicated by daily exercise logs; 80 percent of the exercisers met more
than 80 percent of their six-hour-a-week goal.
A major strength of the study was its randomized,
controlled, clinical-trial design, which enabled the researchers to
minimize the impact of confounding factors, document exercise activity
and examine the direct effects of exercise on colon tissue.
"I think that this study really underscores the new
activity recommendations from the USDA and the Institute of Medicine,
both of which advise people to exercise an hour a day, six days a week
for weight control and general health," McTiernan said.
Researchers from the University of Washington
School of Medicine, Veterans Affairs Puget Sound Health Care System and
Virginia Mason Medical Center in Seattle collaborated on the study.
American Cancer Society on Colon Cancer
Other than skin cancer, colorectal cancer is the
third most common cancer found in men and women in this country. The
American Cancer Society estimates that there will be about 106,680 new
cases of colon cancer and 41,930 new cases of rectal cancer in 2006 in
the United States. Combined, they will cause about 55,170 deaths.
The death rate from colorectal cancer has been
going down for the past 15 years. One reason is that there are fewer
cases. Thanks to colorectal cancer screening, polyps can be found and
removed before they turn into cancer. And colorectal cancer can also be
found earlier when it is easier to cure. Treatments have improved as
well.
Risk Factors for Colorectal Cancer
● Age: Your
chance of having colorectal cancer goes up after age 50. More than 9 out
of 10 people found to have colorectal cancer are older than 50.
● Having had
colorectal cancer before: Even if a colorectal cancer has been
completely removed, new cancers could start in other areas of your colon
and rectum.
● Having a
history of polyps: Some types of polyps increase the risk of colorectal
cancer, especially if they are large or if there are many of them.
● Having a
history of bowel disease: Two diseases called ulcerative colitis and
Crohns disease increase the risk of colon cancer. In these diseases,
the colon is inflamed over a long period of time and there may be ulcers
in its lining. If you have either of these, you should start being
tested at a young age and have the tests often.
● Family
history of colorectal cancer: If you have close relatives who have had
this cancer, your risk is increased. This is especially true if the
family member got the cancer before age 60. People with a family history
of colorectal cancer should talk to their doctors about how often to
have screening tests.
● Certain
family syndromes: A syndrome is a group of symptoms. For example, in
some families, members tend to get a type of syndrome that involves
having hundreds of polyps in their colon or rectum. Cancer often
develops in one or more of these polyps.
If your doctor tells you that you have a
condition that makes you or your family members more likely to get
colorectal cancer, you will probably need to begin colon cancer testing
at a younger age and you might think about genetic counseling.
● Ethnic
background: Jews of Eastern European descent (Ashkenazi Jews) have a
higher rate of colon cancer.
● Diet: A
diet high in fat, especially fat from animal sources, can increase the
risk of colorectal cancer.
● Lack of
exercise: People who are not active have a higher risk of colorectal
cancer.
●
Overweight: Being very overweight increases a person's colorectal cancer
risk.
● Smoking:
Most people know that smoking causes lung cancer, but recent studies
show that smokers are 30% to 40% more likely than nonsmokers to die of
colorectal cancer. And smoking increases the risk of many other cancers
as well.
● Alcohol:
Heavy use of alcohol has been linked to colorectal cancer.
Factors that Are Less Certain
● Race:
African Americans are at higher risk of getting this cancer and dying
from it. The reason for this is not known.
● Diabetes:
People with diabetes have a 30% to 40% increased chance of getting
colorectal cancer. They also tend to have a higher death rate from this
cancer.
●
Night-shift work: One study suggests that working a night shift at least
3 nights a month for at least 15 years might increase the risk of
colorectal cancer in women. More research is needed.
● Other
cancers and their treatment: A recent report on testicular cancer
survivors found that these men had a higher rate of colorectal cancer.
Men who receive radiation therapy for prostate cancer have been reported
to have a higher risk of rectal cancer.
The American Cancer Society and several other
medical organizations recommend earlier testing for people with
increased colorectal cancer risk. These recommendations differ from
those for people at average risk. For more information, talk with your
doctor.
Learn more from American Cancer Society
click here
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