Introduction:
With an expected 2.26 million new cases in 2020, or 12.5% of all cancer cases worldwide, breast cancer (BC) is the most common malignancy to receive a diagnosis. According to current research, even little daily exercise regimens and a nutritious diet can lower the incidence of breast cancer, lessen the negative effects of cancer therapy, and prevent cancer from returning in survivors. Although these lifestyle interventions have many advantages, there hasn't been much practice of them in survivor and at-risk communities up until now. Regretfully, women who receive a breast cancer diagnosis often cut down on their physical activity by 11%. Patients who have chemotherapy (50%) and radiotherapy (24%), in comparison to those who do not receive treatment, have been shown to decrease their physical activity even more. (1)
How exercise reduces risk of breast cancer?
SEX STEROID HORMONES:
The incidence and development of breast cancer are higher in women with raised systemic levels of androgens and oestrogens. Estradiol, testosterone, and sex hormones are inversely linked with physical activity in premenopausal women. Physical activity has been associated with decreased levels of estradiol and estrone after adjusting for body mass index. This suggests that reduced adiposity and weight loss are linked to controlled levels of sex hormones and a lower risk of breast cancer, as sex hormones in postmenopausal women are primarily produced in the adipose tissue.
METABOLIC HORMONES:
Exercise can lower insulin resistance and levels, which in turn can lower total IGF-1, fasting glucose, and IGF binding protein levels. Furthermore, as a result of their decreased body weight following exercise therapies, breast cancer patients had lower fasting insulin levels, which bodes well for their prognosis.
INFLAMMATORY MARKERS:
Tumour necrosis factor alpha (TNF-α), C-reactive protein (CRP), interleukin-1 (IL-1), and IL-6 are well known biomarkers of systemic inflammation linked to breast cancer. (1)In healthy people who have not been diagnosed with cancer, physical activity generally has an anti-inflammatory effect and lowers systemic inflammation.
Through a direct reduction in body fat, physical activity interventions have been shown to significantly increase serum levels of adiponectin and decrease serum levels of leptin. Consequently, exercise may control inflammatory cytokines and adipokines; on the other hand, weight reduction and fat mass are significantly linked to a lower risk of breast cancer.
MYOKINES AND STRESS HORMONES:
Exercise controls levels of circulating myokines, including IL-6, myostatin, myonectin, and irisin.Irisin can reduce the viability of breast cancer by increasing caspase activity and suppressing NF-κB activity, as preclinical studies have shown. Irisin is raised with physical exercise.Through activating the tumour suppressor Hippo signalling pathway, exercise-induced catecholamines mediate the suppressive effects against breast cancer.The quantity and activity of circulating immune cells, such as natural killer cells—the immune cells most sensitive to exercise-dependent mobilisation to the circulation—are influenced by physical activity. (1)
Health benefits of regular exercise :
Engaging in appropriate lifestyle interventions along with targeted exercises have shown to mitigate the adverse effects of cancer treatment, including lymphoedema, weight gain, fatigue, and osteoporosis. Moreover, adopting a healthy lifestyle can not only reduce the risk of heart attacks and strokes but also decrease the likelihood of cancer recurrence, thus fostering long-term well-being. Additionally, prioritizing physical activity and incorporating stress-reducing activities into your routine can bolster mental health, lifting mood and diminishing feelings of stress, anxiety, and depression. Furthermore, maintaining an active lifestyle aids in preserving overall fitness levels and muscle tone, both during and after cancer treatment, preventing or mitigating potential losses in physical strength and agility. (2)
Exercise recommendations for patients with breast cancer:
Recent studies have provided strong evidence for the impact of structured exercise programs on breast cancer outcomes. Aerobic activity scheduled for 30 minutes a day or 150 minutes a week of moderate intensity, including activities such as yard work, bike riding, swimming, dancing and walking, has emerged as important interventions. Furthermore, three times a week using resistance machines, exercise bands, free weights and body weights are done. It has been shown to be beneficial to strength training combined with resistance exercises.
Notably, research shows that adherence to these exercise guidelines is associated with significantly increased survival and a lower risk of breast cancer recurrence at all stages of the disease progression significant reductions, including pre-, post-diagnosis and treatment % of observed reductions those who perform appropriate physical activity. These findings highlight the significant long-term impact of organized physical activity on the health of breast cancer patients, and highlight the important role of physical activity in comprehensive cancer care strategies. (2) (3)
Best moderately intensive activities to meet the recommended daily needs of exercise for breast cancer:
1) Brisk walking
2) Whether it's swimming, dancing, light cycling, or running, pick activities you enjoy to help you stay to your fitness regimen over time.
3) Resistance training:
Exercises that target your muscles, such as the primary muscles in your arms, shoulders, back, hips, thighs, and abdomen, will help you achieve a more toned body. Additionally, they fortify ligaments, tendons, joints, and bones.
Conclusion:
Regular physical activity reduces the incidence of colorectal, endometrial, and breast cancers, according to AICR studies. Numerous common malignancies can be prevented with regular physical activity, a nutritious diet, and appropriate weight management. This is demonstrated by numerous studies with clear and consistent findings. These beneficial practices can also lower the risk of developing other chronic illnesses linked to cancer, like diabetes and obesity.Frequent exercise strengthens the immune system, lowers chronic inflammation, and supports the body's ability to produce as well as utilise hormones like oestrogen and insulin at appropriate levels. Numerous malignancies may be influenced by these hormones at abnormal amounts.
Controlling weight can also be aided by physical activity. Keeping a healthy weight is one of the most crucial things people can do to reduce their risk of cancer, besides quitting smoking.
Writer: Saathwika
Editor: Angad Tiwari
References :
1. Hong, B. S., & Lee, K. P. (2020, September 30). A systematic review of the biological mechanisms linking physical activity and breast cancer. Physical Activity and Nutrition, 24(3), 25–31. https://doi.org/10.20463/pan.2020.0018
2. Nelson, M. (2020, October 22). How does regular exercise affect Breast Cancer recurrence? | AICR. American Institute for Cancer Research. https://www.aicr.org/news/how-does-regular-exercise-affect-breast-cancer-recurrence-aicr/
3. Hudson, H. (2023, September 22). Exercise & Breast Cancer: Impact, Benefits, and Prevention. https://www.patientpower.info/breast-cancer/exercise
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