Kines 426 Quiz 5

• Normal cells criteria

• Reproduce themselves

• Stop reproducing at the right time 

• Stick together in the right place (cell adhesion)

• Self-destruct if they are damaged (apoptosis)

• Become specialized or mature

cancer cells criteria

• Carry on reproducing

• Don’t obey signals from neighbouring cells

• Can become detached from the primary tumour and travel to other parts of the body

• Don’t become specialized, stay immature

• Don’t die if they move to another part of the body

cell adhesion def

Stick together in the right place

apoptosis def

Self-destruct if they are damaged

Carcinogenesis stages

1: initiation, 2: promotion, 3: progression

Stage 1: initiation

normal —> Converted cells

Stage 2: promotion

converted —> Precancerous cells

Stage 3: progression

precancerous —> Cancerous cells

area of most cancer

south

leading sites of new cancer cases

male = prostate women = breast

leading site of death from cancer

lung and bronchus = both

gender with highest cancer incidence rates

male

• Most cancer death rates by race and ethnicity 

• Black and American indian/alaskan native males

• Risk factors - lung cancer nonmod

• Age

• Lung cancer before

• Genetics (family history)

• Previous lung radiation

Risk factors - lung cancer Modifiable 

• Tobacco smoke

• Secondhand smoke

• Exposure to radon, asbestos, or other cancer causing agents

• Risk factors - colon cancer 

  • Nonmodifiable

• Age

• Bad colorectal cancer, polyps or bowel disease before

• Genetics

• Gallbladder removed

• Pelvic radiation

• Risk factors - colon cancer 

  • Modifiable

• Diet (low fiber, high fat)

• Lack of exercise

• Overweight

• Smoking

• Alcohol

• Type 2 diabetes

• Risk factors - breast cancer

  • Nonmodifiable

• Gender

• Age

• Genetic risk (BRCA 1 or 2)

• Family history

• History of breast/ovarian cancer

• Race

• Abnormal breast radiation

• Early onset of menstrual periods

• Late onset of menopause

• Risk factors - breast cancer

  • Modifiable

• Not having children, having children >30yrs old 

• Birth control

• Hormone replacement therapy

• Breastfeeding and pregnancy

• Alcohol

• Exercise

• Risk factors - prostate cancer

  • Modifiable

• Diet 

• Exercise

• Risk factors - prostate cancer

  • Nonmodifiable

• Age

• Race

• Nationality (north american and NW europe) 

• Family history

Harvard alumni study - cancer

< 500 kcal/week had 50% higher risk of cancer death

Fitness and cancer: ACLS

Low fit = more likely to die from cancer

• Research - colon cancer 

• More active a person is, the lower risk is

• Nurses’ Health study - colon cancer

Outlier is <2MET hr/week, little lower risk >21MET hr/week

• PAG report - colon cancer

• PA 3-4hrs/wk ~30% reduction

  • PAGAC= strong 

• Research - breast cancer

• Not as strong as colorectal cancer, but still some evidence 

• Risk is different for pre and post-menopausal

• PAG report - breast cancer

• PA 3-4hrs/wk ~20-40% reduction

• PAGAC= strong

Research - prostate cancer

• Some evidence shown reduction in risk with regular PA, other shows no relationship

• Less consistent than colorectal and breast cancer

•  PAG report - prostate cancer

• Weak relationship 

  • PAGAC = limited

• Effects may vary by age

• PAG report - lung cancer

• evidence show lower risk

  • PAGAC = moderate

• evidence suggests dose-response 

  • PAGAC= limited 

• PA as preventative mechanism (more PA = less cancer)

• Endometrial Cancer: strong

• Esophageal Cancer: strong

• Gastric Cancer: Strong

• Renal Cancer: Strong

• PA shows no effect (good or bad)

• Thyroid cancer: moderate

• Rectal cancer: limited

Mechanism

• Hormones 

  • Estrogen 

  • Testosterone

• Obesity

• Inflammation

• Immune response

• Cancer-related time period

• Prediagnosis: prescreening and screening

• Diagnosis 

• Postdiagnosis: pretreatment, treatment, posttreatment, resumption

prediagnosis

• Prevention → detection

diagnosis

• Detection → buffering

Postdiagnosis

• Buffering → coping → rehab → health promotion → survival

• Buffering → coping → palliation → survival 

• Preventing attenuating or rehab late and long term effects of cancer treatment

• Benefits: walking for muscular strength and endurance

• Cancer treatment

• Surgery 

• Radiation

• Chemotherapy

• Immunotherapy

• Physical changes of treatment 

• Decreased muscle mass, bone health, and immune function

• Psychological and behavioral changes

• Decreases exercise PA and cognitive function

• Increased depression and physical symptoms and pain 

• Breast cancer - nurses health study

• 29% decrease >3 MET hrs / wk after diagnosis 

• Colon cancer Nurses health 

• 18 MET/hrs/wk 61% and 57% reduced risk than those who did < 3

colon cancer CALBG trial

• 18 MET hrs/wk had 49% reduction in risk of recurrence

•  PA and colon cancer treatment

• Stage 3 

• Regular exercise 3x 45mins / week = 45% reduction

• Exercise after chemo for colon cancer

• Structured exercise program or health-education materials

• Significantly longer disease free survival and findings consistent with longer overall survival for exercise program

what type of cancer has strongest evidence

colorectal cancer

how much of country is obese

66%

how many are meeting PA recs

50%

• Fogelholm 2009

• risk of death and CVD decrease in individ w/ higher BMI and good fitness

• increased BMI even w/ high PA increases risk of DM and CVD

  • >35BMI

High fitness

metabolic profile better suited to weight control and improved vascular health

• Genes also impact metabolic profile 

• Aerobics center study

• similar fitness levels

  • higher PA levels had better CV health

• Measurement issues

• fitness vs PA

• objective/direct vs subjective/indirect

• Review

  • Most fitness levels associated directly

  • Most PA assessed via self-report

• BMI as a measure of obesity