Fitness and muscle strength could almost halve cancer patient deaths, study suggests

[Broccoli24]

Fuel to get us to the gym… or whatever we can manage… From The Guardian this morning;

Association of muscle strength and cardiorespiratory fitness with all-cause and cancer-specific mortality in patients diagnosed with cancer: a systematic review with meta-analysis

A data analysis, involving nearly 47,000 patients with various types and stages of cancer, suggests muscular strength and good physical fitness are linked to a significantly lower risk of death from any cause in people with cancer.

The findings were published in the British Journal of Sports Medicine.

To inform potential options for extending survival in these patients, researchers set out to see if muscular strength and cardiorespiratory fitness might be associated with a lower risk of death, and whether cancer type and stage might be influential.

Researchers, led by Edith Cowan University in Australia, looked for relevant studies published in English up to August 2023, including 42 in the final pooled data analysis.

Compared with patients with poor muscle strength and low levels of cardiorespiratory fitness, those at the other end of the spectrum were 31-46% less likely to die from any cause, the researchers said.

This combination of strength and fitness was associated with an 8-46% lower risk of death from any cause in patients with stage 3 or 4 cancer, and a 19-41% lower risk of death from any cause among those with lung or digestive cancers.

“Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in cancer patients in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy,” the researchers wrote.

A second study, also published in the British Journal of Sports Medicine on Wednesday, found maintaining a slimmer waistline along with regular exercise was far more effective at cutting the risk of cancer than doing only one or the other.

The research, funded by the World Cancer Research Fund, found people needed to exercise and keep their weight down to reap the maximum benefit.

The study, of more than 315,000 people, was the first to investigate how the two actions combine to reduce cancer risk.

Dr Helen Croker, assistant director of research and policy at the World Cancer Research Fund, said: “These findings underscore the importance of a holistic lifestyle approach instead of focusing on a single factor to reduce cancer risk. Maintaining a healthy weight and, in particular, having a waist circumference within the recommended level and being physically active, along with eating a healthy diet, are all crucial steps to reduce cancer risk.”

Source

bjsm.bmj.com/content/early/...

[NanoMRI]

Good fuel (I carefully read the paper) but what is sufficient fitness and how effective is this after diagnosis? From article: “Therefore, it remains unknown whether higher muscle strength and cardiorespiratory fitness are associated with a lower risk of mortality in patients already diagnosed with cancer.” “Unfortunately, we could not perform the meta-analysis on cancer-specific mortality owing to the lack of studies investigating muscle strength and death related to cancer only.”

I have been asking these questions since my Dx ten years ago when I stopped working to focus on fitness and researching this beast. I do not have answers but do have my experiences.

For past seven years my uPSA is holding very low stable 0.03X range, no ADT. (Post RP, salvage RT to prostate bed, salvage extended pelvic lymph node surgery, one-year bicalutamide).

Last year diagnosed with metastatic melanoma despite my physical fitness efforts and otherwise most excellent health. I am most grateful my response to doublet immunotherapy is very positive and so far, I am not facing mentionable treatment side effects.

All the best to all of us!

[petabyte]

  Broccoli24 So you are also a member of the "Guardian-reading, tofu-eating wokerati" as well!

Me2 😉

For non UK people that's a quote from a former Home Secretary (Interior Minister).

My interest was in cancer specific mortality, I was already fit so less prone to non cancer mortality.

Shame they did not have this data.

p.s. I'm not "woke" and not that fond of tofu...

[Broccoli24 in reply to petabyte]

Not sure how woke got into this… but hopefully this study is encouraging for some of us.

[petabyte in reply to Broccoli24]

It was meant as a joke from Suella Braverman's comments on Guardian readers.

dailymail.co.uk/news/articl...

[mrscruffy]

Living with the beast for 9 years, go to gym 5 or 6 days a week. Lift heavy in AM and cardio in the PM. Still alive!!! Scientific? Hell no but I feel great and the girls like the way I look so win-win

[Broccoli24 in reply to mrscruffy]

Totally agree!

[Tall_Allen]

I hate to rain on this parade, because I am a big believer in exercise, but honestly, association is not causation. It is far more likely that health-conscious people are more likely to exercise and get screened for cancer. They find cancer earlier, while it is still curable. It is similar to the mistake that was made a few years ago when people got a vaccine for Cholera based on observational data from Sweden. Also, men with multiple metastases may exercise less because of risk of fracture, associated CV illness, and cancer-related and treatment-related fatigue.

However, there is sufficient evidence from prospective randomized trials to recommend exercise for prostate cancer patients taking ADT. It has been shown to diminish musculoskeletal adverse effects, with "substantial improvements in muscular strength, endurance, cardiorespiratory fitness, performance of functional tasks, fatigue mitigation, and preservation of lean body mass. "

ascopubs.org/doi/10.1200/JC...

ascopubs.org/doi/10.1200/JC...

[4tunate1 in reply to Tall_Allen]

Q for you Tall_Allen. We all know how hard it is to maintain any muscle mass while on ADT. I work out, blood flows and all is good. The next day, I feel like I'm starting all over again.

Other than proper diet, hydration, etc. are there any therapies for us Warriors to maintain muscle mass without the needed testosterone? I would love to know of some options. Not looking to get rippedat 61 YO, but would like my gains to not vanish overnight.

[Mgtd in reply to 4tunate1]

Been there! Same feelings. Honestly I believe the reality is just maintaining. That said the resistance and aerobic exercise along with diet control allowed me to lose weight and not gain it while on HRT. In addition I did notice the beginning of an upper six pack. Lost 2” in my waist. I am now out of HRT and boy that exercise habit is really paying off. At 80 I can hang with the younger guys.

Persistence is the key. Enjoy this part of the journey.

[Tall_Allen in reply to 4tunate1]

I wish I knew. Maybe someday there will be a non-androgen, myostatin-inhibitor drug.

[mrscruffy in reply to 4tunate1]

Look at Ostarine and other SARMS. I have made huge muscular gains using it. Check with your MO first> Mine knew what it was and approved

[Bhraen2 in reply to mrscruffy]

Hi. Mrscruffy. Thank you for sharing your success story with Ostarine. Do you feel that besides the muscle gains it also contributes to your success with keeping your prostate cancer under control? And do you cycle on and off of it or do you take it continuously.. Thank you again for sharing your positive results

[mrscruffy in reply to Bhraen2]

I cycle 6 weeks on and 4 weeks off. Ostarine was originally a cancer drug for PC but was found to be a problem at 60X dose so it was abandoned. It suppresses T like other ADT drugs. My start coincided with ADT failure. It brought my PSA down for about another year. Again, nothing scientific here just anecdotal evidence. If it did lower my PSA that was a bonus as my expectation was for only muscle growth. Any other questions feel free to ask

[petabyte in reply to mrscruffy]

I was wondering if Ostarine has improved BMD for you? Any downsides? There seems to be a lot of warnings about toxicity but maybe that is people using high doses as a PED.

This study reports adverse effects similar to placebo although at first sight the authors may not be neutral.

diabetesjournals.org/diabet...

[mrscruffy in reply to petabyte]

Toxicity is definitely a concern, that is why I cycle religiously. I get a liver and kidney panel every 3 months and both come out great. I found at 20mg and 30mg I started to experience fatigue. For me, 15mg is the sweet spot. As far as BMD it only became a concern at the 8 year mark. My MO thinks there is a positive correlation between Ostarine/workouts and BMD but not in any way scientific.

[Bhraen2 in reply to mrscruffy]

Thank you for sharing your experience. Have you tried other sarms?

[mrscruffy in reply to Bhraen2]

I have not, I know there are some that an be used in a "stack" pretty happy with what I am doing

[garyjp9 in reply to mrscruffy]

Do SARMS have any effect onTestosterone levels?

[mrscruffy in reply to garyjp9]

Ostarine was designed as a PC med. It suppresses T

[inthefight in reply to mrscruffy]

Where do you get your Ostarine from and what brand?

[mrscruffy in reply to inthefight]

Pure Rawz. Their stuff is all house branded.

[NanoMRI in reply to Tall_Allen]

No worries Allen, your views do not rain on my experiences, lessons and efforts to stay ahead of this beast.

[Broccoli24 in reply to Tall_Allen]

No worries about the rain.

Even if it helps us avoid co-morbidities, cardio etc… that’s a huge boost… and I think the fact it helps us feel better, gives us a better mindset to tackle this damn thing. I can’t believe it doesn’t slow the cancer down. Just v hard to prove it.

[RMontana]

Absolutely...its the hardest, healthiest thing you can do for yourself that will cost nothing (barring a gym contract option). Dont wait another day. Here is a long thread from 2 months ago. Get out there and get started and dont stop. Rick

healthunlocked.com/advanced...

[RMontana in reply to RMontana]

Something else I came across from the Institute for Human Anatomy (like these guys), that goes to bone density and how critical it is to stress your body...as much as you can, but push yourself just a little bit for a whole-lotta benefit. Check this out...Rick

youtu.be/1gToyjm4NNA?si=cNp...(Not working as expected?)

[RMontana in reply to RMontana]

Here is the Muscle version of the podcast from the Institute for Human Anatomy. Its always good (from my viewpoint) to understand how your body works. Whether exercise is correlated with, or the cause of improved health, is a red herring...sustained exercise cannot not but improve your well being. Listen to this portion and you have both the Bone and Muscle aspects of exercise in hand. Then Just Do It...as the sneaker company says...Rick

youtu.be/2vXOq-aRtYY?si=lGL...(Not working as expected?)

[RMontana in reply to RMontana]

Finally, how your blood changes with exercise...soooooooooooooooooo, exercise affects your Bones, your Muscles and your Blood. Need any other evidence that the 'secret sauce' to better health is just to keep on moving. Any amount of exercise is better than none and too much is not as good as that which is enough. If you are able to hold a conversation while doing what you do to exercise your are doing it right...how easy is that! Throw in some light weights and you are off the races. Keep up the good work out there...Rick

youtu.be/ee0LoPoa7gc?si=H91...(Not working as expected?)

[London441]

Managing expectations is the key to training when older. One of the tricky things about our disease is the struggle to make and maintain strength gains on ADT while being at or approaching what I call ‘the age of steep decline’.

I didn’t notice any impairment in my fitness and strength when I first began ADT but after 6-9 months it became obvious I was swimming upstream. Everything was harder. My cardiovascular fitness took a hit, my strength and most of all my power, making my favorite sports somewhat discouraging.

At my time of diagnosis, I felt young. I was in my early sixties. It seemed to soon for age related decline. I was in the sweet denial of late middle age.

Eventually I settled into a routine on ADT that served me well. The specifics don’t matter; just tracking everything and being grateful for mitigating loss. Making any small improvements became a manageable goal.

Since I had already been training for years, the change in every aspect of my strength and fitness was notable, but all I had to do at the end of the day is to be glad I arrived at ADT in superior strength and fitness for my age. I could not imagine trying to start exercising at 65, which is extremely common. My heart goes out to such men. Now get to work!

The drop in strength and fitness without intervention after age 50 or so really drops off the table, accelerates beginning at 65-70 and beyond. This is regardless of the absence or presence of disease. Even with intervention it becomes tougher.

Most of us with Pca either are diagnosed with it at at 65-75 or somewhat before. The tandem of ADT and advancing age can be devastating. It’s a place we’ve never been before, and we can’t have known what it’s like.

Now we do.

Again, we should all remember the downhill run becomes faster and steeper after 70 or so anyway. ADT only exacerbates it. We need to approach this age range smartly.

I believe doing this can actually help keep us grateful and motivated, knowing that extending life per se is not the point at all.

Longevity for its own sake eventually becomes worthless! So many ‘all cause mortality’ studies… A casual tour of a nursing or assisted living home is all the cautionary tale one should need on that. I’ll take adding life to my years over vice versa and roll the dice from there.

[Broccoli24 in reply to London441]

Yep, I’m 52 and 7 months in and really seeing hormone therapy hit my stamina and strength… muscle tone goes very quickly if I lay off the training. Just finished 6 weeks of RT and was tired as hell so haven’t exercised quite as much and can see the difference… now to get back on it and build back.

[Mgtd in reply to London441]

You really summed up the experience of getting old and adding in HRT. I go to a community gym everyday and we have a group of guys in their late 70 and 80 category. They all do what they can to keep muscle tone.

Just a side note ALL of us are former athletes so training is nothing new for us. We have been doing it all our lives. I guess our goal is to make life better as we age. We all know that we are trying to delay or escape the nursing home syndrome.

That for me would be worse than death!

[carguy]

Personally, I try to exercise regularly but I have found out that I need to include rest days to prevent injury. I try to do light weights/stretching one day, rest the next, swim the following day, rest, weights, rest then biking. If I don’t do rest days, I pull a muscle. I developed tennis elbow by adding wrist weights to my stretching routine and doing too much too soon. With no testosterone, my muscles don’t recover like they used to. Just my personal experience.

[Sandy752]

After 11 years on Lupron (no vacations) and having just turned 80, I am finding it harder and harder to exercise. Doing physical household tasks takes most of the energy I have these days but still try to do some walks.

[Jancapper in reply to Sandy752]

That is very impressive. After 25 months, my ability to exercise fell dramatically, and I am 61.

[Derf4223]

At 70.5 age, I exercise daily, the same routine resistance, ab crunches, stretching and alternate aerobics and elliptical trainer. Walk outside a couple times a week, often with some hills. I have reached the limits of what my joints' osteoarthritis will tolerate. Try and not miss any days. My medical reading says muscles are an important organ in and of themselves in terms of releasing myokines. Whether that helps PCa is moot, but I want other cancers, CVD, etc to stay the heck away for as long as possible. Ciao for now

[j-o-h-n]

Dr Helen Croker?................................hahahahahahahahahahahahaha

Good Luck, Good Health and Good Humor.

j-o-h-n