British researchers report that patients with cancer of the food pipe (esophagus) who exercised — while undergoing chemotherapy before surgery — showed more tumor shrinkage than those who did not exercise.

Today, we take a brief look at the burden of cancer. We will then pivot to an exciting new study showing that exercise may shrink tumor size for cancer patients.

Cancer burden

Cancer is a leading cause of death worldwide, taking the lives of almost ten million individuals each year. The following statistic puts this in perspective: One in six of us will die of cancer.

The most common cancer include breast, lung, colorectal, and prostate cancer. The World Health Organization believes that lifestyle plays a role, with approximately one-third of cancer deaths attributable to tobacco, excessive weight, alcohol, diet, and being sedentary.

Overall, between one-third and one-half of cancers are thought to be preventable by avoiding modifiable risk factors and prevention efforts. Fortunately, many cancers are highly likely to be cured if caught early and managed appropriately.

Exercise and cancer treatment: “Prehabilitation”

I am excited to learn how British researchers showed that patients with esophagus cancer, who completed a structured exercise program during chemotherapy before surgery, had smaller tumors (compared with those who did not exercise).

My enthusiasm for these surprising results recognizes that tumor response to chemotherapy is one of the most important predictors of outcome for esophagus cancers.

The Pre-EMPT study included 40 patients with cancer of the lower esophagus or the esophagus and the stomach junction. Half did a structured rehabilitation exercise program, and the other half did not. All received standard chemotherapy before proceeding to surgery.

The exercise group did moderate-intensity physical activity, including aerobic and strength training. The patients had individualized sessions five to six times weekly, completing a cumulative 150 minutes of activity weekly up until the day before surgery.

Exercise and cancer response — My take

This clinical trial is the first to suggest a structured exercise program may improve chemotherapy response for those with esophagus cancer. The intervention/exercise group appeared to have less inflammation, improved immune system functioning, and improved body composition.

Limitations include a relatively small number of patients and the non-randomized study design. We need confirmation of the research results, but I will counsel my patients with esophagus cancer to consider exercise as a part of management. I look forward to writing the exercise prescription when appropriate.

Thank you for joining me today to explore how exercise may enhance cancer treatment response. Someday, all patients with cancer will have a recommendation of physical activity. How wonderful.

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