People with more lean muscle mass may have an advantage when it comes to fighting cancer, new research suggests.
The study, published in the medical journal Lancet Oncology, is the latest to suggest a patient’s body composition may play a role in cancer survival rates. Researchers from the University of Alberta used body scan imaging to study 250 obese cancer patients. The scans showed that 15 percent of the cancer patients had very low muscle mass relative to their weight.
The obese patients with the lower levels of lean muscle mass lived an average of 10 months less than patients with more muscle mass, even after controlling for other variables like cancer stage and severity.
Other studies have shown that people who exercise have lower rates of some types of cancer. Although the study suggests that higher levels of lean muscle mass help the body better cope with cancer, it’s not clear whether lifting weights prior to or after a diagnosis would improve a patient’s odds for surviving the disease. “That would be the next experiment,” said Dr. Vickie Baracos, a professor of oncology and adjunct professor of human nutrition at the University of Alberta, and lead author on the study. “This intervention has not been tested.”
The data also raise questions about whether body composition should be considered as doctors make treatment decisions and assess a patient’s prognosis. A patient with very low lean body mass, for instance, may be given a more tailored dose of chemotherapy, Dr. Baracos said.
Patients who have been treated for cancer should talk to their doctor before embarking on any exercise routine. For instance, patients who have undergone lymph node removal are at risk for a severe swelling disorder called lymphedema and may be advised against lifting weights.
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Validation for one aspect of the overall protocol (not that I needed it or doubted its validity).
How’s the weather situation? We dodged the big one as it stayed up north of here though more is suppose to be headed this way
— David RipleyThis finding could be misleading; it sounds like a causal association has not been made — in other words, it’s not clear that greater lean muscle mass is *responsible* for improved survival. This characteristic could simply be confounding, in that it goes along with lifestyle characteristics or genes that are more likely to be to blame (e.g., obese people with low muscle mass may more likely be smokers or eat more poorly, thereby exposing themselves to genotoxic substances; did they adjust for smoking, cruciferous vegetable intake, etc?). Now, if a randomized controlled trial showed that added exercise (and resulting greater muscle mass) was associated with better outcomes, that would be something to celebrate! Has that been shown elsewhere?
— TomFromSeattleToo vague. Dr. specifically informed me that radical prostatectomy patients do NOT get lymphedema and he had no objection to weight lifting after 6 weeks.
FROM TPP — Depends. If the patient also had lymph nodes removed, than he is at risk
— jayI haven’t seen the study, but I think it would be a mistake to equate muscle mass and exercise, as the column seems to imply. Yes, they are related, but there are quite a few factors affecting muscle mass (genetics for example) besides simply exercise levels. And at the same exercise levels, some people will develop considerably more or less muscle mass than others.
— CarolynThis phenomenon is easy to explain, particularly for postmenopausal women.
Excessive adipose fat synthesizes a great deal of estrogen outside of the ovaries. Just like with the carcinogenic effect of Hormone Replacement Therapy, excessive endogenous (body’s own) estrogen may fuel other cancers, especially genitourinary. And hot flashes too…
I believe I am the first specialist to describe this connection, at least in plain English.
What should you do? Don’t get overweight and lose weight before reaching menopause. Easier said than done, but still possible.
Konstantin Monastyrsky, author of GutSense.org blog
— Konstantin MonastyrskyGet an Oncotype Dx assessment before you even think of starting chemo.
— RMeasuring the wrong thing again.
But that is what the medical model calls for-measuring the things that they can measure with their new expensive technological toys.
The answers to these questions would be an equally good place to start:
1) Why do people with A also have B?
2) Is there an underlying common condition or rationale that explains both A and B where each is not the cause of the other but explains why A and B seem to go together?
3) What can be done to that underlying common condition so that both A so that B are positively changed? .
In this case, why do people with a certain type of body composition seem to have a greater ability to deal with cellular dysfunction known as cancer and its treatment?
What can people do to maximimize that common condition to improve the preferred body composition and improve their ability to survive cancer and its treatment?
We might feel that leaner is genetic in origin or the result of a practiced life style. While genetics is sometimes a factor, the medical model often gives genetics a relatively low causative rating. So although genetics plays a role, we can for now put it aside.
What is left?
What people are, that is, how they live. And that includes a healthy attitude, healthy nutrition (with necessary supplements), healthy breathing, healthy movement and rest and healthy water.
The one aspect of healthy living this study focuses on is movement (exercise). Asking whether movement alone before and after the detection of a cancer that has taken years in many cases to develop, is a typical phrasing of a question in the medical model approach. Asking other questions are automatically avoided.
Dr. Baracos’ points in the last three paragraphs highlight the medical model approach and limitations:
3rd from last paragraph: “…it’s not clear whether lifting weights prior to or after a diagnosis would improve a patient’s odds for surviving the disease. That would be the next experiment, …” The medical model asks about the effect of one (1) healthy life style condition. Surviving the treatment is never mentioned although everyone knows that chemotherapy and radiation (and surgery) are dangerous.
2nd from last paragraph: “…A patient with very low lean body mass, for instance, may be given a more tailored dose of chemotherapy…” The application of the medical model asks questions about diagnosis and treatment (as in this discussion) not about primary prevention or how to apply several interrelated healthy life style actions.
And 1st paragraph: “….Patients who have been treated for cancer should talk to their doctor before embarking on any exercise routine. …” The question is why? What can the medical doctor say? Yes? No? Maybe? Let me design a movement program? This is not an area of expertise of practitioners of the medical model. A person needs experts on movement, breathing and nutrition to learn what can be done under the circumstances. Talking to your doctor can lead to frustration at both ends, severely limit options, detract from the quality of life during the time left and decrease survival and extension of life.
These points do not and almost never will come from the quoted oncologist who it seems also has skills in nutrition or most other medical doctors! It is outside their education, training and work experience. Nor is there a word about the healthy things to do by yourself. Instead we are fed the same one liner: “… talk your doctor before you do anything by yourself…”
That is the medical model but that is not necessarily the only health and wellness way to proceed.
One thing that is known is that people who live healthy life styles including movement (exercise) will be increasing the flow of blood throughout their bodies. That flow when done correctly includes more oxygen and nutrients due to healthier breathing and digestion (nutrition) and will also improve the removal of toxins that destroy or limit the human body’s natural immunity and cellular communication defenses. People who move in healthy ways are also alive. They have healthy attitudes and seek to grow and continue to live. These healthy life style actions are inter-connected.
And that might be the commonality between lean body composition and improved cancer and cancer treatment survival: learning how to swim (healthy life style) before the impending tsunami wave hits, not scurrying for a life boat after.
— ed gOne can only hope your observations are correct. I am a 65 year old male with a body fat of 13.7% and just recently diagnosed with prostate cancer. By biopsy my cancer is 3+3 on the Gleason scale and I have opted for a radical prostatectomy in the next month. If for no other reason I would believe my life style of exercise and healthy eating habits would have more to do with a speedy recovery than the actual prevention of my cancer.
— BruceThere are just too many variables. Winston Churchill, a heavy smoker and drinker and usually overweight, lived to be 91. Stan Korsmeyer (a noted cancer investigator) never smoked and died of lung cancer at 54. People can guess at correlations and play the odds, but we still have vast knowledge gaps. It seems important to get good nutrition before and for several years after birth, and to avoid obvious sources of carcinogens, but then it gets murky. Pretending it isn’t murky is entertaining but not necessarily accurate.
— DavidBack in March 2008 an article appearing in Cancer Epidemiology, Biomarkers and Prevention came to similar conclusions (as this recent article did) about the need to TITRATE chemotherapy differently, based on estrogen levels–which often are related to a woman’s BODY FAT, weight & exercise levels.
The Lancet Oncology article wasn’t about the estrogen-body-fat-exercise-connection, but since many of your readers may be particularly concerned with breast cancer, I’ll mention a few key points from that article.
1. According to researcher Cheryl Rock: Anti-estrogen drugs can only have so much impact. There are two things apart from these drugs that can help to lower estrogen, or we believe it can, because it can in the general population. One is moderate to vigorous exercise, and the other is healthy weight management, achieving an ideal weight.
2. At issue here is the often under-reported fact that estrogen isn’t only produced by the ovaries, but it’s also produced by our fat tissue. The more fat tissue, the more circulating estrogen in the body. The more estrogen circulating through the body, the more likely a recurrence.
3. This study justifies the use of drugs that help decrease estrogen levels like tamoxifen and aromatase inhibitors. [In the future], we may want to TITRATE different levels of anti-estrogen medications. Right now, we have a standard dosage for everyone, whereas women who are heavier or other women who may have higher estrogen levels for one reason or another may need larger doses.
I’m not a physician or a scientist, but perhaps there are some similar connections to what’s going on in the fat cells of both groups of patients that impacts cancer cell growth.
At least in the breast cancer study there was an explanation of how lowering one’s body fat with exercise & diet can have a positive effect on survival.
If you care to read more, click here:
http://www.happyhealthylonglife.com/happy_healthy_long_life/2008/03/women-with-brea.html
— The Healthy LibrarianAntibodies, used by the immune system to attack cancer are proteins, constructed from amino acids.
The body’s main store of amino acids is muscle.
People undergoing starvation often die from disease because they can no longer construct antibodies.
— C. FredCorrelation does not imply causation.
That said, having more lean muscle mass is always a good thing no matter what ails you.
— Berto at PricePlow.comThe current state of legitimate medical knowledge is that by being overweight and obese, we are inviting the appearance of many types of cancer.
— Holly Wagner MDResearch continues and at the same time, we are overwhelmed by misinformation and “personal experiences” that add no much value to prevention, diagnosis and effective treatment of malignant diseases –The comment regarding Winston Churchill is an example of this.
If we are overweight or obese, it is, really, very simple to correct this situation: I tell my patients that we all have at least three opportunities every day to start losing fat: they are called “breakfast, lunch and dinner” –cut down the amount of fat on every one of these meals and we will lose fat and weight. I guarantee it… The rest is just excuses and laziness…
I’ve always been lean and muscular, thanks to heredity and my exercise regime. During a recent bout of cancer, my response to chemo was so good that my doctors were startled and pleased.
— BtravenI’m always interested in the latest health findings and thinking, which is why I’m here reading the Well Blog.
But in the natural turn of events, theories come and go. They have come and gone for as long as I can remember, and that’s a while.
This one fits into my common sense model: more lean and less fat is probably a good thing, to the extent I can manage it without missing out on the good things in life (such as the creamed cauliflower!), and to the extent I can reasonably affect it.
Makes sense to me, that it’s a good thing to be “metabolically healthy,” as I am–at the same time that I tend to be overweight–but that’s not the only kind of “healthy.” It’s also good way to remind me not to indulge too, too much over the holidays (I’ll just indulge a little bit).
— WesleySo thin people are healthier and have a better chance of survival than fat people. This is science?
— hell’s Kitchen GuyLife is intented to be a struggle,for thousands of years humanity lived on the edge of extinction. Our survival is due solely to the fact that our bodies are tuned to get the most from the least,provided the least does provide the minimum required to survive.Exercise and the right food will keep you alive.Excess will kill you.
— mark g. boydInteresting correlation but not too surprising since more muscle mass generally equates to a healthier lifestyle overall.
— Jefflook at this
— sharon daviesThank you for this, TPP. Finally something about exercise that talks about the benefits of muscle rather than just the downsides of fat.
I recently went to my doctor (for dengue fever) and although he was visibly surprised at how healthy my blood pressure and cholesterol were despite having just had month-long tropical fever, after the blood test all he wanted to talk about was my BMI. He’s a fantastic doctor for tropical medicine, but he’s a marathon runner, and he just can’t imagine that someone who’s “obese” on the BMI could be healthy. He sees all the muscle I’ve earned by genetics and a daily lifting schedule as little more than a heavier form of fat.
I have no doubt some of your readers will see what you wrote and see in the “as percentage of bodyweight” portion of the equation as just another reason to sit an hour on a stationary bike (which cannibalizes muscle as well as fat).
http://www.boldizar.com
— BoldizarI think it is all confounded.
How do they know that obese folks with low muscle mass don’t have other health issues that degrade their health, making them less able to survive?
Cancer treatments themselves often result in reduced muscle mass beause people feel terrible and don’t move around a lot,
Anyway, I’m tired of article that say this or that will prevent cancer. Cancer is not the fault of the patient!
— GingerBKonstantin Monastyrsky has explained the issue with hormonally positive cancer. Even after an oophorectomy estrogen (actually estradiol) is produced. I’m overweight and have had hormonally positive cancer and the battle continues. http://aftercancernowwhat.blogspot.com
— AftercancerIf we are overweight or obese, it is, really, very simple to correct this situation: …The rest is just excuses and laziness…
— Holly Wagner MD
There writes a doctor with no clue about obesity. Sure glad I am not her patient. Not only that, but she apparently offers her patients no help with the issue, just smug condemnation.
— elliePlease don’t confuse thin with fit.Obesity and high fat body mass appears to be the problem. As a 50+ year old heavy weightlifter and bodybuilding (Natural) lifestyle..The high muscle mass has me with the body and health profile of a 30 year old. My peers are amazed Heredity definitly plays a part with a 87 grandfather( mother’s side) and a 92 year old grandmother (fathers side) both still alive and viable, has blessed me with some advantages. But I also feel that my low fat diet 10+ hours of heavy working out with cardio and heavy weightlifting has played a part..a major part.In my on natural observation 30+ years of working out, it appears that the constant building of the lean muscle tissue is a counter attack to the formation of the cancer cells. Kind of like a weed block in your garden. Where the good plants grow, but the weed block stops the weeds from appearing. But who knows for sure?
— Uncle TInteresting study. The bottom line? They all still died. So one group, the thinner group, lived 10 months longer–there is no surprise there—people who work out and eat well and take better care of themselves do not have other disease processes that will kill them sooner. This weekend, as a hospice nurse, I took care of a women with advanced cancer who is actively dying, but has lived longer than anyone ever expected. Very fit, hiked a lot and ate well. But she is still dying from cancer. And she is young. So her body does not want to quit, and her death is painfully slow. Not so sure I am going to run marathons, lift weights all the time and never eat a cookie for that experience. Seems like moderation and balance should be what we strive for. Lifting weights will not prevent death, although you may look far better in a bathing suit, and who doesn’t want that??? Personally, I think that is a better motivator. Looking good and feeling good about ourselves. Wonder how many would live not just longer, but happier that way.
— JN RN