# Exercise as it relates to Disease/Can exercise be an effective method of treatment of Pancreatic cancer as apposed to other types of therapy?

This is an analysis of the case study “exercise as medicine in the management of Pancreatic Cancer”.

## What is the background to this research?

Pancreatic cancer is a malignant cell developing in the pancreas, which affects how the pancreas functions. Pancreatic cancer presents no symptoms in a patient with and early detection is near impossible. Once detected it's often too late as either the cancer is too large or it has spread to other parts of the body. American Cancer Society states 53,070 people will be diagnosed with pancreatic cancer per year with 41,780 fatalities. Currently there is no cure for pancreatic cancer and is predicted to be the second largest cancer killer by 2030, making this a global concern.
Pancreatic cancer affects a patient’s quality of life significantly, often their weight, muscle mass and physical capacity will decrease over time. Evidence has shown that once diagnosed a Pancreatic cancer patient will have a 20% survival rate in the first year. Treatment options such as Chemotherapy can increase the risk of infection and combined with poor appetite and general sickness contribute to physical inactivity. Exercise has been seen as an effective method to increase the physical and mental health for Cancer patients. Cormie et al assesses this link between pancreatic cancer and physically activity.

## Where is the research from?

Cormie et al from the University of Health and Wellness and Sir Charles Gardner Hospital conducted this case study. The researchers of this study have written numerous papers related to physical activity and Cancer’s. The human research ethics committee of the university approved this study.

## What kind of research was this?

The case study that uses quantitative measures in it's research, which means assessing a theory based of completed test data. Additionally, questionnaires and self-reporting were taken.
Advantages and Disadvantages of quantitative research:
| Advantages | Disadvantages |
| Allows researcher to measure and analyse the results | The context of the study may be ignored |
| Researchers can be more objective | Not doing tests in natural settings |
| Hypothesis can be tested because of the statistical data | Large sample of population is required for accurate results |

## What did the research involve?

The case study was based on a 49 year old man who was a 102.3 kg and 171.3 cm tall, unemployed non smoker and was diagnosed with Stage II Pancreatic cancer. The patient had surgery, which was followed by chemotherapy and radiotherapy. A supervised exercise program was carried out for six months adjuvant to therapy, and assessed at a baseline, three months and six months. The program consisted of resistance and aerobic exercises twice a week.

## What were the basic results?

Cormie et al found that the patient showed no adverse affects towards the physical activity, and observed improvements in all measures of physical capacity and functionability over the six month period. The subject attended 73% of the planned sessions, and tolerated the exercises well. The subject missed sessions due to side effects from the chemotherapy. Physical activity saw the subject have reduction in psychological distress from baseline scores. Furthermore the researchers suggest that exercise could decrease the monthly medication expenditure for pancreatic cancer patients.

## How did the researchers interpret the results?

The results showed that there was a positive relationship between, physical activity for pancreatic cancer patients and quality of life. Numerous considerations have been made by the researchers when interpreting the results. Due to the nature of the case study being focused on an individual subject, means that this case study has its limitations. This should be taken in considerations as the subject responded well to the physical activity, but not all pancreatic cancer patients may follow the same pattern. Different stages of the Cancer, different levels of psychological distress/motivation and prior fitness levels may also influence results.

## What conclusions should be taken away from this research?

This article makes a strong case, which links improvements with physical activity for pancreatic cancer patients. This is not without fault; the research is based off one individual and since it’s one of the first papers in this field there are little comparison able to be made specify to pancreatic cancer. The protocols employed made on this study should be replicated with randomised control trial on larger groups would need to be conducted to better understand this link.
Results from this study have been seen similarly in other types of cancers such as colon, breast and prostate. These studies believe that exercise can nearly double the rate of survival. Studies state that if physical activity was involved before and after treatment for breast cancer patients it increase the quality of life and reduce fatigue. Since physical activity increases fitness and muscle strength, this could reverse these affects. All studies related to cancer constantly show that if a person is relatively healthy and able to complete some aerobic and resistance training, it will benefit them.

## Practical Advice

This research suggests exercise is an effective method form of medicine, but further research is required to support and confirm these results and the link between physical activity and pancreatic cancer. From the information available, their is a link between exercising having a positive influence on the health and well being of a person living with some form of cancer.

## Further reading

Further information on Cancer and the benefits of physical activity:
* Physical activity and colon cancer prevention: http://www.ncbi.nlm.nih.gov/pubmed/19209175
* Effect of exercise on cancer-related fatigue: http://www.ncbi.nlm.nih.gov/pubmed/24743466
* Physical activity and survival after breast cancer diagnosis: https://ccplanet.cancer.gov/documents/ibrahim_2011.pdf

## References

* 1 2 3 4 5 6 7 8 9 10 Cormie P, Spry N, Jasas K, Johansson M, Yusoff I, Newton R et al. Exercise as Medicine in the Management of Pancreatic Cancer. Medicine & Science in Sports & Exercise. 2014;46(4):664-670
* 1 2 3 4 Key statistics for Pancreatic cancer [Internet]. Cancer.org. 2016 [cited 8 September 2016].
* 1 2 3 http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-key-statistics
* 1 2 3 4 5 Wolin K, Yan Y, Colditz G, Lee I. Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer. 2009;100(4):611-616.
* 1 2 3 4 5 6 Tomlinson D, Diorio C, Beyene J, Sung L. Effect of Exercise on Cancer-Related Fatigue. American Journal of Physical Medicine & Rehabilitation. 2014;93(8):675-686.
* 1 2 3 4 5 6 Ibrahim EAl-Homaidh A. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Medical Oncology. 2010;28(3):753-765.