By Colleen Moretti
Light-intensity physical activity can improve quality of life as well as physical functioning in colorectal cancer survivors, according to recent research published in Quality of Life Research.
In an interview, researcher Dr. Martijn Bours of the department of epidemiology at Maastricht University in the Netherlands, explained his findings and how survivors can apply them to live a better life.
What do the results of this study mean for colorectal cancer survivors? Why are the results important for them?
We studied relations of physical activity and sedentary behavior with quality of life, level of daily functioning, and fatigue symptoms in nearly 400 patients with bowel cancer. Sedentary behavior refers to waking time spent sitting or lying at low energy expenditure, for instance when watching TV or working on a computer. We specifically focused on the first two years after the end of cancer treatment, because physical and psychological consequences of the cancer diagnosis and treatment can have a large impact on the daily life of bowel cancer patients in this period.
The results of our study show that individual patients who increased their level of physical activity and decreased sedentary behavior reported a better quality of life, increased level of functioning, and decreased symptoms of fatigue.
What is considered light-intensity physical activity?
Most current guidelines that promote physical activity focus on activities of moderate to vigorous intensity, recommending to do these activities at least 2 and a half hours per week. Examples are brisk walking or jogging, playing sports, dancing, or heavy household work. Performing these types of activities may not always be easy for bowel cancer patients who have to deal with the impact of the cancer treatment on their daily lives. Also, these individuals are often 70 year or older and can suffer from other health conditions, like diabetes or rheumatoid arthritis.
Light-intensity physical activities require less energy and may therefore be easier to do for these individuals. Examples of light-intensity activities are walking at a slow pace, playing billiards, or doing light household work while standing, such as cooking or doing the dishes.
Why is it important for this survivor population to stay physically active?
Besides the benefits of physical activity for the quality of life after cancer treatment, leading a physically active lifestyle has many other potential health benefits. Importantly, a physically active lifestyle includes both increasing physical activity and decreasing sedentary behavior. We have found that individuals who adhere to physical activity guidelines can still benefit from decreasing sedentary behavior during the rest of their day. Moving more and sitting less can, for instance, decrease the risk and impact of several health conditions, such as obesity, diabetes, cardiovascular disease and cancer.
What kind of light-intensity physical activity can survivors of colorectal cancer do? What is recommended?
There is no specific recommendation for light-intensity physical activity. Our results suggest that doing any kind of light-intensity physical activity can already have a beneficial influence on quality of life, level of daily functioning, and fatigue symptoms. In a previous study, we observed that replacing 1 hour of sedentary time per day with one hour standing was related with better quality of life and functioning and with less fatigue. So interrupting sedentary time by just standing up for a moment and walking around could already have a positive effect. Further studies would be needed though, to find out whether recommendations about specific types of light-intensity activities are relevant.
How many hours a week of physical activity is recommended for this population?
Current lifestyle guidelines from the World Cancer Research Fund (WRCF) and American Institute for Cancer Research (AICR) for cancer survivors recommend individuals to move more and sit less. Specifically, cancer survivors are recommended to perform 150 minutes of at least moderate-intensity physical activity per week and to limit sedentary habits. Our findings suggest that adhering to these recommendations is beneficial for bowel cancer survivors.
How are physical activity and quality of life associated in this population?
We found that individuals who increased their level of physical activity and decreased sedentary behavior reported a better quality of life and level of functioning and less fatigue symptoms in the first two years after the end of cancer treatment. Individuals who were inactive and sedentary experienced the lowest quality of life and most fatigue symptoms. Individual who adhered to the joint recommendation of being physically active and limiting sedentary habits reported the highest levels of quality of life and least fatigue symptoms, and especially reported higher levels of physical functioning.
Should this change survivorship or treatment plans? Is there enough focus on promoting physical activity after surviving colorectal cancer?
Although our findings are promising and in line with other research showing beneficial effects of increasing physical activity and limiting sedentary behavior in other types of cancer, more research is needed to find out which specific types of activities could be most beneficial for bowel cancer survivors and which types of activities should replace sedentary behavior. Nonetheless, it is advisable for bowel cancer survivor to follow the recommendations to move more and sit less. This will very likely contribute to leading a healthy and happy life after bowel cancer.