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Exercise May Help Brain Cancer Patients Live Longer

Depending on the size, location and type of brain tumor, exercise can be difficult for patients, but new research shows it may impact survival. Here are a few tips to get moving.

BY CHARLOTTE LIBOV
PUBLISHED WEDNESDAY, AUGUST 17, 2011
Although his left side is mostly paralyzed, Bob Hayman walks several yards and pedals 30 minutes each day on his recumbent exercise bike. A lifelong athlete, this Seattle tribal fisheries biologist refuses to allow malignant brain cancer to render him inactive. “Exercise has been a part of my life since I was 9 years old. When I exert myself, I feel better,” says Hayman, who has stage 4 glioblastoma.

A new study suggests that Hayman’s exercise regimen could predict better survival and maybe even prolong his life. The research, published in a July issue of the Journal of Clinical Oncology, looked at 243 patients ranging in age from 20 to 77, who had advanced recurrent malignant gliomas. Those who exercised briskly and regularly (the equivalent of a brisk 30-minute walk five days a week) lived nearly 22 months compared with just over 13 months for those who were less active.

“Numerous studies show exercise lowers fatigue and enhances physical function for cancer patients, but we wanted to look at whether exercise fundamentally is associated with the risk of cancer progressing or coming back,” says Lee W. Jones, PhD, the study’s senior author, who is an exercise scientist and associate professor at Duke Cancer Institute in Durham, N.C. He decided to focus on patients with malignant brain cancer who find exercise difficult.

The brain controls voluntary movement, balance and gait, all essential elements of physical activity. For example, a tumor in the cerebellum can affect all of these abilities. When the brain’s occipital lobe is affected, a portion of vision can be lost as well, making mobility more difficult. In addition, high-grade gliomas are usually treated very aggressively, with surgery, radiation and chemotherapy. These therapies can cause fatigue, dizziness, weakness and lack of balance, making the situation worse. Moreover, long-term use of steroids, which may be given to counteract chemotherapy side effects, also cause muscle wasting. In essence, this is a group of patients in which exercise is particularly difficult; however, this could be the exact group in which there is the greatest benefit.

For Lynne P. Taylor, MD, director of neuro-oncology at the Virginia Mason Medical Center in Seattle, this study provides additional evidence that exercise improves how patients with brain cancer can function, but it stops short of proving exercise prolongs life. The study’s authors point out that it isn’t possible to know whether the benefit is from cancer having less of an impact on the patients who are able to exercise or from some direct anti-cancer effect of exercise. And because the study was based on the patients’ self-evaluation of how much they exercise, the research doesn’t prove whether it was exercise that lengthened their lives or if there was some other factor at play. The ability to exercise could also be associated with fewer symptoms and better overall health. Teasing out this cause and effect will be the subject of their follow-up randomized study.

“In these types of patients, the frontal lobe function of the brain is frequently affected,” Taylor says. “That’s the part that makes you get out of bed, put on your sneakers and go for a run. If you have enough executive function to exercise, your tumor is going to be smaller and you’re more likely to live longer.”

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