Editor's note: The National Cancer Prevention and Treatment Publicity Week (4.15) was initiated by the China Anti-Cancer Association in 1995 and has been successfully held for 29 sessions, and has become the oldest, largest and most influential cancer prevention and treatment brand science popularization activity in mainland China. Since 2018, the China Anti-Cancer Association has proposed to designate April 15 as "China Anti-Cancer Day" every year.
The 30th National Cancer Prevention and Treatment Publicity Week and China Anti-Cancer Day will be held nationwide from April 15 to 21, 2024. To this end, "Yiyue Hui" specially invited Professor Li Ling from the National Molecular Medicine Transformation Center of the Air Force Military Medical University and Zhu Zixuan, a master's student in cell biology from the School of Basic Medical Sciences of the Air Force Military Medical University, to share "Exercise and Cancer Prevention" with everyone!
Interviewees
Prof. Ling Li
Researcher of the National Molecular Medicine Transformation Center of the Air Force Medical University
Chairman of the Tumor Molecular Medicine Committee of the Chinese Anti-Cancer Association
Member of the Standing Committee of the Tumor Marker Committee of the Chinese Anti-Cancer Association
Member of the Cell Engineering and Genetically Modified Organisms Branch of the Chinese Society of Cell Biology
Director of Cell Biology of Shaanxi Province
Zhu Zixuan
He is currently studying for a master's degree in cell biology at the School of Basic Medical Sciences, Air Force Military Medical University
Cancer is the leading cause of death in high-income countries, and even in low- and middle-income countries, cancer is the second leading cause of death. Studies have reported that there are approximately 14 million newly diagnosed cases of cancer worldwide each year, and this number is expected to grow by 70% over the next 20 years [1]. According to the data on the disease burden of malignant tumors in China released by the National Cancer Center of China at JNCC, there will be 4.8247 million new cases of cancer in China in 2022, with a world-standard incidence rate of 201.61 per 100,000 and a world-standard mortality rate of 96.47 per 100,000 in China. As China is the world's most populous country, the number of new cancer cases and deaths far exceeds that of other countries, and it is characterized by large differences between urban and rural areas, uneven regional distribution, and coexistence of cancer spectrum in developed and developing countries. At present, the burden of cancer in mainland China is increasing day by day, and the situation of cancer prevention and control is severe.
Mechanism of cancer development
According to the International Agency for Research on Cancer, about 25% of cancers worldwide are related to poor lifestyle habits (e.g., obesity and long-term sedentary) [2], so changing one's behaviour and optimizing environmental factors are the most cost-effective ways to prevent cancer. In May 2018, the National Cancer Institute and the World Cancer Research Fund (WCR) launched Diet, Nutrition, Exercise and Cancer: A Global Perspective, the most comprehensive and authoritative report on lifestyle and cancer prevention to date.
The preventive effect of exercise on cancer
Numerous clinical and experimental studies have proved that exercise is an important adjunct to cancer treatment, and exercise can significantly improve cancer-related symptoms such as cancer cachexia, fatigue, decreased physical function, and reduced exercise tolerance, as well as reduce cancer risk and improve the quality and effect of radiotherapy and chemotherapy [3-4].
In addition, in addition to individual extreme sports such as skydiving and extreme rock climbing, various types (such as swimming, running, climbing, etc.) and intensity (according to the correlation between heart rate and exercise intensity during exercise, American scholars put forward the following standards: heart rate 160 beats/min, intensity is about 80%, heart rate 140 beats/min, intensity is about 70%, heart rate is 120 beats/min, intensity is about 60%, heart rate 110 beats/min, intensity is about 50%. ) plays a certain role in cancer prevention, reducing inflammatory responses, promoting the normalization of blood vessels in tumors, improving the tumor microenvironment, and enhancing the body's immunity [5]. Specifically, the role of exercise-mediated cancer prevention includes the following five aspects:
1
Regulates body-related metabolism
Exercise can regulate the metabolism of sugar, lipoproteins and hormones in the body, especially for perimenopausal women, exercise has been proven to reduce the incidence of breast cancer, endometrial cancer and other diseases. In addition, the blood circulation is accelerated during exercise, and the excretion of some waste products produced by metabolism in the body increases, which can have an effect on improving the internal environment, and will also promote the body's tissue cells to metabolize more healthily, and ultimately reduce the incidence of cancer. Studies have proved that low- to medium-intensity exercise can reduce the tumor-bearing volume of breast cancer mice, and the mechanism of action is that exercise induces the normalization of intratumoral blood vessels, improves the intratumoral hypoxic environment, and reduces lactate production, while exercise accelerates metabolism in the body and promotes lactate emission and metabolism [6].
2
Regulates the body's immune function
Exercise has a good ability to regulate the body's immune system, which can not only increase the number of immune cells, but also improve the functional activity of immune cells. The body's immune system is like a "guard" to maintain a stable internal environment, and the occurrence of most cancers is closely related to the disorder of immune mechanisms. For example, exercise can stimulate the proliferation and differentiation of CD8+ T cells, induce the transformation of M1 (pro-inflammatory) macrophages into M2 (anti-inflammatory) macrophages [7], and after the immune system is activated, dendritic cells (DCs) take up cancer antigens and present them to CD8+ T cells, so as to facilitate the activation and initiation of CD8+ T cells and the recognition and killing of tumor cells.
3
Control your weight
With the rapid improvement of the mainland's comprehensive national strength and the increasing improvement of the people's quality of life, the dietary structure has gradually changed to that of developed countries; at the same time, the acceleration of the pace of life has also led to a lack of time for exercise and exercise. In particular, the increase in daily food intake, the consumption of high-calorie fast food and high-sugar beverages and other unhealthy eating habits have led to an increase in the average annual obesity rate in mainland China year by year. In addition, with the popularity of electronic entertainment and the increase in takeaway consumption, the proportion of children and adolescents among the obese population in mainland China is increasing year by year. Obesity is not only one of the causes of type II diabetes, but also closely related to the occurrence and development of many cancers, so it is of great significance to establish a lifestyle of regular exercise, healthy diet, and active weight control for cancer prevention.
But blind exercise is unscientific, and different groups of people should differ in the type, intensity and frequency of exercise. The American Medical Association recommends 150~300 minutes of moderate-intensity physical activity or 75~150 minutes of vigorous-intensity physical activity per week for healthy adults, and 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week for young cancer patients [8]. At the same time, eating less out, eating less overly processed foods, reducing sugar intake, and practicing a healthy diet are also one of the key elements of weight control. In summary, developing a healthy diet combined with reasonable exercise can lead to better weight control and active cancer prevention.
4
Improves mood and relieves stress
Studies have shown that the occurrence of certain cancers such as rectal cancer and breast cancer is related to negative emotions such as depression, anxiety, and pessimism. During exercise, the brain releases endorphins, dopamine, and other neurotransmitters that make people feel good, which in turn improves mood, relieves stress, and reduces discomfort caused by bad emotions [9]. At the same time, even in patients with pre-existing cancer, appropriate exercise can reduce negative emotions such as irritability, fear, and anxiety during treatment, which can improve sleep, reduce symptoms such as fatigue and insomnia, increase cancer patients' tolerance to various treatments, improve treatment effects, and improve patients' quality of life [10].
5
Help change bad habits
Bad lifestyle habits such as drinking, smoking, staying up late, and obesity are important risk factors for cancer. For example, alcohol consumption is a definite risk factor for cancer of the mouth, larynx, esophagus, liver, colorectal, breast in women, etc. At the same time, excessive alcohol consumption affects the body's metabolism, which in turn leads to weight gain, which increases the risk of obesity-related cancer, and alcohol consumption also increases the risk of cardiovascular disease [11]. Smoking-induced cancer and its effects on cancer are better known. In addition to lung cancer, smoking increases the risk of gastric, liver, pancreatic, ovarian, and prostate cancers [12].
Bad habits are often addictive, and changing them is not easy, but exercise can be an important help in the process. Studies have shown that moderate-intensity exercise can reduce the desire to smoke and prevent violent reactions after quitting [13]. Exercise can inhibit stress, depression, and uncertainty, which are related to the release of endorphins and dopamine during the exercise described earlier. In addition to this, exercise is a distraction, which reduces the craving for bad habits (smoking, drinking, etc.). It can be seen that establishing good lifestyle habits through exercise is the most effective way to prevent cancer.
All in all, exercise has its own unique and important role in cancer prevention. However, exercise as a good lifestyle habit needs to be adhered to for a long time, and it is not possible to fish for three days and dry the net for two days. In addition, for the choice of exercise intensity and mode, we should give full play to our own subjective initiative, combine the actual condition of our own body or through the guidance of professionals, and gradually carry out moderate exercise, so as to avoid unnecessary training injuries and take care of one at the expense of the other.
So, don't hesitate, keep your mouth shut, open your legs, for the sake of your own health, let go of what you are doing, and start exercising from now on!
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