June 28 — 29, 2007 Advisory Committee Meeting
Minutes

Cancers

Dr. McTiernan reviewed issues surrounding cancer.

Because cancer is a common condition and only about 15% is familial, lifestyle and environmental change are important factors. There most likely will be significant overlap with other groups, even though other groups may not realize it. Some mechanisms that may associate physical activity and cancer, if there is an association, may be related to metabolic factors, hormones, and immune function.

Because there is a rich body of observational data on cancers the Committee will have to realize up front that observational data in this area will be the best source of data. Also, most of the data is on the most common cancers. For other cancers it is important to understand there many not be much data at all.

For cancers where there may not be an effect of exercise or physical activity on incidents of cancer, there still may be an important role in prognosis, either the stage at which a cancer is developed, and one example would be prostate cancer perhaps, or just once somebody gets the cancer, what's their prognosis? While we are not talking about acute rehab for this issue, cancer survivors of some type tend to be long-term cancer survivors with many years of life left. Therefore, a recommendation for that group for lifestyle changes may be of benefit.

Phase two of the literature review should include more mechanistic literature searches, some of which will overlap with other groups. Mechanisms will be very important to identify in order to come up with a potential prescription for physical activity or exercise for cancer prevention or risk reduction.

A key question regarding cancer will be whether physical activity alone is beneficial or whether weight control is an important part. Some of the data suggest that for some cancers, physical activity may be most beneficial if the individual keeps the weight down, but other studies may not find that. Additionally, are there some subgroups that will benefit more from physical activity than others?

In general, we should be looking at the associations for the main cancers as well as what data exists on the less common cancers and try to come up with a recommended prescription. Finally, we also need to address the cancer survivor group.

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