Exercise and Bladder Cancer Survival

According to the latest estimates by the American Cancer Society (1), approximately 74,690 new cases of bladder cancer will be diagnosed in the year 2014 within United States alone. Fortunately, due to advanced screening and therapeutic modalities, the cancer survival rate is improving in most western countries, yet it is estimated that this malignancy will claim 15,580 deaths in the current year.

Bladder Cancer Survival Factors

There are a number of factors that may influence treatment options and survival rate in bladder cancer victims, such as:

• Stage at Diagnosis: In about 50% cases, the bladder cancer is diagnosed when the malignant lesion is still confined to the bladder wall, (which is associated with good prognosis and better chances of survival). At stage 0 to 1, 5-year survival rate is approximately 88 to 98%. In another 35% cases, the cancer is diagnosed when the abnormal lesions has invaded the bladder wall, which can affect the disease prognosis profoundly. 5-year survival rate at stage II and III is 63% and 46% respectively. In the remaining 10-15% cases, cancer is diagnosed when the malignant cells are spread to distant sites of the body. In all such cases, prognosis is poor and 5-year cancer survival rate is only 15%.
• Gender Differences: Males are approximately 4 times more likely to develop bladder cancer than females. The lifetime risk to develop bladder malignancy in males is 1 in 26 (1). However, most females tend to ignore the classic symptom of bladder malignancy i.e. appearance of blood in the urine. Study reported in British Journal of Cancer (2) reported that more females die of bladder malignancy when compared to males due to factors like advanced stage at diagnosis, poor overall health and delay in seeking treatment.
• Advanced Age: The chances of survival are higher in younger subjects as compared to elderly (more than 90% cases of bladder cancer are reported in adults over the age of 55 years)
• History of Smoking: Chronic smoking affects the prognosis and survival in bladder cancer patients. Chronic smokers are 4-times more likely to die of bladder cancer than non-smokers.
• Exercise: According to latest research and advanced clinical studies, it has been observed that exercise and regular physical activity can increase the chances of bladder cancer survival in patients.

Bladder Cancer Survival and Exercise

What is the Association?

It has been reported previously that regular physical activity improves the survival in cancer patients (regardless of the site, size and location of malignant lesion). Exercise and physical activity has a profound effect on the maintenance of overall health that improves the treatment outcomes in bladder cancer, according to new research.Here is how it works:Exercise Boosts ImmunityResearch conducted by Vallance and associates (3) suggested that resistance training and aerobic training improves psychosocial, physical and immunological outcomes in bladder cancer patients. With healthy exercise regimens, following benefits can be achieved:

• Lower risk of recurrence of bladder cancer after complete treatment
• Minimal risk of dying from their primary bladder malignancy
• Higher rate and longer duration of survival than other cancer survivors

Exercise Decreases the Risk of Mortality from Non-Cancer CausesChronic metabolic health issues like diabetes, hypertension and cardiovascular diseases are a leading cause of death in cancer survivors and healthy subjects. With exercise, metabolic and other health related issues can be optimally managed that can directly help in increasing overall survival by 50% in bladder cancer survivors as suggested by the clinical studies.Improvement in the Quality of Life

Besides improving the survival rate, exercise also improves overall quality of life and functional independence in bladder cancer patients. Study reported in the peer reviewed journal Cancer Epidemiology and Biomarkers Prevention (4) suggested that:

• 7% bladder malignancy survivors lives a sedentary lifestyle with absolutely no physical activity
• About 16% perform some degree of physical activity (which is insufficient according to the current guidelines)
• Only 22% reported significant adherence to the standard guidelines for the maintenance of physical activity and exercise.

Study also suggested that physically active bladder cancer survivors have a better quality of life in terms of:

• Functional well-being (mood, activity status, energy levels and productivity)
• Sexual functioning (more physically active males are at lesser risk of experiencing erectile dysfunction and other sexual disorders)
• Better scoring in fatigue and stamina

Recommended Guidelines for Physical Activity in Bladder Cancer Patients

According to latest guidelines, bladder cancer patients (or individuals suffering from other malignancies) should spend approximately 150 minutes per week in physical activity of moderate to strenuous intensity. Alternately, individuals who perform vigorous exercises should only spend at least 75 minutes per week in their workout regimen (4).References:

1. Noon, A. P., Albertsen, P. C., Thomas, F., Rosario, D. J., & Catto, J. W. F. (2013). Competing mortality in patients diagnosed with bladder cancer: evidence of undertreatment in the elderly and female patients. British journal of cancer, 108(7), 1534-1540.
2. Karvinen, K. H., Courneya, K. S., North, S., & Venner, P. (2007). Associations between exercise and quality of life in bladder cancer survivors: a population-based study. Cancer Epidemiology Biomarkers & Prevention, 16(5), 984-990.
3. Vallance, J., Spark, L., & Eakin, E. (2013). Exercise behavior, motivation, and maintenance among cancer survivors. In Exercise, Energy Balance, and Cancer (pp. 215-231). Springer New York.
4. Porserud, A., Sherif, A., & Tollbäck, A. (2014). The effects of a physical exercise programme after radical cystectomy for urinary bladder cancer. A pilot randomized controlled trial. Clinical rehabilitation, 28(5), 451-459.