Health experts have known for some time that regular exercise reduces colon cancer risk. Even more exciting is the idea that it's never too late to reap these benefits. For colon cancer survivors, exercise may be one key for keeping the disease from returning.

Colon Cancer Survivors Need to Move Too

The latest research supports the notion that being physically active after colon cancer diagnosis truly is worth the effort. Using information gathered from the long-running Health Professionals Follow-up Study, researchers at Harvard have confirmed that regular exercise greatly reduces risk of colon cancer recurrence.

Men with a history of stage I to stage III colorectal cancer who engaged in an average of 27 metabolic equivalent-hours (MET-hours) of exercise per week, reduced risk of colon cancer recurrence by 53%. This means that something as simple as a few good sweat sessions per week can reduce the likelihood of getting cancer again by more than half!

This finding agrees with earlier research showing exercise reduces risk of recurrence in female colon cancer survivors. We now have good evidence that exercise reduces recurrence risk in both male and female colon cancer survivors.

What's a MET?

Research on exercise uses a measure called a metabolic equivelent, or MET, to keep track of physical activity performed by study participants. One MET refers to the amount of oxygen you consume and the number of calories you burn at rest. If you are exercising at a level of 7 METs, this means that you are working about 7 times as hard as you would be at rest.

Exercising at a level of 7 METs means you are burning 7 times the calories you normally burn at rest. You are consuming about 7 times the amount of oxygen as you would at rest as well.

The Healthful Life Project of the University of Medicine & Dentistry of New Jersey (UMDNJ) provides a detailed chart of the METs per hour of typical activities such as walking, jogging, and playing tennis. The chart also provides sample calculations for determining your MET-hours per week.

Getting the Go Ahead and Getting Started

If you want to add exercise into your health and wellness routine, talk to your doctor. Make sure you are OK to begin or increase a physical activity program. Once you have clearance from your doctor, start slow and work up to more vigorous and longer physical activity over time.

For example, if you are starting from a baseline of no regular exercise, you may want to aim for 15 minutes of brisk walking 3-5 times per week. After 3 weeks or so, begin to add a few minutes to each session. Most exercise experts agree that it's more important to increase the duration of exercise first, before increasing intensity.

Meet Your MET Goals

Your goal is to get in as many MET-hours per week as you can, up to about 25-30 total METs. As an example, taking a one-hour brisk walk each day will get you to about 25 METs.

What if you can't or don't want to exercise this much? Not to worry: Any exercise that you get above a baseline of about 3 MET-hours per week, which is very little activity, will improve your health.

The research on exercise and colon cancer survival shows that there is a "dose-response" relationship between exercise and lower risk. This means that if you exercise a little, you reduce your risk of recurrence a little. If you exercise a moderate amount, you reduce your risk a moderate amount, and so forth. If you can squeeze in 8, 10, or 20 MET-hours worth of exercise per week, you will reap benefits and you will reduce risk of recurrence. Any activity is better than none.

Keeping it in Perspective

It can be inspiring to learn about how you can take control of your health and reduce your risk of colon cancer recurrence, but don't get too caught up in the numbers. For many people, tracking each and every minute of exercise or calculating MET-hours would be a chore. It would take all the enjoyment out of being active and healthy. There is no need to do this.

Looking at the MET-hours of different activities will just give you a general idea of goals and what to aim for. Focus on activities you enjoy, do them regularly, and you'll be on your way to lower colon cancer risk, even if you've already had this disease.

Statins are a group of medications that are used to lower cholesterol levels. Reducing cholesterol levels appears to reduce the risk of heart disease, the number one killer in the US. Many millions of people take statins, so knowing these medications are safe is very important.

Do Statins Have Other Benefits?

In addition to reducing cholesterol levels, statins also can have anti-inflammatory effects in the body. This has led to the hope that these drugs also may have a role in reducing the risk of other chronic diseases, including cancer. Colon cancer in particular is of interest, because regular use of other anti-inflammatory medications, including aspirin, do reduce risk.

No Magic Bullet

A new, long-term study out of Canada suggests that as used for heart disease prevention, statins do not have a role in reducing colon cancer risk. After following over 35,000 people who regularly used statins, and more than 10,000 people who used these medications long-term (more than 5 years), researchers did not find a lower risk of colon cancer in the statin users.

This result may be disappointing for those focused on colon cancer prevention, but there is a silver lining to the story. The researchers did not show a markedly increased risk of colon cancer in regular and long-term statin users either. Statins may not be the colon cancer prevention medication we'd hoped for, but when it comes to colon cancer risk, they do appear safe for long-term use.

Being diagnosed with cancer can bring a wide range of emotions, including grief. Grief is defined as a normal reaction to loss. With cancer, the losses may be large and small.

People may grieve the loss of independence or their status as a "healthy person". People may grieve the loss of their normal role in the family or even the loss of a body part due to surgery. Regardless of the source of grief, one of the most important things to know is that there is no "one right way" to grieve.

Stages of Grief

In the past, many mental health experts felt that there were emotional stages most grieving people moved through. They expected each person would move through these stages in a specific order as well. Newer studies and work with grieving people have shown this is not necessarily true.

Mental health experts now point out that grief can include emotions as different as denial, anger, and guilt. This can lead to physical problems as well. Addressing these physical problems won't resolve the grief completely, but can help a person feel better and cope with the emotional aspects of grief more effectively.

Helping Yourself Cope

According to the Mayo Clinic Health Letter, there are several positive steps that may help a person better cope with grief:

• Express feelings and seek support. Family, friends, support groups, a religious community, or grief counselor can provide support in times of crisis. If you've been diagnosed with cancer, you need support now more than ever, so don't hold your feelings in.
• Avoid making major life decisions. When grieving, you may not think as clearly as you normally would. Options that seem like a good idea now may not be right for you in the future. To avoid making any major decisions you may later regret, seek help for coping with your grief first. Focus on the big life decisions when you are in a better place emotionally.
• Take care of yourself. Get plenty of rest, eat right, and get regular, moderate exercise if you can do so. If you have been diagnosed with cancer, ask your doctor if it is OK to exercise.
• Give it time. Moving through and beyond grief may take months or even years in some cases. If you feel that your grief is so severe that you cannot function in your daily life, talk to your doctor. He or she can explain options such as counseling or antianxiety and antidepressant medications. These approaches can use used to get through a particularly rough patch.

The bottom line is that grief is a normal response to cancer. Don't feel badly if you're not grieving in a way that people expect or want. Just be sure to take care of your emotional and physical needs. It's OK to work through grief at your own pace and in your own way.

You may have heard about research showing that our health and lifestyle choices affect colon cancer risk. What about how these things affect whether we get cancer again, if we've already had it? For cancer survivors, is it ever "too late" to get benefit from avoiding tobacco, exercising regularly, and eating right?

The studies on this topic, though few at this point, are very encouraging. They suggest that even after diagnosis regular exercise and a healthy diet do matter.

Spreading the Word

Do colon cancer survivors know about this research? Do many of them understand that by taking good care of themselves, they may reduce their risk of recurrence (getting cancer again)? A researcher at the Cancer Institute of New Jersey (CINJ) aims to find out.

Previous study by this researcher, Dr. Elliot Coups, shows that 80% of colorectal cancer survivors do not regularly exercise. 57% do not meet recommendations for eating enough fruits and vegetables every day. Dr. Coups indicates that more research is needed because inactivity and poor diet may increase the risk for colorectal cancer recurrence.

The research is designed to help health experts better understand how and why colorectal and other cancer survivors modify their exercise and diet habits. This information, in turn, can be used by doctors, nurses, dietitians, health coaches, and other health care providers to help cancer survivors make healthy behavior changes. As well, this research may be used to help people have success maintaining these health changes for the long-term.

How to Get Involved

According to Dr. Coups, people who meet all of the following criteria may be eligible to participate in the study:

• Men and women over 21 years of age
• People who have been diagnosed with stage I, II or III colorectal cancer
• People who are within six weeks of having completed their cancer treatment

For additional information on how to participate, please call CINJ at 877-512-8928.