Two studies recently published have shown that
exercise can protect against skin and bowel
cancer, and they have identified new mechanisms
that could be responsible for this effect.
Published in the journal "Carcinogenesis",
one study found that female mice that had
24-hour access to running wheels and were
exposed to ultraviolet B light (UVB) took
longer to develop skin tumours, developed
fewer and smaller tumours, and had decreased
amounts of body fat compared to mice that
did not have access to running wheels. The
second study looked at the development of
pre-cancerous polyps in the intestines of
male mice and discovered that voluntary exercise
and a restricted diet reduced the number and
size of polyps and improved survival.
Dr Allan Conney, Garbe Professor of Cancer
and Leukemia Research and Director of the
Susan Lehman Cullman Laboratory for Cancer
Research at Rutgers University, New Jersey,
USA, is one of the authors of the skin cancer
study. He said that programmed cell death
(apoptosis), triggered by exercise, might
explain why the running wheel mice did better.
"Preliminary indications from follow-up work
in the laboratory suggest that voluntary exercise
enhances UVB-induced apoptosis in the skin,
and that it also enhances apoptosis in UVB-induced
tumours. So, although UVB is triggering the
development of tumours, exercise is counteracting
the effect by stimulating the death of the
developing cancer cells.
"Our studies may be the first to suggest
an apoptotic mechanism for the effect of voluntary
exercise in the development of cancer. In
addition, we found that voluntary exercise
decreased body fat and that the number of
tumours decreased with decreasing amounts
of fat. This effect may also play an important
role in the mechanism and warrants further
investigation, bearing in mind the growing
rates of obesity in the Western world, particularly
in the USA and UK," he said.
Dr Lisa Colbert, Assistant Professor at the
University of Wisconsin-Madison, USA, lead
author of the bowel cancer study, said that
her study was the first to suggest that a
negative energy balance, produced by increasing
the mice's energy output (by use of a running
wheel) while maintaining a restricted calorie
intake, appeared to be the important factor
in inhibiting the growth of polyps (the fore-runners
of bowel tumours).
"Negative energy balance was indicated by
a lower body weight among the exercising mice,
although they retained more body fat at the
end of the study than the non-exercising mice
– an observation that might be due to the
fact that the exercising mice were healthier,
while the health of the non-exercising mice
was beginning to decline due to higher numbers
of polyps. There were higher levels of hormones
known to be associated with the onset of cancer
– insulin-like growth factor-1 (IGF-1) and
corticosterone – amongst the exercising mice,
but this did not correlate with higher total
polyp numbers. These data suggest that voluntary
exercise that induces a negative energy balance
protects against the onset of cancer in these
mice, but that the mechanism is unlikely to
be related to body composition, IGF-1 or corticosterone."
Dr Conney emphasised that it was not known
yet whether exercise decreased the risk of
sunlight-induced skin cancer in humans, and
clinical trials were needed to investigate
this further. However, in bowel cancer, evidence
from population studies already suggests that
physically active people have a reduced risk
of developing the disease, but the mechanisms
remain unclear.
The skin cancer study involved two experiments.
In a "high risk" model, mice were exposed
to UVB three times a week for 16 weeks, and
then for the subsequent 14 weeks, in the absence
of further UVB treatment, half the mice had
access to running wheels in their cages while
the other half did not. In a second, "complete
carcinogenesis" model, mice were exposed to
UVB twice a week for 33 weeks and, from the
beginning, half had access to a running wheel
and half did not. Mice not exposed to UVB
acted as controls for the study. In both models,
the exercising mice increased their food intake
and maintained their normal body weight.
The exercising mice in the high risk model
had an average of seven weeks without tumours
after the UVB exposure ceased, while the non-exercising
mice only had an average of 3.5 tumour-free
weeks.
Dr Conney said: "In both the no running wheel
and running wheel groups, the number of tumours
per mouse increased with time, but throughout
the 14 weeks of tumour development, animals
with access to running wheels had a decreased
number of tumours per mouse compared to animals
with no running wheels. At all times, the
tumour size in the no running wheel group
was greater than in the running wheel group;
on average, the tumour size per mouse for
the no wheel group was just over three times
more than for the exercise group."
In the complete carcinogenesis model, mice
with no running wheel started to develop tumours
20 weeks after the start of UVB exposure,
while tumours in the running wheel group started
after 23 weeks. The average tumour-free time
was 25 weeks for the no running wheel group
and 27 weeks for the running wheel group.
Dr Conney said: "The rate of increase in
tumour numbers per mouse for the no running
wheel group was significantly greater than
that for the running wheel group. On average,
the tumour size per mouse for the no running
wheel group was about 3.5 times more than
in the exercise group.
"In both models, voluntary running decreased
the number of non-malignant tumours per mouse
by 34%. Exercise substantially decreased the
size of non-malignant tumours and malignant
tumours: in the high risk model, the non-malignant
tumour size per mouse was decreased by 54%
and the malignant tumour size per mouse by
73%, and in the complete carcinogenesis model,
tumour size per mouse was decreased by 75%
and 69% respectively."
For the bowel cancer study, Dr Colbert and
her co-authors used mice (APC Min mice) that
had a genetic mutation that predisposed them
to develop intestinal polyps. "Our studies
are relevant for humans in that these Min
mice have a mutation in one of the same genes,
APC, that is also mutated in human colon cancer,"
she explained. "The protective effect of exercise
and lower body weight in our mice is consistent
with epidemiological evidence in humans that
suggests higher levels of activity and lower
body weight reduces the risk of colon cancer."
Mutations in the APC gene in humans are responsible
for an inherited condition called familial
adenomatous polyposis (FAP). FAP affects about
one in 10,000-15,000 people worldwide, 95%
of whom will develop numerous polyps in the
bowel which eventually develop into colon
cancer, usually before the age of 40. The
gene is mutated in sporadic forms of colon
cancer as well.
The researchers randomly assigned seven-week-old
male mice to either voluntary wheel running
or to no exercise for 10 weeks. For the first
three weeks both groups had the same amount
of food and water, but after that the exercising
mice were fed the amount that the non-exercising
mice had eaten the week before so that their
food consumption was unable to rise with their
increased activity, thereby producing a negative
energy balance.
By the end of the ten weeks, six of the 23
control mice had died due to the number of
polyps that had grown and the resulting anaemia,
while all the 24 exercising mice were still
alive.
"The exercising mice ran an average of 3.8
km a day, and the further they ran the fewer
polyps they had. Exercise significantly reduced
total polyp number and polyp size, as well
as prolonging survival," said Dr Colbert.
"On average there were 16 polyps per mouse
in the exercising mice compared to 22 polyps
in the control mice – a decrease of 25%."