Dr. Marisa Bittoni has always been interested in cancer research. Her research focuses mainly on how lifestyle habits, such as exercise, diet and smoking, can reduce or prevent cancer development. As a Research Assistant Professor at The Ohio State University, she has spent the last eight years designing and implementing studies related to this topic. This year, Dr. Bittoni received the Lung Cancer Discovery Award from the American Lung Association to fund her most recent study, which seeks to examine the link between exercise and lung cancer prevention.

“I have found that some doctors and oncologists don’t consider lifestyle as a factor that can prevent lung cancer, especially exercise. So, we got a lot of push back when previously submitting this study, because many people link lung cancer solely to smoking. But we wanted to show that there are other factors that can make a difference in reducing lung cancer risk and preventing its development.”

BeWell Study: How diet is related to cancer prevention

Previous research by Dr. Bittoni and her team has shown that there was a 40-50% decrease in cancer mortality in people who had healthier diets and exercise habits. So, Dr. Bittoni and colleagues created two interventional? studies that separately examined these variables. The first study was a diet intervention that examined the effect of black raspberries in reducing lung cancer risk. Participants were long-time smokers from the OSU Lung Screening Clinic (age 55-80), who were at high-risk for lung cancer.

Once selected, participants were given a berry drink twice daily that had been developed at OSU from locally grown black raspberries packaged in a 6-ounce juice box. “Berries are full of antioxidants and other nutrients that help with cancer prevention,” she explained. Participants also provided urine and stool samples in which changes in bodily inflammation and gut bacteria (microbiome) were measured, which have both shown associations with cancer.

BeFit Study: How exercise is related to cancer prevention

After the diet study was completed, Dr. Bittoni and her team developed a sister study focused on exercise to be conducted in this same population of high-risk smokers. Due to the pandemic, they also used social media to find eligible candidates and were able to adapt and conduct these studies virtually. “It had been difficult convincing funders how important this study was, which is why I was so thrilled to receive the grant from the American Lung Association,” she said.

Participants for the exercise study are divided into two groups, a control group where only light walking is encouraged (as normally recommended by physicians), and an exercise group that performs both resistance (lifting weights) and aerobic training. The resistance training begins with two weekly resistance sessions with a trainer, then decreases to once per week, so that participants can effectively transition to exercising on their own. “The 12-week combined resistance training and aerobic program conforms to the American College of Sports Medicine physical activity guidelines that are recommended for all Americans, which we have referenced in our proposal,” Dr. Bittoni explained.

In addition to the trainer, participants also receive behavioral support for one hour per week in which they can join a virtual support group (via Zoom) where they can discuss any challenges or barriers that they have encountered.

How does it really help?

Many people are interested to know if exercise is just good for your overall health or if there is something specific that leads to cancer prevention. “We know that there are certain steps that must happen for cancer to occur, and we have seen that exercise can specifically interfere with some of those steps and block the cancer,” she said.

As a result of these initial studies, Dr. Bittoni and colleagues will seek to conduct future large-scale studies to further examine changes in the microbiome (gut bacteria) and bodily inflammation to determine how exercise may prevent cancer in this very direct way. “For example, exercise can decrease inflammation which may inhibit tumor growth,” she said. “We know that exercise can make a difference on a cellular level, we just need to understand exactly how it does this, including the amounts and types of exercise that are needed so we can provide information to help people make changes that may save their lives.”

Learn more about lung cancer prevention on our website.

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