Activity Trackers: Do They Have A Place in Kidney Cancer?

Activity trackers: could they have a role in helping to prevent kidney cancer and in supporting people with kidney cancer?

Dr Rebecca Case-Upton BSc (Hons), PhD
Kidney Cancer UK Medical Publications

What are they?
You can’t have missed the popular trend for wearable activity trackers: all around us people have suddenly started sporting plastic wristbands with the noble intention of starting a healthier life. Adorning wrists everywhere, they’ve quickly become all the rage with some of the more well-known brands becoming synonymous with the device. A more jazzed-up version of the traditional pedometer, a basic activity tracker tracks and records steps, distance covered, calories burned and active minutes. Some also have a clock. More advanced models boast a dizzying array of features including: sleep-tracking, alarms, barometers for measuring height climbed, heart-rate monitoring and built-in GPS. Some enable people to connect with friends to see how many steps they are taking. And some, but not all, have a display which shows some of the information and they can be sychronised with smartphones, tablets or PCs to enable a more detailed view of daily activity.
With a common goal of reaching 10,000 steps each day, by tracking every footstep and exercise milestone, these wearable devices are providing people with a new-found motivation and enabling them to keep tabs on their own fitness like never before.
Preventing illnesses where being over-weight is a risk factor
The fitness and health benefits of wearing one in the general population are clear: the NHS report that one in four British adults is obese and that the UK has the highest level of obesity in Western Europe. “Obesity levels in the UK have more than trebled in the last 30 years and, on current estimates, more than half the population could be obese by 2050.”(1)
It is well-established that people who are very overweight have a higher risk of developing kidney cancer: nearly a quarter (an estimated 24%) of kidney cancers in the UK are linked to being overweight and obese (2):
• Kidney cancer risk among men is 22% higher in those who are overweight (body mass index [BMI] 25-30) and 63% higher in those who are obese (BMI 30+).
• Kidney cancer risk among women is 38% higher in those who are overweight and 95% higher in those who are obese (2).
Of concern, the average person only walks between 3000 and 4000 steps per day, which is less than half the daily steps recommended. Yet by simply wearing an activity tracker to monitor activity levels and actively aim for 10,000 steps per day, people can be sure they are covering more than the 150 minutes of recommended weekly exercise. (3) If wearing an activity tracker encourages people to be more active and therefore results in a healthier weight, people’s risk of developing diseases where being overweight is a risk factor – including kidney cancer – would be reduced.
But can these small devices that you can wear 24/7 to monitor every footstep, every mile clocked up, every calorie burned, and even the quality of your shuteye have such a valid role for people with kidney cancer?
The evidence for supporting exercise in people with cancer
A concise evidence review published by Macmillan – the importance of physical activity for people living with and beyond cancer – reports that the evidence is growing to support the role of physical activity during and after cancer treatment. “Keeping active throughout the cancer journey can preserve or improve physical function and pyschological well-being, reducing the negative impact of some cancer-related side-effects. Regular physical activity also has a potential role in reducing risk of cancer recurrence and increasing survival.”(4) Other interesting observations from the report include:
• “Although the body of evidence on the survival benefits associated with physical activity is still developing, the emerging picture is highly encouraging.”
• “Although no formal physical activity guidelines exist in the UK for people living with and beyond cancer, we can be confident that advising and supporting otherwise healthy cancer survivors to gradually build up to the health-related physical activity guidelines for the general population are appropriate.”
• There is no reliable information available on the proportion of cancer survivors meeting physical activity recommendations in the UK. However a study of 716 older men and women with a history of cancer in England revealed that only 51% reported being moderately active for more than once a week. Furthermore among cancer survivors there is evidence that while some health-related behaviours (eg diet, smoking) improve after a cancer diagnosis, physical activity levels reduce significantly.”
The report concluded, “Activity should be promoted to patients at all stages of cancer from initial diagnosis through to the later stages, where being active can continue to benefit physical function and quality of life. The evidence shows that if an activity recommendation is carefully tailored to the individual, and takes account of potential side-effects, it is likely to have a positive impact.”
Our view
With an increasing number of people surviving cancer it is important to think about long-term health and life after cancer. The many health benefits of exercise are well-known and wearing an activity tracker can help to promote and make you aware of how much exercise you do. Wearing one of these devices can help you think about adding in a bit more physical activity during everyday tasks. For instance, perhaps people could consider walking for fifteen minutes to an appointment instead of driving. Although this might not be possible everyday due to illness or fatigue, by being conscious of trying to add in steps whenever possible, overall people’s activity levels should increase, along with other health benefits of exercise.
It is, however, vitally important to use activity trackers in a positive way, rather than allowing yourself to become frustrated if you can’t do as much as you like. Some activity trackers allow you to set your own goals; rather than 10,000 steps, perhaps 7000 is more achievable and you can aim to increase this slowly over time? Whatever your individual goal is, always make sure you are proud of what you achieve.
In addition to encouraging a slightly more active lifestyle, a tracker can also help to highlight those days when you are doing too much and need to slow down. They could be a really useful tool to make sure you are getting regular rest times and have the recommended number of hours of sleep. It is important to have good quality periods of rest to allow you to recover after surgery or during cancer treatment.
Fatigue levels can be a very distressing side-effect of cancer and its treatment. Our annual survey illustrated this point and over 70 percent of people taking tyrosine kinase inhibitors experienced fatigue as a treatment side-effect. It is important to get the exercise balance right when coping with fatigue. Gentle exercise, such as walking, can boost energy levels, however it is important to pace yourself and not do too much. Wearing an activity tracker won’t be for everyone but they may well offer people a way to monitor their lifestyle and get the balance right for them.
In summary
In our view, activity trackers are not just for sporty people; they could also be a useful tool in helping to prevent diseases where being overweight is a risk factor and for people with kidney cancer; to help monitor their individual activity levels and sleep patterns. They can be used as a way of self-evaluating general day-to-day activity, which can be used positively to aid recovery and build strength and stamina. However, it is important to stress that if their use causes anxiety or frustration then their usefulness would be outweighed. Making the decision to wear one of these devices will all depend on the individual – whether they are likely to see one as useful or as frustrating – and their level of health. But by monitoring activity and rest periods, used wisely, activity trackers can certainly have their place in improving the overall health of people with kidney cancer.
*Please consult with your specialist before undertaking any exercise over and above your daily walking routine.

(1) http://www.nhs.uk/Livewell/loseweight/Pages/statistics-and-causes-of-the-obesity-epidemic-in-the-UK.aspx
(2) http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/kidney-cancer/risk-factors#ref-3
(3) http://www.nhs.uk/Livewell/loseweight/Pages/10000stepschallenge.aspx
(4) http://www.macmillan.org.uk/documents/aboutus/commissioners/physicalactivityevidencereview.pdf

 
Activity Trackers: Do They Have A Place in Kidney Cancer?