Department of Public Health Thesis


ANDREWS UNIVERSITY Department of Public Health


Signature Assignment-Physical Activity Promotion Plan



Presented in Partial Fulfillment of the Requirements for the class: FTES510-999 Fitness and Health Promotion

Spring 20__ Dr. Padma Tadi Uppala





Overview and rationale

Among the different types of cancer, breast cancer is the most prevalent type of cancer in

women worldwide, in both developed and developing countries. “Approximately 40,610 women

are expected to die of breast cancer in 2017 in the US. Mortality rates for 2011-2017 for breast

cancer rates for Non-Hispanic Whites was 21.2 and for Non-Hispanic Blacks was 29.8% per

100,000 women” (American Cancer Society, 2017). In Michigan, breast cancer is the most

diagnosed cancer and the second-leading cause of cancer deaths in women. According to Institute

for Health Metrics and Evaluation (2016), age-standardized breast cancer rate in 2014 was 27.2

per 100,000 women for Berrien County, above the state and national average rate. In 2011 the

prevalence of obesity in women from Berrien County exceeded the state average rate and only half

the female population meet physical activity (PA) recommendations. A large number of studies

show the relationship between obesity/sedentary lifestyle and increased risk of breast cancer.

According to research, exercise could help prevent cases and deaths caused from breast cancer.

With exercise, there is a decrease in estradiol and an increase in the binding globulin to sex

hormones, which causes reduction of inflammatory and increase of the anti-inflammatory

substances which may prevent the development of cancer (Silva, 2018).

Treatment for breast cancer, such as surgery (radical or conservative mastectomy),

chemotherapy, radiotherapy or hormone therapy, is associated with the impairment of the body,

causing physical consequences such as fatigue and pain, as well as changes in body image, psychic,

emotional and social declines (Ussher, Perz & Gilbert, 2012). In this sense, the need for

interventions that minimize such complications, coupled with a healthy lifestyle, especially in

relation to eating habits and physical activity levels, is emphasized (George et al., 2011).



Physical exercise is a useful tool to manage post-treatment complications of cancer,

because it generates an increase in cardiorespiratory fitness and flexibility, gains in self-image,

self-esteem, decrease in depression and anxiety, and improvement in sleep quality (Battaglini et

al., 2014). Physical activity has been shown to be beneficial for breast cancer survivors, women in

initial stage, and women with metastatic breast cancer (advanced stage). However, due to fear of

bone fracture and fatigue related to cancer or cancer treatment that affects normal functioning,

those with metastatic breast cancer have typically been excluded from exercise interventions (Yee,


A community-based exercise intervention with breast cancer survivors was shown to be

feasible and improve significantly physical, psychological and functional well-being (Knobf,

Thompson, Fennie & Erdos, 2014). In Canada, a 12-week exercise program known as the “Breast

cancer patients Engaging in Activity while Undergoing Treatment” (BEAUTY) was also feasible

and effective in improving quality of life, preventing declines in physical and psychosocial

outcomes (Leach, Danyluk, Nishimura & Culos-Reed, 2015). These studies support the need to

include PA programming as part of treatment for breast cancer patients.

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