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Nascimento-Gonçalves E, Seixas F, Palmeira C, Martins G, Fonseca C, Duarte JA, Faustino-Rocha AI, Colaço B, Pires MJ, Neuparth MJ, Moreira-Gonçalves D, Fardilha M, Henriques MC, Patrício D, Pelech S, Ferreira R, Oliveira PA. Lifelong exercise training promotes the remodelling of the immune system and prostate signalome in a rat model of prostate carcinogenesis. GeroScience 2024; 46:817-840. [PMID: 37171559 PMCID: PMC10828357 DOI: 10.1007/s11357-023-00806-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/21/2023] [Indexed: 05/13/2023] Open
Abstract
This work aimed to understand how lifelong exercise training promotes the remodelling of the immune system and prostate signalome in a rat model of PCa. Fifty-five male Wistar rats were divided into four groups: control sedentary, control exercised, induced PCa sedentary and induced PCa exercised. Exercised animals were trained in a treadmill for 53 weeks. Pca induction consisted on the sequential administration of flutamide, N-methyl-N-nitrosourea and testosterone propionate implants. Serum concentrations of C-reactive protein (CRP) and tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) were not different among groups. Peripheral levels of γδ T cells were higher in Pca exercised group than in the PCa sedentary group (p < 0.05). Exercise training also induced Oestrogen Receptor (ESR1) upregulation and Mitogen-activated Protein Kinase 13 (MAPK13) downregulation, changed the content of the phosphorylated (at Ser-104) form of this receptor (coded by the gene ESR1) and seemed to increase Erα phosphorylation and activity in exercised PCa rats when compared with sedentary PCa rats. Our data highlight the exercise-induced remodelling of peripheral lymphocyte subpopulations and lymphocyte infiltration in prostate tissue. Moreover, exercise training promotes the remodelling prostate signalome in this rat model of prostate carcinogenesis.
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Affiliation(s)
- Elisabete Nascimento-Gonçalves
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-Os-Montes and Alto Douro (UTAD), 5000-801, Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), UTAD, 5000-801, Vila Real, Portugal
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro (UA), 3810-193, Aveiro, Portugal
| | - Fernanda Seixas
- Animal and Veterinary Research Centre (CECAV), Associate Laboratory for Animal and Veterinary Science - AL4AnimalS, UTAD, 5000-801, Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-Os-Montes and Alto Douro, 5000-801, Vila Real, Portugal
| | - Carlos Palmeira
- Clinical Pathology Department, Portuguese Institute of Oncology of Porto, 4200-072, Porto, Portugal
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, 4200-072, Porto, Portugal
- School of Health Science Fernando Pessoa and FP-i3iD, 4200-253, Porto, Portugal
| | - Gabriela Martins
- Clinical Pathology Department, Portuguese Institute of Oncology of Porto, 4200-072, Porto, Portugal
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, 4200-072, Porto, Portugal
| | - Carolina Fonseca
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-Os-Montes and Alto Douro (UTAD), 5000-801, Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), UTAD, 5000-801, Vila Real, Portugal
| | - José Alberto Duarte
- CIAFEL, Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4200-450, Porto, Portugal
| | - Ana I Faustino-Rocha
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-Os-Montes and Alto Douro (UTAD), 5000-801, Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), UTAD, 5000-801, Vila Real, Portugal
- Department of Zootechnics, School of Sciences and Technology, University of Évora, 7004-516, Évora, Portugal
- Comprehensive Health Research Centre, 7004-516, Évora, Portugal
| | - Bruno Colaço
- Animal and Veterinary Research Centre (CECAV), Associate Laboratory for Animal and Veterinary Science - AL4AnimalS, UTAD, 5000-801, Vila Real, Portugal
- Department of Zootechnics, University of Trás-Os-Montes and Alto Douro, 5000-801, Vila Real, Portugal
| | - Maria João Pires
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-Os-Montes and Alto Douro (UTAD), 5000-801, Vila Real, Portugal
- Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), UTAD, 5000-801, Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-Os-Montes and Alto Douro, 5000-801, Vila Real, Portugal
| | - Maria João Neuparth
- Research Center in Physical Activity, Health and Leisure (CIAFEL)-Faculty of Sports-University of Porto (FADEUP), Portugal and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116, Gandra, Portugal
| | - Daniel Moreira-Gonçalves
- Research Center in Physical Activity, Health and Leisure (CIAFEL)-Faculty of Sports-University of Porto (FADEUP), Portugal and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Margarida Fardilha
- Department of Medical Sciences, iBiMED - Institute of Biomedicine, University of Aveiro, 3810-193, Aveiro, Portugal
| | - Magda C Henriques
- Department of Medical Sciences, iBiMED - Institute of Biomedicine, University of Aveiro, 3810-193, Aveiro, Portugal
| | - Daniela Patrício
- Department of Medical Sciences, iBiMED - Institute of Biomedicine, University of Aveiro, 3810-193, Aveiro, Portugal
| | - Steven Pelech
- Department of Medicine, University of British Columbia, Vancouver, B.C, Canada
- Kinexus Bioinformatics Corporation, Suite 1 - 8755 Ash Street, Vancouver, BC, V6P 6T3, Canada
| | - Rita Ferreira
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193, Aveiro, Portugal
| | - Paula A Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-Os-Montes and Alto Douro (UTAD), 5000-801, Vila Real, Portugal.
- Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), UTAD, 5000-801, Vila Real, Portugal.
- Department of Veterinary Sciences, University of Trás-Os-Montes and Alto Douro, 5000-801, Vila Real, Portugal.
- Clinical Academic Center of Trás-Os-Montes and Alto Douro, University of Trás-Os-Montes and Alto Douro, 5000-801, Vila Real, Portugal.
- University of Trás-os-Montes and Alto Douro, Quinta dos Prados, 5001-801, Vila Real, Portugal.
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Günbatar N, Bulduk B, Bezgin S, Oto G, Bayıroğlu F, Bulduk M. The Effect of Moderate-Intensity Physical Exercise on Some Serum Inflammation Markers and the Immune System in Rats Fed Intermittent Fasting with a High-Fat Diet. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1687. [PMID: 37763806 PMCID: PMC10537032 DOI: 10.3390/medicina59091687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: This study aimed to investigate the impact of moderate-intensity physical exercise on serum inflammation markers and the immune system in rats that were fed a high-fat diet (HFD) with intermittent fasting. Materials and Methods: A total of 48 Wistar albino male rats were included in the study and divided into eight groups, each consisting of six rats. Group 1 served as the control group (CG), receiving a standard diet. Group 2 followed the standard nutrition program with intermittent fasting (CG + IF). Group 3 underwent exercise with a standard diet (CG + E). Group 4 underwent both a standard diet with intermittent fasting and exercise (CG + IF + E). Group 5 was fed a high-fat diet (HFD). Group 6 received a high-fat diet with intermittent fasting (HFD + IF). Group 7 followed a high-fat diet with exercise (HFD + E). Group 8 underwent both a high-fat diet with intermittent fasting and exercise (HFD + IF + E). The study lasted for 8 weeks. Results: The results of the analysis show that lymphocyte cell levels in groups HFD + IF, HFD + IF, and HFD + IF + E were higher compared to groups CG-HFD (p < 0.05). Additionally, B lymphocyte and monocyte cell levels were higher in group HFD + IF + E compared to groups CG, CG + IF, and CG + IF + E, as well as CG, CG + IF, and CG + E, respectively. TNF-α levels were significantly higher in group HFD compared to the other groups. Furthermore, IL 10 levels were higher in group HFD + IF + E compared to the other groups. Conclusions: These findings indicate that moderate exercise and intermittent fasting, particularly in groups fed a high-fat diet, increased anti-inflammatory cytokine levels, and certain immune system cell counts, while decreasing pro-inflammatory cytokine levels.
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Affiliation(s)
- Nizamettin Günbatar
- Van School of Health, Van YuzuncuYıl University, 65090 Van, Turkey; (B.B.); (S.B.); (M.B.)
| | - Bahattin Bulduk
- Van School of Health, Van YuzuncuYıl University, 65090 Van, Turkey; (B.B.); (S.B.); (M.B.)
| | - Selver Bezgin
- Van School of Health, Van YuzuncuYıl University, 65090 Van, Turkey; (B.B.); (S.B.); (M.B.)
| | - Gökhan Oto
- Department of Pharmacology, Van YuzuncuYıl University, 65090 Van, Turkey;
| | - Fahri Bayıroğlu
- Faculty of Medicine, Department of Physiology, Yıldırım Beyazıt University, 06200 Ankara, Turkey;
| | - Mehmet Bulduk
- Van School of Health, Van YuzuncuYıl University, 65090 Van, Turkey; (B.B.); (S.B.); (M.B.)
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Park S, Park SK, Jee YS. Effects of walking training at different speeds on body composition, muscle contractility, and immunocytes in the elderly: A single-blinded randomized controlled trial. Arch Gerontol Geriatr 2023; 106:104871. [PMID: 36450211 DOI: 10.1016/j.archger.2022.104871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study investigated the changes in body composition, muscle contractility and immunocytes of the elderly using three types of walking. MATERIAL AND METHODS Seventy-six participants were randomly assigned to control group (CON), slow walking group (SWG), moderate walking group (MWG), or fast walking group (FWG). RESULTS Muscle mass in CON decreased (-2.55 ± 3.63%; P < 0.05), while it increased in FWG (1.92 ± 4.46%; P < 0.05). Fat mass in CON increased, whereas it decreased in MWG and FWG (-18.71 ± 14.22%; P < 0.001). Tc (contraction time) of biceps femoris (BF) decreased in CON, while a decreasing tendency was seen in SWG. Although Tc of BF increased in MWG, it showed a marked increase in FWG (21.19 ± 24.53%; P < 0.05). A similar tendency was observed in the rectus femoris. Leukocytes did not change in CON, but they showed an increasing tendency in MWG and FWG. Neutrophils decreased in CON, whereas the other groups showed an increasing tendency. Lymphocytes (10.25 ± 19.48%; P < 0.01) and helper T cells (14.32 ± 17.99%; P < 0.05) showed an increase in FWG, and NK cell was improved in SWG, but showed a clear increase in MWG (38.45 ± 96.96%; P < 0.05) and FWG (52.69 ± 58.37%; P < 0.05). CONCLUSIONS This study concludes that fast walking by the elderly improves the muscle contractility, which can also be expected to improve the function of immunocytes by increased or maintained muscle mass and decreased fat mass after 12 weeks.
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Affiliation(s)
- Sihwa Park
- Research Institute of Sports and Industry Science, Hanseo University, #1 Hanseo-ro, Haemi-myeon, Seosan 31962, Korea
| | - Sang-Kyun Park
- Department of Physical Education, Chungnam National University, Daehak-ro, Yuseong-gu, Daejeon 34134, Korea.
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, #1 Hanseo-ro, Haemi-myeon, Seosan 31962, Korea.
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Choi D, Choi S, Kim KH, Kim K, Chang J, Kim SM, Kim SR, Cho Y, Lee G, Son JS, Park SM. Combined Associations of Physical Activity and Particulate Matter With Subsequent Cardiovascular Disease Risk Among 5‐Year Cancer Survivors. J Am Heart Assoc 2022; 11:e022806. [PMID: 35491990 PMCID: PMC9238603 DOI: 10.1161/jaha.121.022806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The combined associations of physical activity and particulate matter (PM) with subsequent cardiovascular disease (CVD) risk is yet unclear. Methods and Results The study population consisted of 18 846 cancer survivors who survived for at least 5 years after initial cancer diagnosis from the Korean National Health Insurance Service database. Average PM levels for 4 years were determined in administrative district areas, and moderate‐to‐vigorous physical activity (MVPA) information was acquired from health examination questionnaires. A multivariable Cox proportional hazards model was used to evaluate the risk for CVD. Among patients with low PM with particles ≤2.5 µm (PM2.5; (19.8–25.6 μg/m3) exposure, ≥5 times per week of MVPA was associated with lower CVD risk (adjusted hazard ratio [aHR], 0.77; 95% CI, 0.60–0.99) compared with 0 times per week of MVPA. Also, a higher level of MVPA frequency was associated with lower CVD risk (P for trend=0.028) among cancer survivors who were exposed to low PM2.5 levels. In contrast, ≥5 times per week of MVPA among patients with high PM2.5 (25.8–33.8 μg/m3) exposure was not associated with lower CVD risk (aHR, 0.98; 95% CI, 0.79–1.21). Compared with patients with low PM2.5 and MVPA ≥3 times per week, low PM2.5 and MVPA ≤2 times per week (aHR, 1.26; 95% CI, 1.03–1.55), high PM2.5 and MVPA ≥3 times per week (aHR, 1.34; 95% CI, 1.07–1.67), and high PM2.5 and MVPA ≤2 times per week (aHR, 1.38; 95% CI, 1.12–1.70) was associated with higher CVD risk. Conclusions Cancer survivors who engaged in MVPA ≥5 times per week benefited from lower CVD risk upon low PM2.5 exposure. High levels of PM2.5 exposure may attenuate the risk‐reducing effects of MVPA on the risk of CVD.
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Affiliation(s)
- Daein Choi
- Department of Medicine Mount Sinai Beth IsraelIcahn School of Medicine at Mount Sinai New York NY
| | - Seulggie Choi
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
| | - Kyae Hyung Kim
- Department of Family Medicine Seoul National University Hospital Seoul South Korea
| | - Kyuwoong Kim
- Division of Cancer Control and Policy National Cancer Control InstituteNational Cancer Center Goyang South Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
| | - Sung Min Kim
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
| | - Seong Rae Kim
- Department of Dermatology Seoul National University Hospital Seoul South Korea
| | - Yoosun Cho
- Total Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul South Korea
| | - Gyeongsil Lee
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
- Department of Family Medicine Seoul National University Hospital Seoul South Korea
| | - Joung Sik Son
- Department of Family Medicine Korea University Guro Hospital South Korea
| | - Sang Min Park
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
- Department of Family Medicine Seoul National University Hospital Seoul South Korea
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Thomas R, Kenfield SA, Yanagisawa Y, Newton RU. Why exercise has a crucial role in cancer prevention, risk reduction and improved outcomes. Br Med Bull 2021; 139:100-119. [PMID: 34426823 PMCID: PMC8431973 DOI: 10.1093/bmb/ldab019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Exercise is one of several factors known to lower the risk of developing cancer, as well as improve outcomes in patients already diagnosed. People who exercise after cancer have lower rates of cancer complications, treatment toxicities, relapse and improved survival. This review highlights the supportive data and biochemical processes, which explain these potential benefits. SOURCES OF DATA PubMed, Embase, Medline and Cochrane libraries were searched for papers which addressed the effects of exercise and physical activity on cancer for this review. The search terms used were physical activity, exercise and cancer up to February 2021. We also referred to the background research required for international exercise intervention study involving men with prostate cancer (INTERVAL-GAP4) and scrutinized references within the robust papers published on this subject to ensure we did not miss any clinically studies. One hundred and eighty eight papers were included. AREAS OF AGREEMENT Exercise programmes mitigate many of the complications and risks associated with cancer, particularly thromboembolism, fatigue, weight gain, arthralgia, cognitive impairment and depression. AREAS OF CONTROVERSY Molecular and biomarker changes, resulting from exercise, suggest that exercise elicits beneficial changes in insulin-related pathways, down-regulates inflammation and serum oestrogen levels, and enhances oxidative, immune and cellular repair pathways. Nonetheless, the evidence remains preliminary. GROWING POINTS The timing, intensity and challenges of prehabilitation, adjunct and rehabilitation exercise programmes are being increasingly understood but their implementation remains sporadic. AREAS FOR DEVELOPING RESEARCH More robust clinical trial data are needed to substantiate a causal effect of exercise on overall and cancer-specific survival. These studies are ongoing. Research evaluating the most cost-efficient ways of incorporating prehabilitation, adjunct and rehabilitation programmes into routine practice would be helpful to funding bodies and health care strategists.
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Affiliation(s)
- Robert Thomas
- Department of Oncology, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
| | - Stacey A Kenfield
- Departments of Urology and Epidemiology and Biostatistics, University of California at San Francisco, Mission Hall, Box 1695-550, 16th Street, 6th Floor, San Francisco, CA 9414, USA
| | - Yuuki Yanagisawa
- Department of Medicine, Bedford Hospital, Kempston road, Bedford MK42 9DJ, UK
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, WA 6027, Australia
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Vafaee R, Tavirani MR, Tavirani SR, Razzaghi M. Assessment of cancer prevention effect of exercise. Hum Antibodies 2021; 30:31-36. [PMID: 34459390 DOI: 10.3233/hab-210454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are many documents about benefits of exercise on human health. However, evidences indicate to positive effect of exercise on disease prevention, understanding of many aspects of this mechanism need more investigations. Determination of critical genes which effect human health.GSE156249 including 12 gene expression profiles of healthy individual biopsy from vastus lateralis muscle before and after 12-week combined exercise training intervention were extracted from gene expression omnibus (GEO) database. The significant DEGs were included in interactome unit by Cytoscape software and STRING database. The network was analyzed to find the central nodes subnetwork clusters. The nodes of prominent cluster were assessed via gene ontology by using ClueGO. Number of 8 significant DEGs and 100 first neighbors analyzed via network analysis. The network includes 2 clusters and COL3A1, BGN, and LOX were determined as central DEGs. The critical DEGs were involved in cancer prevention process.
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Affiliation(s)
- Reza Vafaee
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Rezaei Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sina Rezaei Tavirani
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Morishita S, Hamaue Y, Fukushima T, Tanaka T, Fu JB, Nakano J. Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2021; 19:1534735420917462. [PMID: 32476493 PMCID: PMC7273753 DOI: 10.1177/1534735420917462] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose: Exercise could lower the risk of cancer recurrence and
improve mortality, exercise capacity, physical and cardiovascular function,
strength, and quality of life in patients with cancer. This systematic review
and meta-analysis of randomized controlled trials (RCTs) aimed to determine the
effects of exercise on mortality and recurrence in patients with cancer.
Methods: We searched for articles published before May 2019 in
MEDLINE, CINAHL, the Cochrane Library, Scopus, ProQuest, and PEDro. We included
RCTs of exercise interventions, such as resistance exercise and aerobic
exercise, in patients with cancer that evaluated the risk of mortality and
recurrence. The standardized mean difference with 95% confidence intervals (CIs)
was calculated for quantitative indices. The random-effect model was used as the
pooling method. Results: Of 2868 retrieved articles, 8 RCTs were
included in the meta-analysis, with a mean PEDro score of 4.50 (SD = 1.25).
Exercise significantly reduced the risk of mortality in patients with cancer and
in cancer survivors (risk ratio [RR] = 0.76, 95% CI = 0.40-0.93,
I2 = 0%, P = .009). Exercise
significantly reduced the risk of recurrence in cancer survivors (RR = 0.52, 95%
CI = 0.29-0.92, I2 = 25%, P =
.030). Conclusion: This study found that exercise has a favorable
effect on mortality and recurrence in patients with cancer. However, the effect
could not be fully determined due to data insufficiency.
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Affiliation(s)
| | - Yohei Hamaue
- Niigata University of Health and Welfare, Niigata, Japan
| | | | - Takashi Tanaka
- Hyogo College of Medicine Hospital, Nishinomiya, Hyogo, Japan
| | - Jack B Fu
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Lohsiriwat V, Lertbannaphong S, Polakla B, Riansuwan W. Implementation of enhanced recovery after surgery and its increasing compliance improved 5-year overall survival in resectable stage III colorectal cancer. Updates Surg 2021; 73:2169-2179. [PMID: 33599947 DOI: 10.1007/s13304-021-01004-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/10/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Enhanced recovery after surgery (ERAS) improves short-term outcomes after colorectal cancer (CRC) surgery, but its benefits on oncological results remain unclear. The objectives of this study are (1) to compare 5-year overall survival (OS) following non-metastatic CRC surgery between ERAS and conventional care (CC), and (2) to evaluate the association between ERAS compliance and OS. METHODS Patients undergoing curative resection for stage I-III CRC in a university hospital were reviewed. Utilizing the 2010-2012 CRC registry, 5-year OS of surgical patients between ERAS and CC were compared. Utilizing the 2010-2016 ERAS registry, 5-year OS between patients with high ERAS compliance (≥ 70%) and their counterparts were compared. RESULTS Between 2010 and 2012, 349 patients had curative surgery: 70 (20%) with ERAS and 279 (80%) with CC. The 5-year OS was 80.3% in ERAS and 65.6% in CC (HR 0.54, 95%CI 0.33-0.88, p = 0.014). After adjustment with other variables, ERAS was associated with better 5-year OS for stage III CRC only (72.6% vs. 57.2%, adjusted HR 0.54, 95%CI 0.30-0.98, p = 0.041). Regarding ERAS compliance, 320 patients were reviewed: 232 (73%) with high compliance. The 5-year OS was 83.9% in high compliance and 69.6% in low compliance (HR 0.49, 95% CI 0.29-0.83, p = 0.007). After adjustment with cancer staging, high compliance had better 5-year OS in stage III CRC only (80.5% vs. 60.7%, adjusted HR 0.44, 95%CI 0.23-0.84, p = 0.013). CONCLUSION ERAS was associated with improved 5-year OS following non-metastatic CRC surgery (especially stage III disease) than CC. High ERAS compliance had better OS than its counterpart.
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Affiliation(s)
- Varut Lohsiriwat
- Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lung Road, Bangkok, 10700, Thailand.
| | - Sarinda Lertbannaphong
- Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Bundhawich Polakla
- Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woramin Riansuwan
- Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Yildiz Kabak V, Gursen C, Aytar A, Akbayrak T, Duger T. Physical activity level, exercise behavior, barriers, and preferences of patients with breast cancer-related lymphedema. Support Care Cancer 2020; 29:3593-3602. [PMID: 33170403 DOI: 10.1007/s00520-020-05858-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/26/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To identify physical activity level, exercise behavior, barriers, and preferences in female patients with breast cancer-related lymphedema (BCRL). METHODS Patients with BCRL consulted to physical therapy to receive lymphedema treatment were included. Age, gender, body mass index matched healthy controls (HC) were included to identify differences. The transtheoretical model was used to determine exercise behavior. Physical activity level was assessed by the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The exercise barriers and preferences of patients with BCRL were recorded using a checklist based on the previous studies. RESULTS A total of 48 female patients with BCRL and 38 female HC participated in the study. Physical activity level was significantly lower in patients with BCRL when compared to HC (p ˂ 0.05). However, the number of participants who engaged in regular exercise was significantly higher in patients with BCRL than HC (33.2% vs 7.9%, p ˂ 0.05). The most common exercise barriers were fatigue (64.5%), having other responsibilities (60.4%), and weather-related factors (56.2%). Majority of the participants preferred to participate in a supervised (79.1%), structured (66.6%), combined-type (77.1%), and moderate intensity (79.1%) exercise program, and they preferred to be informed at the time of the cancer diagnosis (45.8%) by a physiotherapist (66.6%). Moreover, the most preferred exercise type was walking/jogging (66.6%). CONCLUSION The present study showed inadequate physical activity and exercise behavior in patients with BCRL. Supportive care interventions are needed to overcome barriers for patients with BCRL. Preferences of patients and exercise enjoyment should also be taken into consideration to increase the participation in exercises.
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Affiliation(s)
- Vesile Yildiz Kabak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey.
| | - Ceren Gursen
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey
| | - Ayca Aytar
- Vocational School of Health Sciences, Baskent University, Ankara, Turkey
| | - Turkan Akbayrak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey
| | - Tulin Duger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey
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10
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Hwang S, Kang D, Lee M, Byeon JY, Park H, Park D, Kim K, Lee S, Chu SH, Kim NK, Jeon JY. Changes in DNA methylation after 6‐week exercise training in colorectal cancer survivors: A preliminary study. Asia Pac J Clin Oncol 2020; 18:52-60. [DOI: 10.1111/ajco.13482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/04/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Seo‐Hyeon Hwang
- Exercise Medicine Center for Diabetes and Cancer Patients Institute of Convergence of Science (ICONS) Yonsei University Seoul South Korea
- Department of Sport Industry Studies Yonsei University Seoul South Korea
| | - Dong‐Woo Kang
- Behavioural Medicine Laboratory, Faculty of Kinesiology, Sport, and Recreation University of Alberta Edmonton AB Canada
| | - Mi‐Kyung Lee
- Exercise Medicine Center for Diabetes and Cancer Patients Institute of Convergence of Science (ICONS) Yonsei University Seoul South Korea
- Department of Sport Industry Studies Yonsei University Seoul South Korea
| | - Ji Yong Byeon
- Department of Sport Industry Studies Yonsei University Seoul South Korea
| | - Hanui Park
- Department of Sport Industry Studies Yonsei University Seoul South Korea
| | - Dong‐Hyuk Park
- Department of Sport Industry Studies Yonsei University Seoul South Korea
| | - Kyung‐Chul Kim
- Department of healthy aging Gangnam Major Clinic Seoul South Korea
| | - Seung‐Tae Lee
- Department of Laboratory Medicine Yonsei University College of Medicine Seoul South Korea
| | - Sang Hui Chu
- Department of Clinical Nursing Science, College of Nursing, Biobehavioural Research Center Yonsei University Nursing Policy Research Institute Seoul South Korea
| | - Nam Kyu Kim
- Department of Surgery Yonsei University College of Medicine Seoul South Korea
| | - Justin Y. Jeon
- Exercise Medicine Center for Diabetes and Cancer Patients Institute of Convergence of Science (ICONS) Yonsei University Seoul South Korea
- Department of Sport Industry Studies Yonsei University Seoul South Korea
- Cancer Prevention Center Shinchon Severance Hospital Seoul South Korea
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11
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Swan F, Chen H, Forbes CC, Johnson MJ, Lind M. CANcer BEhavioural nutrition and exercise feasibility trial (CanBenefit); phase I qualitative interview findings. J Geriatr Oncol 2020; 12:641-648. [PMID: 33059998 DOI: 10.1016/j.jgo.2020.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/09/2020] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Older people with lung cancer are often frail and unfit due to their cancer and co-morbidities and may tolerate cancer treatments poorly. Physical activity (PA) and a healthy diet offer quality of life benefit to people with cancer before, during, and post treatment. However, older adults are poorly represented in the clinical trials on which recommendations were made. OBJECTIVE To assess the acceptability, usefulness, and practicality of delivering a tailored wellbeing (PA and nutrition) intervention for older adults with lung cancer before, during, and after cancer treatments (chemotherapy and/or immunotherapy). METHODS Semi-structured interviews conducted with nine patients with lung cancer and three patients with mesothelioma, ≥70 years and ten informal carers, and nine Multidisciplinary Team (MDT) members. A topic guide covered the acceptability, usefulness, and practicality of a wellbeing intervention as well as specific feedback on individual components. Data were subjected to thematic analysis. FINDINGS Four themes were generated: current lack of wellbeing care in clinical work; preferred "can have" dietary and "can do" PA advice; peer support as facilitating factor; and barriers to compliance including patients' psychological and physical issues as well as current cancer pathway and staffing issues. CONCLUSION Older adults with lung cancer would welcome a proactive, clear and instructive, wellbeing intervention. Many barriers to compliance exist, particularly before and during cancer treatments due to the psycho-social impact of diagnosis, and the effects of cancer treatment. The intervention must be tailored to individual need and address physical limitations, psychological and social welfare in addition to PA and nutritional advice.
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Affiliation(s)
- Flavia Swan
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK.
| | - Hong Chen
- Institute of Applied Health Research, Murray Learning Centre, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Cynthia C Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Michael Lind
- Academic Department of Oncology, Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, Kingston-Upon-Hull, UK
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12
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Hashem F, Stephensen D, Bates A, Pellatt-Higgins T, Hobbs RNP, Hopkins M, Woodward H, Stavropoulou C, Swaine IL, Ali H. Acceptability and Feasibility of an Isometric Resistance Exercise Program for Abdominal Cancer Surgery: An Embedded Qualitative Study. Cancer Control 2020; 27:1073274820950855. [PMID: 33035075 PMCID: PMC7791474 DOI: 10.1177/1073274820950855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although it is recognized in the early stages of cancer recovery that changes in
lifestyle including increases in physical activity improves physical function,
there are no clear findings whether low versus moderate intensity activity or
home or gym exercise offer optimal benefit. Isometric-resistance exercises can
be carried out with very little equipment and space and can be performed while
patients are bed-bound in hospital or at home. This embedded qualitative study,
based in an English hospital trust providing specialist cancer care, was
undertaken as a component of a feasibility trial to evaluate the acceptability
and feasibility of an isometric-resistance exercise program and explore the
suitability of functional assessments by drawing from the experiences of
abdominal cancer patients following surgery. Telephone interviews were
undertaken with 7 participants in the intervention group, and 8 interviews with
the usual care group (n = 15). The gender composition consisted of 11 females
and 4 males. Participants’ ages ranged from 27 to 84 (M = 60.07, SD = 15.40).
Interviews were conducted between August 2017 and May 2018, with audio files
digitally recorded and data coded using thematic framework analysis. Our results
show that blinding to intervention or usual care was a challenge, participants
felt the intervention was safe and suitable aided by the assistance of a
research nurse, yet, found the self-completion questionnaire tools hard to
complete. Our study provides an insight of trial processes, participants’
adherence and completion of exercise interventions, and informs the design and
conduct of larger RCTs based on the experiences of abdominal cancer surgery
patients.
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Affiliation(s)
- Ferhana Hashem
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - David Stephensen
- Physiotherapy Department, East Kent Hospitals University Foundation NHS Trust, Kent and Canterbury Hospital, Canterbury, Kent, United Kingdom.,Haemophilia Centre, Royal London Hospital, United Kingdom
| | - Amanda Bates
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - Tracy Pellatt-Higgins
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - Ralph Nobby Peter Hobbs
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
| | - Malcolm Hopkins
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
| | - Hazel Woodward
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
| | | | - Ian L Swaine
- Centre for Science and Medicine in Sport and Exercise, University of Greenwich, Gillingham, Chatham, United Kingdom
| | - Haythem Ali
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, United Kingdom
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13
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Hanson ED, Sakkal S, Que S, Cho E, Spielmann G, Kadife E, Violet JA, Battaglini CL, Stoner L, Bartlett DB, McConell GK, Hayes A. Natural killer cell mobilization and egress following acute exercise in men with prostate cancer. Exp Physiol 2020; 105:1524-1539. [PMID: 32715550 DOI: 10.1113/ep088627] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/29/2020] [Indexed: 01/19/2023]
Abstract
NEW FINDINGS What is the central question of this study? What are the characteristics of the NK cell response following acute moderate-intensity aerobic exercise in prostate cancer survivors and is there a relationship between stress hormones and NK cell mobilization? What is the main finding and its importance? NK cell numbers and proportions changed similarly between prostate cancer survivors and controls following acute exercise. Consecutive training sessions can likely be used without adverse effects on the immune system during prostate cancer treatment. ABSTRACT Prostate cancer treatment affects multiple physiological systems, although the immune response during exercise has been minimally investigated. The objective was to characterize the natural killer (NK) cell response following acute exercise in prostate cancer survivors. Prostate cancer survivors on androgen deprivation therapy (ADT) and those without (PCa) along with non-cancer controls (CON) completed a moderate intensity cycling bout. NK cells were phenotyped before and 0, 2 and 24 h after acute exercise using flow cytometry. CD56 total NK cell frequency increased by 6.2% at 0 h (P < 0.001) and decreased by 2.5% at 2 h (P < 0.01) with similar findings in CD56dim cells. NK cell counts also exhibited a biphasic response. Independent of exercise, ADT had intracellular interferon γ (IFNγ) expression that was nearly twofold higher than CON (P < 0.01). PCa perforin expression was reduced by 11.4% (P < 0.05), suggesting these cells may be more prone to degranulation. CD57- NK cells demonstrated increased perforin and IFNγ frequencies after exercise with no change within the CD57+ populations. All NK and leukocyte populations returned to baseline by 24 h. NK cell mobilization and egress with acute exercise appear normal, as cell counts and frequencies in prostate cancer survivors change similarly to CON. However, lower perforin proportions (PCa) and higher IFNγ expression (ADT) may alter NK cytotoxicity and require further investigation. The return of NK cell proportions to resting levels overnight suggests that consecutive training sessions can be used without adverse effects on the immune system during prostate cancer treatment.
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Affiliation(s)
- Erik D Hanson
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Samy Sakkal
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Shadney Que
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Eunhan Cho
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Elif Kadife
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - John A Violet
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
| | - Claudio L Battaglini
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Lee Stoner
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - David B Bartlett
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Glenn K McConell
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Alan Hayes
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Vic, Australia.,Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Vic, Australia
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14
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Forbes CC, Swan F, Greenley SL, Lind M, Johnson MJ. Physical activity and nutrition interventions for older adults with cancer: a systematic review. J Cancer Surviv 2020; 14:689-711. [PMID: 32328828 PMCID: PMC7473955 DOI: 10.1007/s11764-020-00883-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/02/2020] [Indexed: 12/17/2022]
Abstract
Purpose The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC). Methods We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials. Results Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice. Conclusions Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement. Implications for Cancer Survivors More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations. Electronic supplementary material The online version of this article (10.1007/s11764-020-00883-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cynthia C Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK. .,University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire, HU6 7RX, UK.
| | - Flavia Swan
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Sarah L Greenley
- Academy of Primary Care, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Michael Lind
- Cancer Research Group, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
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15
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Hyatt A, Drosdowsky A, Williams N, Paton E, Bennett F, Andersen H, Mathai J, Milne D. Exercise Behaviors and Fatigue in Patients Receiving Immunotherapy for Advanced Melanoma: A Cross-Sectional Survey via Social Media. Integr Cancer Ther 2020; 18:1534735419864431. [PMID: 31382768 PMCID: PMC6685109 DOI: 10.1177/1534735419864431] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective: Treatment with immunotherapy has positively changed the long-term outlook of many patients with advanced melanoma; however, fatigue is a common and debilitating side effect. Evidence indicates exercise can improve treatment-related fatigue for patients receiving chemotherapy and radiotherapy. However, currently little is known about exercise behaviors and preferences of patients receiving immunotherapy. This project aimed to describe self-reported levels of fatigue related to immunotherapy; patient perspectives of exercise behaviors; and barriers and facilitators to engagement in exercise for patients receiving, or recently completed immunotherapy for unresectable stage III and stage IV melanoma. Method: A cross-sectional purpose-built survey was distributed to members of the Melanoma Patients Australia closed Facebook group via an online survey platform. The survey remained active for 1 month, with 3 posts during this time inviting members to participate. Results: A total of 55 responses were collected. Just over half the participants (n = 31; 56%) described exercising while receiving immunotherapy, with walking as the most common activity (n = 24; 77%). Participants described a range of physical and emotional benefits of exercise, the most predominant being fatigue reduction. Barriers to exercise also included fatigue and competing physical demands at home or work. Patient understanding of what constitutes exercise appeared to differ from clinical classifications. Conclusions: Results from this study indicate that patients are engaging in exercise while receiving immunotherapy, with the intent of mediating treatment-related fatigue. Identification of preferred exercise activities and barriers will assist in developing tailored exercise interventions for this cohort.
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Affiliation(s)
- Amelia Hyatt
- 1 Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Narelle Williams
- 2 Melanoma And Skin Cancer Trials Ltd, Australia.,3 Monash University, Melbourne, Victoria, Australia
| | - Elizabeth Paton
- 2 Melanoma And Skin Cancer Trials Ltd, Australia.,3 Monash University, Melbourne, Victoria, Australia
| | - Fiona Bennett
- 4 Melanoma Patients Australia, Brisbane, Queensland, Australia
| | | | | | - Donna Milne
- 1 Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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16
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Exercise and Physical Activity in Patients with Osteosarcoma and Survivors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1257:193-207. [PMID: 32483741 DOI: 10.1007/978-3-030-43032-0_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exercise has the potential to positively affect patients with osteosarcoma by improvement of function, mitigation of disability, and maintenance of independence and quality of life. Exercise may also directly impact cancer treatment efficacy. This chapter examines the feasibility and use of exercise or physical activity as therapy in the treatment of osteosarcoma and its survivors. It additionally presents the benefits of physical activity as treatment and rehabilitation both preoperatively (prehabilitation) and postoperatively. This chapter will also discuss barriers to exercise and physical activity for patients with osteosarcoma and its survivors, emphasizing the need for a comprehensive and cohesive support system to promote its incorporation into patient treatment plans and ensure compliance.
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17
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Exercise training, circulating cytokine levels and immune function in cancer survivors: A meta-analysis. Brain Behav Immun 2019; 81:92-104. [PMID: 31454519 DOI: 10.1016/j.bbi.2019.08.187] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/06/2019] [Accepted: 08/21/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Anti-cancer therapies lead to chronic non-resolving inflammation and reduced immune function. One potential therapy is exercise training, but the effectiveness of these interventions to improve immune-related outcomes, the gaps in the literature, and recommendations to progress the field need to be determined. OBJECTIVES (1) to conduct separate meta-analyses in cancer survivors to determine the effects of exercise training on pro- and anti-inflammatory markers, and immune cell proportions and function; and (2) to perform subgroup analyses to determine whether exercise modality, cancer type, and specific markers help to explain heterogeneity in each meta-analysis. DATA SOURCES Electronic databases (PubMed/MEDLINE, EMBASE, CENTRAL, and CINAHL) from inception to March 2018. The reference lists of eligible articles and relevant reviews were also checked. STUDY SELECTION Inclusion criteria were adult cancer survivors from randomized controlled trials performing structured exercise intervention (aerobic, resistance or combined training or Tai Chi/yoga) compared to usual care control group and included pro-inflammatory, anti-inflammatory, and/or immune cell outcomes. APPRAISAL AND SYNTHESIS METHODS A total of 5349 potentially eligible articles were identified, of which 26 articles (27 trials) met the inclusion criteria. Effect sizes were calculated as standardized mean differences (SMD), where <0.2 was defined as trivial, 0.2-0.3 as small, 0.4-0.8 as moderate, and >0.8 as a large effect. RESULTS Exercise training decreased pro-inflammatory markers (SMD: -0.2, 95% CI: -0.4, -0.1, p < 0.001). Sub-group analysis for the pro-inflammatory markers indicated that combined aerobic and resistance training had the greatest effect (SMD: -0.3, 95% CI: -0.5, -1.9, p < 0.001), that prostate (SMD: -0.5, 95% CI: -0.8, 0.1, p = 0.004) and breast cancer populations were most responsive (SMD: -0.2, 95% CI: -0.3, -0.1, p = 0.001), and that C-reactive protein (SMD: -0.5, 95% CI: -0.9, -0.06, p = 0.025) and tumor necrosis factor (SMD: -0.3, 95% CI: -0.5, -0.06, p = 0.004) were the most sensitive to change. Exercise training tended to decrease anti-inflammatory markers (p = 0.072) but had no effect on natural killer or natural killer T cell proportions or cytotoxic activity. CONCLUSIONS Exercise training reduces pro-inflammatory markers in cancer survivors, with the strongest evidence for combined training and for prostate and breast cancer survivors. Further research is warranted to determine if these changes are clinically relevant or are associated with improvements in symptoms. To strengthen future research, focusing on novel immune populations that include functional parameters and standardized reporting of key immune outcomes is recommended.
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18
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Luan X, Tian X, Zhang H, Huang R, Li N, Chen P, Wang R. Exercise as a prescription for patients with various diseases. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:422-441. [PMID: 31534817 PMCID: PMC6742679 DOI: 10.1016/j.jshs.2019.04.002] [Citation(s) in RCA: 212] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/12/2019] [Accepted: 03/01/2019] [Indexed: 05/18/2023]
Abstract
A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy. Because each sport has its own set of characteristics and physiological complications that tend to occur during exercise training, the effects and underlying mechanisms of exercise remain unclear. Thus, the first step in probing the effects of exercise on different diseases is the selection of an optimal exercise protocol. This review summarizes the latest exercise prescription treatments for 26 different diseases: musculoskeletal system diseases (low back pain, tendon injury, osteoporosis, osteoarthritis, and hip fracture), metabolic system diseases (obesity, type 2 diabetes, type 1 diabetes, and nonalcoholic fatty liver disease), cardio-cerebral vascular system diseases (coronary artery disease, stroke, and chronic heart failure), nervous system diseases (Parkinson's disease, Huntington's disease, Alzheimer's disease, depression, and anxiety disorders), respiratory system diseases (chronic obstructive pulmonary disease, interstitial lung disease, and after lung transplantation), urinary system diseases (chronic kidney disease and after kidney transplantation), and cancers (breast cancer, colon cancer, prostate cancer, and lung cancer). Each exercise prescription is displayed in a corresponding table. The recommended type, intensity, and frequency of exercise prescriptions are summarized, and the effects of exercise therapy on the prevention and rehabilitation of different diseases are discussed.
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Affiliation(s)
- Xin Luan
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiangyang Tian
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Haixin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- Department of Sport, Huainan Normal University, Huainan 232038, China
| | - Rui Huang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Na Li
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Peijie Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- Corresponding authors.
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- Corresponding authors.
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19
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West MA, Astin R, Moyses HE, Cave J, White D, Levett DZH, Bates A, Brown G, Grocott MPW, Jack S. Exercise prehabilitation may lead to augmented tumor regression following neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Acta Oncol 2019; 58:588-595. [PMID: 30724668 DOI: 10.1080/0284186x.2019.1566775] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose: We evaluate the effect of an exercised prehabilitation programme on tumour response in rectal cancer patients following neoadjuvant chemoradiotherapy (NACRT). Patients and Methods: Rectal cancer patients with (MRI-defined) threatened resection margins who completed standardized NACRT were prospectively studied in a post hoc, explorative analysis of two previously reported clinical trials. MRI was performed at Weeks 9 and 14 post-NACRT, with surgery at Week 15. Patients undertook a 6-week preoperative exercise-training programme. Oxygen uptake (VO2) at anaerobic threshold (AT) wasmeasured at baseline (pre-NACRT), after completion of NACRT and at week 6 (post-NACRT). Tumour related outcome variables: MRI tumour regression grading (ymrTRG) at Week 9 and 14; histopathological T-stage (ypT); and tumour regression grading (ypTRG)) were compared. Results: 35 patients (26 males) were recruited. 26 patients undertook tailored exercise-training with 9 unmatched controls. NACRT resulted in a fall in VO2 at AT -2.0 ml/kg-1/min-1(-1.3,-2.6), p < 0.001. Exercise was shown to reverse this effect. VO2 at AT increased between groups, (post-NACRT vs. week 6) by +1.9 ml/kg-1/min-1(0.6, 3.2), p = 0.007. A significantly greater ypTRG in the exercise group at the time of surgery was found (p = 0.02). Conclusion: Following completion of NACRT, exercise resulted in significant improvements in fitness and augmented pathological tumour regression.
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Affiliation(s)
- M. A. West
- Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R. Astin
- Department of Medicine, Institute for Sport, Exercise and Health, University College London, London, UK
| | - H. E. Moyses
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - J. Cave
- Department of Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D. White
- Department of Radiology, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - D. Z. H. Levett
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A. Bates
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - G. Brown
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, UK
| | - M. P. W. Grocott
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S. Jack
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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20
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West SL, Banks L, Schneiderman JE, Caterini JE, Stephens S, White G, Dogra S, Wells GD. Physical activity for children with chronic disease; a narrative review and practical applications. BMC Pediatr 2019; 19:12. [PMID: 30621667 PMCID: PMC6325687 DOI: 10.1186/s12887-018-1377-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Physical activity (PA) is associated with a diverse range of health benefits. International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits. However, current guidelines are intended for healthy children, and thus may not be applicable to children with a chronic disease. Specifically, the dose of PA and disease specific exercise considerations are not included in these guidelines, leaving such children with few, if any, evidence-based informed suggestions pertaining to PA. Thus, the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases: respiratory, congenital heart, metabolic, systemic inflammatory/autoimmune, and cancer. METHODS For each disease, we present the pathophysiology of exercise intolerance, summarize the pediatric exercise intervention research, and provide PA suggestions. RESULTS Overall, exercise intolerance is prevalent in pediatric chronic disease. PA is important and safe for most children with a chronic disease, however exercise prescription should involve the entire health care team to create an individualized program. CONCLUSIONS Future research, including a systematic review to create evidence-based guidelines, is needed to better understand the safety and efficacy of exercise among children with chronic disease.
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Affiliation(s)
- Sarah L. West
- Department of Biology, Trent/Fleming School of Nursing, Trent University, Toronto, Canada
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane E. Schneiderman
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Jessica E. Caterini
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Samantha Stephens
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy Management and Evaluation, The University of Toronto, Toronto, Canada
| | - Gillian White
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Oshawa, Canada
| | - Greg D. Wells
- Translational Medicine, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 10th floor, 686 Bay St., Toronto, ON M5G 0A4 Canada
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21
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Malcomson FC. Mechanisms underlying the effects of nutrition, adiposity and physical activity on colorectal cancer risk. NUTR BULL 2018. [DOI: 10.1111/nbu.12359] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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22
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Caru M, Kern L, Bousquet M, Curnier D. Preventive fraction of physical fitness on risk factors in cardiac patients: Retrospective epidemiological study. World J Cardiol 2018; 10:26-34. [PMID: 29707165 PMCID: PMC5919890 DOI: 10.4330/wjc.v10.i4.26] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/15/2018] [Accepted: 04/01/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To quantify the preventive fraction of physical fitness on the risk factors in patients with cardiovascular diseases (CVDs).
METHODS A total of 249 subjects (205 men and 44 women) suffering from CVD were categorized into four groups, according to their percentage of physical fitness. We calculated the odds ratio to obtain the preventive fraction in order to evaluate the impact of the physical fitness level on the risk factors (i.e., abdominal obesity, depression, diabetes, dyslipidemia, hypertension, obesity, overweight and smoking).
RESULTS It is observed that a normal physical fitness level is sufficient to induce a preventive action on abdominal obesity (38%), diabetes (12%), hypertension (33%), obesity (12%) and overweight (11%). Also, the preventive fraction increases with the level of physical fitness, in particular for hypertension (36%) and overweight (16%). A high physical fitness level does not necessarily induce a preventive action in most risk factors, excluding depression.
CONCLUSION This is the first study which demonstrates that reaching a normal physical fitness level is enough to induce a protection for some risk factors, despite having a CVD.
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Affiliation(s)
- Maxime Caru
- Department of Science and Technology of Physical Activities and Sports, University Paris Nanterre, Nanterre 92000, France
- Department of Kinesiology, University of Montreal, Montreal H2X 0A9, Canada
| | - Laurence Kern
- Department of Science and Technology of Physical Activities and Sports, University Paris Nanterre, Nanterre 92000, France
| | - Marc Bousquet
- Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville 31650, France
| | - Daniel Curnier
- Department of Kinesiology, University of Montreal, Montreal H2X 0A9, Canada
- University of Montreal Hospital Research Center, Montreal H2X 0A9, Canada
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23
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Stephensen D, Hashem F, Corbett K, Bates A, George M, Hobbs RP, Hopkins M, Hutchins I, Lowery DP, Pellatt-Higgins T, Stavropoulou C, Swaine I, Tomlinson L, Woodward H, Ali H. Effects of preoperative and postoperative resistance exercise interventions on recovery of physical function in patients undergoing abdominal surgery for cancer: a systematic review of randomised controlled trials. BMJ Open Sport Exerc Med 2018; 4:e000331. [PMID: 29719727 PMCID: PMC5926571 DOI: 10.1136/bmjsem-2017-000331] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 12/20/2022] Open
Abstract
Objective To systematically review the effects of preoperative and postoperative resistance exercise training on the recovery of physical function in patients undergoing abdominal surgery for cancer. Data sources A systematic review of English articles using Medline, Physiotherapy Evidence Database, CINAHL and the Cochrane Library electronic databases was undertaken. Eligibility criteria for selecting studies Studies were included if they used a randomised, quasi-randomised or controlled trial study design and compared the effects of a muscle-strengthening exercise intervention (±other therapy) with a comparative non-exercise group; involved adult participants (≥18 years) who had elected to undergo abdominal surgery for cancer; and used muscle strength, physical function, self-reported functional ability, range of motion and/or a performance-based test as an outcome measure. Results Following screening of titles and abstracts of the 588 publications retrieved from the initial search, 24 studies met the inclusion criteria and were accessed for review of the full-text version of the article, and 2 eligible studies met the inclusion criteria and were included in the review. One exercise programme was undertaken preoperatively and the other postoperatively, until discharge from hospital. The exercise interventions of the included studies were performed for five and eight sessions, respectively. There were no differences between groups in either study. Conclusion The only two studies designed to determine whether preoperative or postoperative resistance muscle-strengthening exercise programmes improved or negatively affected physical function outcomes in patients undergoing abdominal surgery for cancer provide inconclusive results.
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Affiliation(s)
- David Stephensen
- Physiotherapy Department, East Kent Hospitals University Foundation NHS Trust, Canterbury, UK
| | - Ferhana Hashem
- Centre for Health Service Studies, University of Kent, Canterbury, UK
| | - Kevin Corbett
- Centre for Critical Research in Nursing and Midwifery, Middlesex University, London, UK
| | - Amanda Bates
- Centre for Health Service Studies, University of Kent, Canterbury, UK
| | - Michelle George
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Ralph Peter Hobbs
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Malcolm Hopkins
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Irena Hutchins
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | | | | | | | - Ian Swaine
- Centre for Science and Medicine in Sport and Exercise, University of Greenwich, Chatham, UK
| | - Lee Tomlinson
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Hazel Woodward
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Haythem Ali
- Research and Development, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
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24
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Phipps AI, Shi Q, Zemla TJ, Dotan E, Gill S, Goldberg RM, Hardikar S, Jahagirdar B, Limburg PJ, Newcomb PA, Shields A, Sinicrope FA, Sargent DJ, Alberts SR. Physical Activity and Outcomes in Patients with Stage III Colon Cancer: A Correlative Analysis of Phase III Trial NCCTG N0147 (Alliance). Cancer Epidemiol Biomarkers Prev 2018; 27:696-703. [PMID: 29563133 DOI: 10.1158/1055-9965.epi-17-0769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/29/2017] [Accepted: 03/16/2018] [Indexed: 12/17/2022] Open
Abstract
Background: Prior studies have supported an inverse association between physical activity and colon cancer risk and suggest that higher physical activity may also improve cancer survival. Among participants in a phase III adjuvant trial for stage III colon cancer, we assessed the association of physical activity around the time of cancer diagnosis with subsequent outcomes.Methods: Before treatment arm randomization (FOLFOX or FOLFOX + cetuximab), study participants completed a questionnaire including items regarding usual daily activity level and frequency of participation in recreational physical activity (N = 1,992). Using multivariable Cox models, we calculated HRs for associations of aspects of physical activity with disease-free (DFS) and overall survival (OS).Results: Over follow-up, 505 participants died and 541 experienced a recurrence. Overall, 75% of participants reported recreational physical activity at least several times a month; for participants who reported physical activity at least that often (vs. once a month or less), the HRs for DFS and OS were 0.82 [95% confidence interval (CI), 0.69-0.99] and 0.76 (95% CI, 0.63-0.93), respectively. There was no evidence of material effect modification in these associations by patient or tumor attributes, except that physical activity was more strongly inversely associated with OS in patients with stage T3 versus T4 tumors (Pinteraction = 0.03).Conclusions: These findings suggest that higher physical activity around the time of colon cancer diagnosis may be associated with more favorable colon cancer outcomes.Impact: Our findings support further research on whether colon cancer survival may be enhanced by physical activity. Cancer Epidemiol Biomarkers Prev; 27(6); 696-703. ©2018 AACR.
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Affiliation(s)
- Amanda I Phipps
- Epidemiology Department, University of Washington, Seattle, Washington. .,Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qian Shi
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Tyler J Zemla
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Efrat Dotan
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Sharlene Gill
- British Columbia Cancer Agency, Vancouver, British Canada, Canada
| | | | - Sheetal Hardikar
- Epidemiology Department, University of Washington, Seattle, Washington.,Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | | | - Polly A Newcomb
- Epidemiology Department, University of Washington, Seattle, Washington.,Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anthony Shields
- Wayne State University/Karmanos Cancer Institute, Detroit, Michigan
| | | | - Daniel J Sargent
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
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25
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Influence of physical activity on the immune system in breast cancer patients during chemotherapy. J Cancer Res Clin Oncol 2018; 144:579-586. [PMID: 29305709 DOI: 10.1007/s00432-017-2573-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Physical activity can impact the immune system in different ways, e.g. by alteration of the humoral and cellular immune response. Physical activity at medium intensity enhances numbers of cytotoxic T cells, NK cells and macrophages in healthy people. The aim of this study was to compare the effects of endurance and resistance training on the immune system in breast cancer patients during adjuvant chemotherapy. METHODS In a prospective, controlled and randomized intervention exploratory trial, 12-week supervised endurance or resistance training were compared with usual care twice a week. Endpoints were the absolute numbers of the immune cells such as CD3+ T lymphocytes including CD4+- and CD8+, αβ T cells, γδT cells, CD3-/CD16+/56+ NK cells and CD19+ B cells, before and after 12 weeks of treatment. Cell numbers were analyzed using fluorescence-activated cell sorting. RESULTS Despite different physical interventions in all groups immune cell count decreased in CD3 T cells including TCR αβ and CD4 T cells, NK cells and CD19 B cells 12 weeks after initiation of chemotherapy and start of the physical intervention program, while the reduction of γδ T cells and CD8 T cells is less prominent in the RT and UC group. CONCLUSION Chemotherapy led to a decrease in nearly all measured immune cells. In this study, physical intervention with endurance or resistance training did not suppress cellular immunity any further. Larger multicenter trials are needed to evaluate the exact impact of sports intervention on immune cell subpopulations.
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26
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Ha KJ, Lee SY, Lee H, Choi SJ. Synergistic Effects of Proprioceptive Neuromuscular Facilitation and Manual Lymphatic Drainage in Patients with Mastectomy-Related Lymphedema. Front Physiol 2017; 8:959. [PMID: 29234287 PMCID: PMC5712373 DOI: 10.3389/fphys.2017.00959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/10/2017] [Indexed: 11/13/2022] Open
Abstract
Purpose: Manual lymphatic drainage (MLD) and proprioceptive neuromuscular facilitation (PNF) are potential therapeutic strategies to reduce mastectomy-induced edema. The purpose of this study was to investigate whether the combination of these therapies would induce synergistic effects to treat lymphedema-related complications and to analyze a possible physiological mechanism involved in the observed effects. Methods: A total of 55 patients diagnosed with mastectomy-induced lymphedema were recruited and randomized into three experimental groups: PNF group (n = 17), MLD group (n = 20), and PNF + MLD group (n = 18). They were subjected to designated rehabilitation program three times a week for 16 weeks. ROM (flexion of the shoulder joint), edema size, arterial blood flow velocity, and degree of pain and depression were measured every 4 weeks over experimental period. Results: Lymphedema volume, VAS pain scale, and Beck depression scale were decreased in PNF and MLD groups for 16 weeks in a time-dependent manner. In combination, a greater reduction of these variables was observed over 16 weeks compared to each PNF and MLD. While axillary arterial blood circulation rate in the affected extremity was increased in both PNF and PNF + MLD groups over 16 weeks, this value was not increased in MLD group throughout the experimental period. A greater reduction of scales of VAS pain and Beck Depression Inventory (BDI) was observed in PNF + MLD group after the 16 week-treatment, as compared to each PNF and MLD group. Pearson's coefficients test demonstrated that there are significant correlation of depression against pain (r = 0.616, p < 0.01), ROM (r = −0.478, p < 0.01), and lymphedema size (r = 0.492, p < 0.01). Conclusion: The combination of MLD and PNF induces potent synergistic effects on edema volume, shoulder range of motion (ROM), pain, and depression in patients with lymphedema. In addition, an increased rate of axillary arterial blood flow in PNF-treated patients provide a potential physiological mechanism by which local arterial pulsation in the affected extremity plays a positive role in the treatment of lymphedema. Therefore, it is suggested to incorporate an element of PNF into traditional MLD method to facilitate treatment process for patients with lymphedema.
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Affiliation(s)
- Kyung-Jin Ha
- Department of Sports and Health Science, Kyungsung University, Busan, South Korea
| | - Sang-Yeol Lee
- Department of Physical Therapy, Kyungsung University, Busan, South Korea.,Korea Proprioceptive Neuromuscular Facilitation Association, Busan, South Korea
| | - Hojun Lee
- Department of Sports and Health Science, Kyungsung University, Busan, South Korea.,Department of Rehabilitation Medicine, College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung-Jun Choi
- Department of Sports and Health Science, Kyungsung University, Busan, South Korea
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27
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Abdalla DR, Gomes BBM, Murta EFC, Michelin MA. Bone marrow-derived dendritic cells under influence of experimental breast cancer and physical activity. Oncol Lett 2017; 13:1406-1410. [PMID: 28454269 DOI: 10.3892/ol.2017.5589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/28/2016] [Indexed: 01/17/2023] Open
Abstract
Immune cells are required in the immune response against tumours, although sometimes without success. The present study aimed to investigate dendritic cell (DC) maturation in animals with induced immunosuppression that were subjected to physical activity (PA). Immunosuppression was induced using 7,12-dimethyl-benzanthracene (DMBA). A total of 56 Balb/c mice were divided into four groups, including the control group, non-DMBA administered/PA group (GII), DMBA administered/non-PA group (GIII) and the DMBA administered/PA group (GIV). Bone marrow was removed from the leg bones following sacrifice. Bone marrow-derived DCs were stimulated to differentiate by granulocyte-macrophage colony-stimulating factor, interleukin (IL)-4 and tumour necrosis factor-α, after which the phenotype was assessed by flow cytometry and the cytokine profile was assessed using ELISAs. PA significantly increased the percentage of DCs in GII (55.38±2.63%) and GIV (50.1±3.1%) mice, as compared with GI (34.61±1.28%) and GIII (36.25±1.85%) mice (P<0.05). In addition, GIV mice showed a significantly higher level of cluster of differentiation (CD) 80+/CD86+ DCs (76.38±6.31%), as compared with GI (54.03±6.52%) and GIII (52.07±5.74%) mice (P<0.05). Furthermore, GIV mice showed a significantly higher level of CD80+/major histocompatibility complex class II double labelling (P<0.05), as compared with GIV (95.35±1.22%) and GIII (76.15±5.53%) mice. The expression of interferon-γ was significantly increased in GIV mice [5.89 (5.2-7.12)], as compared with GIII mice [2.75 (1.33-4.4)] (P<0.05). Similarly, the expression of IL-12 was markedly increased in GIV mice [1.27 (0.26-2.57)] compared with GIII mice [0.73 (0.44-1.47)], although the difference was not significant (P=0.063). The results of the present study suggested that PA was able to promote the maturation of DCs and their secretion of anti-tumour cytokines. Therefore, PA may emerge as a tool in immunotherapy.
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Affiliation(s)
- Douglas R Abdalla
- Oncology Research Institute, Federal University of the Triângulo Mineiro, Uberaba, MG 38025-180, Brazil
| | - Bruno B M Gomes
- Oncology Research Institute, Federal University of the Triângulo Mineiro, Uberaba, MG 38025-180, Brazil
| | - Eddie F C Murta
- Discipline of Gynecology and Obstetrics, Oncology Research Institute, Federal University of the Triângulo Mineiro, Uberaba, MG 38025-180, Brazil
| | - Márcia A Michelin
- Discipline of Immunology, Oncology Research Institute, Federal University of the Triângulo Mineiro, Uberaba, MG 38025-180, Brazil
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28
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Liu P, You J, Loo WTY, Sun Y, He Y, Sit H, Jia L, Wong M, Xia Z, Zheng X, Wang Z, Wang N, Lao L, Chen J. RETRACTED ARTICLE: The efficacy of Guolin-Qigong on the body-mind health of Chinese women with breast cancer: a randomized controlled trial. Qual Life Res 2017; 26:2321-2331. [DOI: 10.1007/s11136-017-1576-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2017] [Indexed: 12/22/2022]
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29
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Thomas RJ, Kenfield SA, Jimenez A. Exercise-induced biochemical changes and their potential influence on cancer: a scientific review. Br J Sports Med 2017; 51:640-644. [PMID: 27993842 PMCID: PMC5466928 DOI: 10.1136/bjsports-2016-096343] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2016] [Indexed: 12/20/2022]
Abstract
AIM To review and discuss the available international literature regarding the indirect and direct biochemical mechanisms that occur after exercise, which could positively, or negatively, influence oncogenic pathways. METHODS The PubMed, MEDLINE, Embase and Cochrane libraries were searched for papers up to July 2016 addressing biochemical changes after exercise with a particular reference to cancer. The three authors independently assessed their appropriateness for inclusion in this review based on their scientific quality and relevance. RESULTS 168 papers were selected and categorised into indirect and direct biochemical pathways. The indirect effects included changes in vitamin D, weight reduction, sunlight exposure and improved mood. The direct effects included insulin-like growth factor, epigenetic effects on gene expression and DNA repair, vasoactive intestinal peptide, oxidative stress and antioxidant pathways, heat shock proteins, testosterone, irisin, immunity, chronic inflammation and prostaglandins, energy metabolism and insulin resistance. SUMMARY Exercise is one of several lifestyle factors known to lower the risk of developing cancer and is associated with lower relapse rates and better survival. This review highlights the numerous biochemical processes, which explain these potential anticancer benefits.
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Affiliation(s)
| | - Stacey A Kenfield
- Department of Urology, University of California, San Francisco, California, USA
| | - Alfonso Jimenez
- Centre for Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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30
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Cao Dinh H, Beyer I, Mets T, Onyema OO, Njemini R, Renmans W, De Waele M, Jochmans K, Vander Meeren S, Bautmans I. Effects of Physical Exercise on Markers of Cellular Immunosenescence: A Systematic Review. Calcif Tissue Int 2017; 100:193-215. [PMID: 27866236 DOI: 10.1007/s00223-016-0212-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 11/07/2016] [Indexed: 12/31/2022]
Abstract
Aging affects negatively the immune system, defined as immunosenescence, which increases the susceptibility of elderly persons to infection, autoimmune disease, and cancer. There are strong indications that physical exercise in elderly persons may prevent the age-related decline in immune response without significant side effects. Consequently, exercise is being considered as a safe mode of intervention to reduce immunosenescence. The aim of this review was to appraise the existing evidence regarding the impact of exercise on surface markers of cellular immunosenescence in either young and old humans or animals. PubMed and Web of Science were systematically screened, and 28 relevant articles in humans or animals were retrieved. Most of the intervention studies demonstrated that an acute bout of exercise induced increases in senescent, naïve, memory CD4+ and CD8+ T-lymphocytes and significantly elevated apoptotic lymphocytes in peripheral blood. As regards long-term effects, exercise induced increased levels of T-lymphocytes expressing CD28+ in both young and elderly subjects. Few studies found an increase in natural killer cell activity following a period of training. We can conclude that exercise has considerable effects on markers of cellular aspects of the immune system. However, very few studies have been conducted so far to investigate the effects of exercise on markers of cellular immunosenescence in elderly persons. Implications for immunosenescence need further investigation.
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Affiliation(s)
- H Cao Dinh
- Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - I Beyer
- Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - T Mets
- Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - O O Onyema
- Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - R Njemini
- Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - W Renmans
- Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - M De Waele
- Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - K Jochmans
- Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - S Vander Meeren
- Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - I Bautmans
- Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
- Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
- Geriatrics Department, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
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31
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Evans ES, Hackney AC, Pebole MM, McMurray RG, Muss HB, Deal AM, Battaglini CL. Adrenal Hormone and Metabolic Biomarker Responses to 30 min of Intermittent Cycling Exercise in Breast Cancer Survivors. Int J Sports Med 2016; 37:921-929. [PMID: 27490111 DOI: 10.1055/s-0042-110654] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to explore the effect of one bout of aerobic exercise on epinephrine, norepinephrine, cortisol, glucose, lactate, and free fatty acid (FFA) responses in breast cancer survivors and healthy controls. 9 female breast cancer survivors and 9 women without a history of cancer completed 30 min of cycle ergometry exercise at 60% of VO2peak. Blood samples were taken pre-exercise, immediately post-exercise, and 2 h post-exercise from which plasma concentrations of study variables were measured. Immediately and 2 h post-exercise, increases were observed in epinephrine (control group only) norepinephrine (both groups), lactate (both groups), and FFA (both groups immediately post-exercise; breast cancer survivor group only at 2 h post-exercise) (p<0.05). Cortisol decreased immediately and 2 h post-exercise in the control group while glucose decreased immediately post-exercise in the breast cancer survivor group (p<0.05). In conclusion, breast cancer survivors appeared to display attenuated epinephrine, cortisol, and lactate responses while displaying larger magnitude changes in glucose and FFA responses compared to controls. These preliminary findings may have implications for the regulation of metabolism during exercise in breast cancer survivors.
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Affiliation(s)
- E S Evans
- Physical Therapy Education, Elon University, Elon, NC, United States
| | - A C Hackney
- Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, United States
| | - M M Pebole
- Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, United States
| | - R G McMurray
- Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, United States
| | - H B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - A M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - C L Battaglini
- Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, United States
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32
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Kim JJ, Shin YA, Suk MH. Effect of a 12-week walking exercise program on body composition and immune cell count in patients with breast cancer who are undergoing chemotherapy. J Exerc Nutrition Biochem 2015; 19:255-62. [PMID: 26525495 PMCID: PMC4624127 DOI: 10.5717/jenb.2015.15092812] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/18/2015] [Accepted: 09/28/2015] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the effect of a 12-week walking exercise program on body composition and immune cell count in patients with breast cancer who are undergoing chemotherapy. METHODS Twenty patients (age, 47.8 ± 3.12) participated in the study. Body composition (weight, body mass index, muscle weight, body fat mass, and percent body fat) and the cell counts for immune cells (white blood corpuscles, lymphocytes, helper T cells, cytotoxic T cells, natural killer cells, and natural killer T cells) were measured before and after the 12-week walking exercise program. SPSS 17.0 statistical software was used. The two-way repeated ANOVA with post hoc was used to determine the difference between time and interaction. RESULTS There were significant reductions in the weight (p < .05), BMI (p < .01), and percent body fat (p < .05) after the 12-week walking exercise program. However, the immune cell counts did not change significantly. CONCLUSION These results indicated that the 12-week walking exercise program had an effect on the balances among weight, BMI and percent body fat in patients with breast cancer.
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Affiliation(s)
- Ji Jeong Kim
- College of Sports Science, Department of exercise prescription and rehabilitation, Dankook University, Cheonan,
Republic of Korea
| | - Yun A Shin
- College of Sports Science, Department of exercise prescription and rehabilitation, Dankook University, Cheonan,
Republic of Korea
| | - Min Hwa Suk
- College of Sports Science, Department of exercise prescription and rehabilitation, Dankook University, Cheonan,
Republic of Korea
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Evans ES, Hackney AC, McMurray RG, Randell SH, Muss HB, Deal AM, Battaglini CL. Impact of Acute Intermittent Exercise on Natural Killer Cells in Breast Cancer Survivors. Integr Cancer Ther 2015; 14:436-45. [PMID: 25873292 DOI: 10.1177/1534735415580681] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Current research examining the effect of exercise on immune responses in cancer survivors is limited. OBJECTIVE The aim of this pilot study was to examine the effect of 1 bout of intermittent exercise on natural killer (NK) cell numbers in breast cancer survivors. METHODS A total of 9 women with stage I to III invasive breast cancer who were 3 to 6 months posttreatment and 9 sedentary women without a history of cancer completed 10 three-minute intervals of aerobic exercise on the cycle ergometer at 60% of VO2peak (peak oxygen uptake). Whole blood samples were taken pre-exercise, immediately postexercise, and at 2 hours and 24 hours postexercise. NK cell counts were assessed using flow cytometry. RESULTS In both groups, NK cell counts significantly increased immediately postexercise compared with pre-exercise (P = .004-.008) and returned to near pre-exercise levels during recovery (P = .129-.547). Absolute NK cell counts were significantly lower in breast cancer survivors immediately postexercise when compared with controls (P = .046). CONCLUSIONS The breast cancer survivor group exhibited NK cell responses to 30 minutes of moderate-intensity intermittent aerobic exercise that were comparable with that in the group of physically similar women without a history of cancer. Immune changes related to cancer treatments may be related to the lower absolute NK cell counts observed in the breast cancer survivor group. Although the results of this study are preliminary in nature, they suggest that this type of exercise does not disrupt this aspect of innate immunity in recent breast cancer survivors, thereby supporting current exercise recommendations for this population.
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Affiliation(s)
- Elizabeth S Evans
- Elon University, NC, USA University of North Carolina at Chapel Hill, NC, USA
| | - A C Hackney
- University of North Carolina at Chapel Hill, NC, USA
| | | | | | - Hyman B Muss
- University of North Carolina at Chapel Hill, NC, USA
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Wekesa A, Harrison M, Watson RW. Physical activity and its mechanistic effects on prostate cancer. Prostate Cancer Prostatic Dis 2015; 18:197-207. [PMID: 25800589 DOI: 10.1038/pcan.2015.9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 02/04/2015] [Accepted: 02/06/2015] [Indexed: 12/22/2022]
Abstract
Beneficial effects of physical activity have been illustrated in numerous aspects of health. With the increasing incidence of prostate cancer and changes in physical activity of men, understanding the link between the two has important implications for changing this cancer burden. Both positive and negative associations between physical activity and prostate cancer have been previously demonstrated in observational epidemiological studies. Elucidating the biological mechanisms would lead to a better understanding of how physical activity influences the progression of prostate cancer. This review was undertaken to: (1) identify evidence in literature that demonstrates the effects of physical activity on skeletal muscle secretomes, (2) indicate the plausible signaling pathways these proteins might activate, and (3) identify evidence in literature that demonstrates the roles of the signaling pathways in prostate cancer progression and regression. We also discuss proposed biological mechanisms and signaling pathways by which physical activity may prevent the development and progression of prostate cancer. We discuss proteins involved in the normal and aberrant growth and development of the prostate gland that may be affected by physical activity. We further identify future directions for research, including a better understanding of the biological mechanisms, the need to standardize physical activity and identify mechanistic end points of physical activity that can then be correlated with outcomes.
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Affiliation(s)
- A Wekesa
- UCD School of Medicine and Medical Science, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - M Harrison
- Department of Health, Sport and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - R W Watson
- UCD School of Medicine and Medical Science, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
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Liu J, Chen P, Wang R, Yuan Y, Wang X, Li C. Effect of Tai Chi on mononuclear cell functions in patients with non-small cell lung cancer. Altern Ther Health Med 2015; 15:3. [PMID: 25653009 PMCID: PMC4321705 DOI: 10.1186/s12906-015-0517-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 01/07/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Tai Chi is the Chinese traditional medicine exercise for mind-body health. The objective of this study is to investigate the effect of Tai Chi Chuan (TCC) exercise on the proliferative and cytolytic/tumoricidal activities of peripheral blood mononuclear cells (PBMCs) in postsurgical non-small cell lung cancer (NSCLC) patients. METHODS Patients (n = 27) were randomly divided into the control group (n = 13) and the TCC group (n = 14). TCC group participated in Tai Chi 24-type exercise for 16 weeks, 60-min every time, and three times a week. Peripheral blood was collected and PBMCs isolated before and after the 16-week TCC, PBMC proliferation and co-culture of PBMCs with the NSCLC cell line A549 were performed for proliferation and cell cytolysis assays. Analysis of NKT cells, NK cells, and CD123+ and CD11c + dendritic cells were also performed. RESULTS (1) After 16-week of TCC, cell proliferation increased significantly as compared with the control. (2) PBMCs from the TCC group also demonstrated enhanced cytolytic/oncolytic activity against A549 cells. (3) Significant differences were also found in NK cell percentage at t = 16 weeks, post-pre changes of NKT and DC11c between groups. CONCLUSION Regular Tai Chi exercise has the promise of enhancing PBMC proliferative and cytolytic activities in NSCLC patients. Our results affirm the value of a future trial with a larger scale and longer duration for cancer survivors. TRIAL REGISTRATION ChiCTR-TRC-11001404 .
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Hwang KH, Cho OH, Yoo YS. The Effect of Comprehensive Care Program for Ovarian Cancer Survivors. Clin Nurs Res 2014; 25:192-208. [PMID: 25427648 DOI: 10.1177/1054773814559046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was done to investigate the effects of comprehensive care program on cardiopulmonary function, muscle strength, immune response, and quality of life in ovarian cancer survivors. Participants were 40 ovarian cancer survivors, 20 in the experimental group and 20 in the control group, at C university hospital gynecological cancer center from May 2009, to December 2010. The treatment was a comprehensive care program for 8 weeks consisting of group education and self-help group support, home-based exercise, and relaxation. Data were analyzed by t test and repeated-measures ANOVA. Cardiopulmonary function, measured by 12-min walk distance; muscle strength, measured by the chair-stand test; and quality of life were more increased in the experimental group. But immune response was not statistically significant. These results indicate that the comprehensive care program is an effective nursing intervention to improve cardiopulmonary function, muscle strength, and quality of life in ovarian cancer survivors.
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Ha K, Choi S. The Effect of a PNF Technique Program after Mastectomy on Lymphedema Patients' Depression and Anxiety. J Phys Ther Sci 2014; 26:1065-7. [PMID: 25140098 PMCID: PMC4135199 DOI: 10.1589/jpts.26.1065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/23/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was conducted to examine the effects of exercises applied with PNF
techniques performed for 30 minutes per session, three times per week, after receipt of
radiation therapy following mastectomy on depression and anxiety in patients diagnosed
with lymphedema and to prepare basic data for creation of self-directed exercise programs
for lymphedema patients that will enable them to perform exercises within the range of no
pain. [Methods] The subjects of this study were 45 patients selected from among those
diagnosed with breast cancer who showed lymphedema after anti-cancer therapy following
mastectomy. [Results] The Beck depression score changed significantly during the five
assessment periods however, there was no significant difference between the treatment
groups. Post hoc analyses revealed that there was significant improvement in the Beck
depression score from 4 weeks in all three groups. The interaction between group and time
was also statistically significant. [Conclusion] In conclusion, PNF techniques helped to
improve the depression and anxiety rates. Four weeks after the start of therapy, PNF
techniques Depression and anxiety to create a greater degree of decline was on
display.
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Affiliation(s)
- Kyungjin Ha
- College of Arts, School of Sports and Health, Kyungsung University, Republic of Korea
| | - Seungjun Choi
- College of Arts, School of Sports and Health, Kyungsung University, Republic of Korea
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Abstract
BACKGROUND Although exercise is a recommended rehabilitation intervention for many breast cancer survivors, exercise activity after cancer treatment is rarely reported in this patient group in Taiwan. OBJECTIVE The objectives of this study were to analyze trends in exercise activity in breast cancer survivors in Taiwan. INTERVENTIONS/METHODS This prospective, longitudinal study with repeated-measures design used standardized instruments to measure trends in exercise activity but performed no treatments or interventions. RESULTS Of the 196 breast cancer survivors who participated in this study, 39% regularly engaged in light-to-moderate intensity exercise for approximately 15 minutes per day throughout the 6-month period of the study. Of these, 40% indicated that their exercise stage had increased, and only 13% indicated that their exercise stage had decreased. The most common exercise activities were walking, hiking, calisthenics, folk dancing, chi kung and tai chi. Although most women reported that exercise made them feel better both physically and emotionally, most said that they exercised mainly for health maintenance reasons. CONCLUSIONS Frequency, duration, and intensity of exercise significantly increased during the 6-month study but did not reach the recommended levels. Most women believed that physical activity enhanced their recovery from cancer treatment. IMPLICATIONS FOR PRACTICE When planning patient education interventions for breast cancer survivors, healthcare professionals should consider not only the role of exercise in breast cancer recovery, but also trends in exercise behavior among breast cancer survivors. The findings of this study contribute to the literature on exercise trends in breast cancer survivors.
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Guinan EM, Connolly EM, Hussey J. Exercise training in breast cancer survivors: a review of trials examining anthropometric and obesity-related biomarkers of breast cancer risk. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x12y.0000000057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Buffart LM, Galvão DA, Brug J, Chinapaw MJM, Newton RU. Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 2013; 40:327-40. [PMID: 23871124 DOI: 10.1016/j.ctrv.2013.06.007] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/20/2013] [Accepted: 06/25/2013] [Indexed: 01/22/2023]
Abstract
Physical activity during and after cancer treatment has beneficial effects on a number of physical and psychosocial outcomes. This paper aims to discuss the existing physical activity guidelines for cancer survivors and to describe future research directions to optimize prescriptions. Studies on physical activity during and after cancer treatment were searched in PubMed, Clinicaltrials.gov, Australian New Zealand Clinical Trials Registry, and Dutch Trial registry. Physical activity guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for all cancer survivors. However, the development of these guidelines has been limited by the research conducted. To be able to develop more specific guidelines, future studies should focus on identifying clinical, personal, physical, psychosocial, and intervention moderators explaining 'for whom' or 'under what circumstances' interventions work. Further, more insight into the working mechanisms of exercise interventions on health outcomes in cancer survivors is needed to improve the efficacy and efficiency of interventions. Finally, existing programs should embrace interests and preferences of patients to facilitate optimal uptake of interventions. In conclusion, current physical activity guidelines for cancer survivors are generic, and research is needed to develop more personalized physical activity guidelines.
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Affiliation(s)
- L M Buffart
- EMGO Institute for Health and Care Research and the VU University Medical Center, Department of Epidemiology and Biostatistics, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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Exercise in the prevention and rehabilitation of breast cancer. Wien Klin Wochenschr 2013; 125:297-301. [PMID: 23653151 DOI: 10.1007/s00508-013-0365-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 04/04/2013] [Indexed: 12/14/2022]
Abstract
Breast cancer is the most common type of cancer among women worldwide. Several epidemiological studies have shown an inverse relationship between the risk of breast cancer and physical activity levels, whereas exercise training has been recognized as a significant means in the rehabilitation process of breast cancer survivors. The relative risk reduction of breast cancer for women who engaged in moderate to vigorous physical activity for 3-5 days peek week ranged between 20-40 %. Furthermore, several studies demonstrated a 24-67 % reduction in the risk of total deaths and 50-53 % reduction in the risk of breast cancer deaths in women who are physically active after breast cancer diagnosis compared with sedentary women. Breast cancer survivors should be encouraged to participate in rehabilitation programs in order to obtain numerous physiological and psychological benefits. These include reductions in fatigue and improvements in immune function, physical functioning, body composition, and quality of life. Based on recent scientific evidence, a complete rehabilitation program for patients with breast cancer should combine both strength and aerobic exercise in order to maximize the expected benefits.
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The influence of physical activity on the profile of immune response cells and cytokine synthesis in mice with experimental breast tumors induced by 7,12-dimethylbenzanthracene. Eur J Cancer Prev 2013; 22:251-8. [DOI: 10.1097/cej.0b013e3283592cbb] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Madarnas Y, Dent SF, Husain SF, Robinson A, Alkhayyat S, Hopman WM, Verreault JL, Vandenberg T. Real-world experience with adjuvant fec-d chemotherapy in four Ontario regional cancer centres. ACTA ACUST UNITED AC 2012; 18:119-25. [PMID: 21655158 DOI: 10.3747/co.v18i3.751] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The efficacy of adjuvant chemotherapy with fec-d (5-fluorouracil-epirubicin-cyclophosphamide followed by docetaxel) is superior to that with fec-100 alone in women with early-stage breast cancer. As the use of fec-d increased in clinical practice, health care providers anecdotally noted higher-than-expected toxicity rates and frequent early treatment discontinuations because of toxicity. In the present study, we compared the rates of serious adverse events in patients who received adjuvant fec-d chemotherapy in routine clinical practice with the rates reported in the pacs-01 trial. METHODS We retrospectively reviewed all patients prescribed adjuvant fec-d for early-stage breast cancer at 4 regional cancer centres in Ontario. Information was collected from electronic and paper charts by a physician investigator from each centre. Data were analyzed using chi-square tests, independent samples t-tests, one-way analysis of variance, and univariate regression. RESULTS The 671 electronic and paper patient records reviewed showed a median patient age of 52.2 years, 229 patients (34.1%) with N0 disease, 508 patients (75.7%) with estrogen or progesterone receptor-positive disease (or both), and 113 patients (26%) with her2/neu-overexpressing breast cancer. Febrile neutropenia occurred in 152 patients (22.7%), most frequently at cycle 4, coincident with the initiation of docetaxel [78/152 (51.3%)]. Primary prophylaxis with hematopoietic growth factor support was used in 235 patients (35%), and the rate of febrile neutropenia was significantly lower in those who received prophylaxis than in those who did not [15/235 (6.4%) vs. 137/436 (31.4%); p < 0.001; risk ratio: 0.20]. CONCLUSIONS In routine clinical practice, treatment with fec-d is associated with a higher-than-expected rate of febrile neutropenia, in light of which, primary prophylaxis with growth factor should be considered, per international guidelines. Adoption based on clinical trial reports of new therapies into mainstream practice must be done carefully and with scrutiny.
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Affiliation(s)
- Y Madarnas
- Cancer Centre of Southeastern Ontario, Kingston General Hospital, and Department of Medicine, Queen's University, Kingston, ON
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Chamorro-Viña C, Guilcher GMT, Khan FM, Mazil K, Schulte F, Wurz A, Williamson T, Reimer RA, Culos-Reed SN. EXERCISE in pediatric autologous stem cell transplant patients: a randomized controlled trial protocol. BMC Cancer 2012; 12:401. [PMID: 22963378 PMCID: PMC3503655 DOI: 10.1186/1471-2407-12-401] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 08/28/2012] [Indexed: 12/18/2022] Open
Abstract
Background Hematopoietic stem cell transplantation is an intensive therapy used to improve survivorship and cure various oncologic diseases. However, this therapy is associated with high mortality rates and numerous negative side-effects. The recovery of the immune system is a special concern and plays a key role in the success of this treatment. In healthy populations it is known that exercise plays an important role in immune system regulation, but little is known about the role of exercise in the hematological and immunological recovery of children undergoing hematopoietic stem cell transplant. The primary objective of this randomized-controlled trial (RCT) is to study the effect of an exercise program (in- and outpatient) on immune cell recovery in patients undergoing an autologous stem cell transplantation. The secondary objective is to determine if an exercise intervention diminishes the usual deterioration in quality of life, physical fitness, and the acquisition of a sedentary lifestyle. Methods This RCT has received approval from The Conjoint Health Research Ethics Board (CHREB) of the University of Calgary (Ethics ID # E-24476). Twenty-four participants treated for a malignancy with autologous stem cell transplant (5 to 18 years) in the Alberta Children’s Hospital will be randomly assigned to an exercise or control group. The exercise group will participate in a two-phase exercise intervention (in- and outpatient) from hospitalization until 10 weeks after discharge. The exercise program includes strength, flexibility and aerobic exercise. During the inpatient phase this program will be performed 5 times/week and will be supervised. The outpatient phase will combine a supervised session with two home-based exercise sessions with the use of the Wii device. The control group will follow the standard protocol without any specific exercise program. A range of outcomes, including quantitative and functional recovery of immune system, cytokine levels in serum, natural killer (NK) cells and their subset recovery and function, and gene expression of activating and inhibitory NK cell receptors, body composition, nutrition, quality of life, fatigue, health-related fitness assessment and physical activity levels will be examined, providing the most comprehensive assessment to date. Discussion We expect to find improvements in immunological recovery and quality of life, and decreased acquisition of sedentary behavior and fitness deconditioning. The comprehensive outcomes generated in this RCT will provide preliminary data to conduct a multisite study that will generate stronger outcomes. Trial registration Gov identification # NCT01666015
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Factors that affect decisions about physical activity and exercise in survivors of breast cancer: a qualitative study. Phys Ther 2012; 92:525-36. [PMID: 22156026 DOI: 10.2522/ptj.20110115] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Exercise has many benefits for survivors of breast cancer, yet only half of this population regularly exercise. Fear has been identified as a barrier to exercise for people with neuromusculoskeletal conditions but has been minimally explored in women with breast cancer. OBJECTIVES The purposes of this study were: (1) to investigate factors that affected decisions about physical activity and exercise in survivors of breast cancer and (2) to determine whether fear was a factor. DESIGN This investigation was a grounded-theory qualitative study. Qualitative data were triangulated with data from 2 quantitative scales that measured participants' beliefs about exercise and their activity levels. METHODS Thirty-four survivors of breast cancer in 8 focus groups participated in semistructured interviews that were recorded, transcribed, and coded. Concept maps created for each group were merged to develop themes. Beliefs about physical activity and exercise were assessed with the Decisional Balance Scale. The Rapid Assessment of Physical Activity was used to assess behaviors regarding physical activity and exercise before and after the breast cancer diagnosis. RESULTS Participants generally believed that exercise was beneficial (Decisional Balance Scale score: X=28.1 [of a maximum score of 44], SD=7.6, range=10-43). Participants decreased the amount of physical activity or exercise during treatment but increased the amount of exercise beyond prediagnosis levels after treatment (Rapid Assessment of Physical Activity score: median=6, range=2-7). Three prominent themes described participants' behaviors regarding physical activity or exercise: values and beliefs about exercise, facilitators and barriers that were both similar to those affecting the general population and cancer specific, and lack of or inaccurate information about safe exercise. CONCLUSIONS Survivors who were active were not afraid to exercise. However, concern about lymphedema and knowledge about safe and effective exercise programs influenced choices regarding physical activity and exercise.
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Okamoto I, Wright D, Foster C. Impact of cancer on everyday life: a systematic appraisal of the research evidence. Health Expect 2012; 15:97-111. [PMID: 21332618 PMCID: PMC5060604 DOI: 10.1111/j.1369-7625.2011.00662.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To conduct a systematic appraisal of the published literature reviews related to the impact of cancer on everyday life. This theme was identified as the top priority area for research by participants in the Macmillan Listening Study, which was the first UK-wide public consultation exercise to identify patients' priorities for cancer research. SEARCH STRATEGY The top priority area was divided into ten sub-themes, and a modified systematic review was undertaken for each sub-theme using electronic searches. INCLUSION CRITERIA Literature review papers were included if they were written in English, involved patients diagnosed ≥18 years, any cancer types and published between 2000 and 2006. DATA EXTRACTION AND SYNTHESIS Two thousand and two hundred and fifty-two potentially eligible papers were identified. Abstracts were read by the first author and selected for inclusion in the review. Twenty percentages of the papers were also read independently by other authors. Sixty-two review papers were finally selected. MAIN RESULTS The systematic appraisal revealed that some sub-themes of the patient-identified priority area (e.g., how to support family members of cancer patients) were under-researched, while other sub-themes (e.g., anxiety and depression experienced by cancer patients) had been explored to some extent. Certain areas of research interest to patients were found to have been explored; however, their significance was limited by the quality of the research. CONCLUSION The systematic appraisal highlights important areas for future research and the need for more effective dissemination of study findings to wider audiences, including service users. This study also indicates the need for further research to enhance the generalizability and/or significance of findings.
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Affiliation(s)
- Ikumi Okamoto
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield, Southampton, UK.
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Exercise interventions in children with cancer: a review. Int J Pediatr 2011; 2011:461512. [PMID: 22121378 PMCID: PMC3205744 DOI: 10.1155/2011/461512] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 09/03/2011] [Accepted: 09/03/2011] [Indexed: 11/17/2022] Open
Abstract
The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL) diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.
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Chen MF, Chen HI, Jen CJ. Exercise training upregulates macrophage MKP-1 and affects immune responses in mice. Med Sci Sports Exerc 2011; 42:2173-9. [PMID: 20404768 DOI: 10.1249/mss.0b013e3181e2158d] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Currently, it is unclear how chronic exercise affects immunity. Mitogen-activated protein kinase (MAPK) mediates the production of proinflammatory cytokines, whereas MAPK phosphatase-1 (MKP-1) plays an essential role in intracellular homeostasis by negatively regulating macrophage MAPK activation. We hypothesized that chronic exercise might upregulate macrophage MKP-1 and thus prevent excessive inflammatory responses. METHODS To verify this hypothesis, we compared the basal immune status and lipopolysaccharide (LPS)-evoked immune responses between sedentary and 8-wk treadmill exercise-trained male C57BL/6 mice. RESULTS Although the basal levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were undetectable in the serum of both groups, the exercised mice showed the following immune adaptations in vivo: (i) higher basal MKP-1 mRNA level in peritoneal macrophages, (ii) lower basal p38 MAPK activity and enhanced MKP-1 immunostaining in macrophages, and (iii) lower serum levels of IL-6 and TNF-α and less leukocyte infiltration into peritoneal cavity after systemic administration of LPS when compared with sedentary controls. In addition, when peritoneal macrophages isolated from exercised mice were exposed to LPS in vitro, they showed (i) accelerated MKP-1 protein expression, (ii) reduced p38 MAPK activity, and (iii) reduced cytokine secretion of IL-6, TNF-α, and monocyte chemotactic protein-1. Finally, 2 months of deconditioning completely reversed the exercise-enhanced basal MKP-1 immunostaining in macrophages and the exercise-suppressed cytokine secretion under LPS-evoked conditions. CONCLUSIONS Exercise training upregulated basal macrophage MKP-1 expression, accelerated LPS-evoked MKP-1 up-regulation, and affected LPS-evoked immune responses in mice.
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Affiliation(s)
- Mei-Feng Chen
- Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan, Taiwan
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Loprinzi PD, Cardinal BJ. Effects of physical activity on common side effects of breast cancer treatment. Breast Cancer 2011; 19:4-10. [PMID: 21725654 DOI: 10.1007/s12282-011-0292-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 06/14/2011] [Indexed: 01/27/2023]
Abstract
Motivating women with breast cancer to engage in regular physical activity may be an enormous challenge given the common side effects of breast cancer treatment. The objective of this narrative review is to briefly summarize recent research evidence examining the influence of physical activity on commonly occurring side effects of breast cancer treatment. Overall, current research evidence indicates that regular participation in physical activity after breast cancer diagnosis may mitigate common side effects of breast cancer adjuvant therapy, including fatigue, depression, impaired quality of life, decreased muscular strength, decreased aerobic capacity, and weight gain. Future research could examine the influence that physical activity has on the effectiveness of breast cancer treatment. Implications for health care professionals are discussed.
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Affiliation(s)
- Paul D Loprinzi
- Department of Exercise Science, Bellarmine University, Louisville 40205, KY, USA.
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Hypoxic exercise training promotes antitumour cytotoxicity of natural killer cells in young men. Clin Sci (Lond) 2011; 121:343-53. [DOI: 10.1042/cs20110032] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The cytotoxic functions of NKs (natural killer cells) are critical in enabling the immune system to cope efficiently with malignancy. In the present study, we compared how various exercise regimens without/with hypoxia influence phenotypic characteristics of NK subsets and cytotoxicity of NKs to NPCs (nasopharyngeal carcinoma cells). A total of 60 sedentary males were randomly divided into five groups. Each group (n=12) underwent one of five regimens: normoxic (21% O2) control (N-C), hypoxic (15% O2) control (H-C), normoxic exercise (50% maximal work rate under 21% O2; N-E), hypoxic relative exercise (50% maximal heart rate reserve under 15% O2; H-RE) or hypoxic absolute exercise (50% maximal work rate under 15% O2; H-AE) for 30 min/day, 5 days/week for 4 weeks. The results showed that hypoxic exercise regimens increased pulmonary ventilation and tissue oxygen utilization. Moreover, the H-RE regimen resulted in enhanced aerobic fitness at a less intensive training workload in the H-AE regimen. Before each regimen, strenuous exercise elevated NK perforin/granzyme B content and promoted cytotoxicity of NKs to NPCs. However, the percentage of NKs expressing homing (CD11a)/terminally differentiated (CD57)/inhibitory [KLRG1 (killer cell lectin-like receptor G1)] molecules that entered the bloodstream from peripheral tissues increased following this exercise. After 4 weeks, both the H-AE and H-RE regimens produced an up-regulated expression of memory (CD45RO)/activating (NKG2D) molecules and was accompanied by a decrease in CD57/KLRG1 levels on NKs at rest and after strenuous exercise. Furthermore, the two regimens increased resting and exercise NK perforin/granzyme B content and NK-induced phosphatidylserine exposure of NPCs. In contrast, no significant change in the phenotypic characteristics of blood NK subsets or NK-induced NPC apoptosis was observed in the N-C, H-C and N-E regimens. Therefore we conclude that 15% O2 exercise training reduces terminally differentiated NK subsets and up-regulates the expression of activating molecules and cytotoxic granule proteins in NKs, thereby enhancing the capacity of anti-NPC cytotoxicity by NKs. These findings could help to determine effective hypoxic exercise regimens for improving individual aerobic capacity and simultaneously promoting the natural cytotoxicity of NKs.
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