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Lee DJ, Byeon JY, Park DH, Oh CG, Lee J, Choi YD, Kang DW, An KY, Courneya KS, Lee DH, Jeon JY. Effects of exercise during active surveillance for prostate cancer: A systematic review and meta-analysis. Support Care Cancer 2024; 32:406. [PMID: 38833183 DOI: 10.1007/s00520-024-08606-z] [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: 12/19/2023] [Accepted: 05/24/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE The efficacy of exercise in men with prostate cancer (PCa) on active surveillance (AS) remains unclear. In this meta-analysis, we aimed to examine the effects of exercise in PCa patients on AS. METHODS A literature search was conducted in PubMed, EMBASE, and the Cochrane Library using search terms, including exercise, PCa, AS, and randomized controlled trials (RCTs). The means and standard deviations for peak oxygen consumption (VO2peak), prostate-specific antigen (PSA) levels, and quality of life (QoL) were extracted for the intervention and control groups. A random-effects model was used to summarize the effects of exercise. RESULTS Of the 158 identified studies, six RCTs with 332 patients were included. The interventions included lifestyle modifications (aerobic exercise + diet) in three studies and different exercise modalities in three studies. The intervention duration was 2-12 months; three interventions were supervised and three were self-directed. The pooled weighted mean difference between exercise and usual care for VO2peak was 1.42 mL/kg/min (95% confidence interval [CI]: 0.30 to 2.54, P ≤ 0.001). A non-significant effect was observed for QoL (pooled standardized mean difference [SMD]: 0.24, 95% CI: - 0.03 to 0.51, P = 0.08) which became statistically significant and stronger after excluding one outlier study (P < 0.001). Exercise also had a positive effect on PSA levels (pooled SMD: - 0.43, 95% CI: - 0.87 to 0.01, P = 0.05). CONCLUSION Exercise improves cardiorespiratory fitness and may improve QoL and PSA levels in men with PCa on AS. Further studies with larger sample sizes are warranted to obtain more reliable results.
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Affiliation(s)
- Dong-Jun Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
- Department of Physical Therapy, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ji Yong Byeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
| | - Dong-Hyuk Park
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
| | - Chang Geun Oh
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
| | - Jongsoo Lee
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Ki-Yong An
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Dong Hoon Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Seoul, Republic of Korea.
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Hu S, Guinan E, Mockler D, O'Neill L. Retention rates and reasons for non-retention in exercise oncology trials in the post-treatment phase-a systematic review. J Cancer Surviv 2024:10.1007/s11764-024-01569-4. [PMID: 38570403 DOI: 10.1007/s11764-024-01569-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Retention is a key marker of trial success. Poor retention can induce bias, reduce statistical power and minimise the validity of trials. This review examined retention rates in exercise trials in cancer survivors, reasons for non-retention and retention strategies utilised. METHODS A systematic review was conducted using a predefined search strategy in EMBASE RCTs, MEDLINE OVID, CINAHL, Web of Science-Core Collection and Cochrane Central Register of Controlled Trials (CENTRAL). The search was conducted on 27/03/2023. Title and abstract screening, full text review and data extraction were completed in duplicate. RESULTS Of 17,524 studies identified, 67 trials involving 6093 participants were included. The median overall retention rate immediately post-intervention was 89.85%, range (52.94-100%) and mean 87.36% (standard deviation 9.89%). Trials involving colorectal cancer survivors only had the highest median retention rate (94.61%), followed by breast (92.74%), prostate (86.00%) and haematological cancers (85.49%). Studies involving mixed cancer cohorts had the lowest retention rate (80.18%). The most common retention strategies were wait-list control groups, regular check-ins/reminders and free exercise equipment. Common reasons for non-retention were lost to follow-up, health problems, personal reasons including family/work commitments and travel burden, and disease progression. CONCLUSIONS Retention rates in exercise oncology trials are approximately 90% immediately post-interventions. Our previous work highlighted variable suboptimal recruitment rates of median 38% (range 0.52-100%). Recruitment rather than retention should be prioritised for methodology research in exercise oncology. IMPLICATIONS FOR CANCER SURVIVORS Optimising the quality of exercise oncology trials is critical to informing high quality survivorship care. PROSPERO registration number: CRD42023421359.
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Affiliation(s)
- S Hu
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, University of Dublin, Dublin 8, Ireland
| | - E Guinan
- Trinity St. James's Cancer Institute, Dublin, Ireland
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - D Mockler
- John Stearne Library, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland
| | - L O'Neill
- Trinity St. James's Cancer Institute, Dublin, Ireland.
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland.
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Zhu Q, Xiong X, Zheng Q, Deng Q, Hao Y, Liu D, Zheng J, Zhang G, Li J, Yang L. High-intensity interval training versus moderate-intensity continuous training for localized prostate cancer under active surveillance: a systematic review and network meta-analysis. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00801-7. [PMID: 38378977 DOI: 10.1038/s41391-024-00801-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) have been increasingly adopted for localized prostate cancer (PCa) under active surveillance (AS). However, it is unclear which training modality is the most favorable in terms of cardiorespiratory fitness and biochemical progression. METHODS We searched PubMed, Cochrane and Embase for relevant RCTs. PRISMA guideline was adopted to ensure optimal conduct of this study. Serum prostate specific antigen (PSA) and peak VO2 were selected as primary outcomes and PSA doubling time (PSADT) and testosterone were selected as secondary outcomes. Only articles written in English were included. Cochrane risk-of-bias tool was used for risk of bias evaluation. RESULTS A total of 501 studies were selected. Six RCTs with 222 patients were included for data extraction and analysis. High-intensity interval training (HIIT) group demonstrated significantly lower PSA compared with usual care (UC) (MD = -1.4; 95%CI = -2.77 to -0.03) and moderate-intensity continuous training (MICT) group (MD = -1.67; 95%CI = -3.30 to -0.05). Both HIIT and MICT showed significantly improved peak VO2 compared with UC. No significant difference was observed in PSADT and testosterone among different training modalities and UC. Regarding peak VO2, MICT had the highest surface under cumulative ranking curve (SUCRA) scores (98.1%). For serum PSA, HIIT had the highest probability (97.8%) to be the training with the highest efficacy. The potential source of bias mainly came from poorly performed allocation concealment and blinding strategies. CONCLUSIONS The present study indicated that HIIT and MICT showed considerable cardiorespiratory benefits for localized PCa. HIIT was preferred over MICT in biochemical progression control in terms of decreasing serum PSA levels. However, MICT was favored over HIIT regarding cardiorespiratory benefits. The findings of this study may facilitate future lifestyle intervention, particularly in the form of physical training, for individuals diagnosed with localized PCa under AS.
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Affiliation(s)
- Qiyu Zhu
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, PR China
| | - Xingyu Xiong
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, PR China
| | - Qian Zheng
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Qi Deng
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Yun Hao
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Dingbang Liu
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Jiaming Zheng
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Guangyue Zhang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Jiakun Li
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, PR China.
| | - Lu Yang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, PR China.
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Tsuji K, Tsuchiya Y, Ueda H, Ochi E. Home-based high-intensity interval training improves cardiorespiratory fitness: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2023; 15:166. [PMID: 38053128 DOI: 10.1186/s13102-023-00777-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND High-intensity interval training (HIIT) is an effective methods to improve maximal oxygen uptake. However, there is no definitive conclusion about the specific effectiveness of home-based HIIT. This review investigated the effects of home-based HIIT on cardiorespiratory fitness in a systematic review and meta-analysis. METHODS Four electronic databases were searched (PubMed, Cochran database, Web of Science, Igaku Chuo Zasshi) for studies through March 25, 2023. Eligibility criteria include randomized controlled trials of home-based HIIT in adult people regardless disease or handicaped. Comparisons were made between non-exercise controls, laboratory-based HIIT, and moderate-intensity continuous training (MICT). The primary outcome was defined as cardiorespiratory fitness and the secondary outcome was defined as patient-reported outcomes. The standardized mean difference (SMD) with 95% confidence intervals (CIs) was calculated for quantitative indices. The random-effect model was used as the pooling method. RESULTS Two hundred seven studies were identified, and 15 satisfied the inclusion criteria. The meta-analysis for cardiorespiratory fitness showed superiority of home-based HIIT to non-exercise controls (SMD 0.61, 95% CI: 0.21, 1.02). However, no significant difference in cardiorespiratory fitness was observed between home-based HIIT and lab-based HIIT (SMD: -0.35, 95%CI: -0.73, 0.03). Also, no significant difference was observed between the home-based HIIT and MICT (SMD 0.34, 95% CI: -0.05, 0.73). CONCLUSION These results indicated that home-based HIIT was an effective intervention for improving cardiorespiratory fitness in healthy adults and patients. Importantly, this review found no significant differences in cardiorespiratory fitness between home-based HIIT and the group of laboratory HIIT and MICT, highlighting its comparable effectiveness and potential as a practical and valuable exercise intervention.
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Affiliation(s)
- Katsunori Tsuji
- Sports Research Center, Hosei University, 4-1 Kizukiomachi Nakahara, Kawasaki, Kanagawa, 211-0031, Japan.
| | - Yosuke Tsuchiya
- Center for Liberal Arts, Laboratory of Health and Sports Sciences, Meiji Gakuin University, 1518, Kamikurata-Cho, Totsuka, Yokohama, Kanagawa, 244-8539, Japan
| | - Hisashi Ueda
- Faculty of Health and Medical Science, Teikyo Heisei University, 4-1, Uruidominami, Ichihara, Chiba, 290-0193, Japan
| | - Eisuke Ochi
- Faculty of Bioscience and Applied Chemistry, Hosei University, 3-7-2, Kajino, Koganei, Tokyo, 184-8584, Japan.
- Graduate School of Sports and Health Studies, Hosei University, 4342, Aihara-Cho, Machida, Tokyo, 194-0298, Japan.
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5
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Santos A, Braaten K, MacPherson M, Vasconcellos D, Vis-Dunbar M, Lonsdale C, Lubans D, Jung ME. Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses. Int J Behav Nutr Phys Act 2023; 20:134. [PMID: 37990239 PMCID: PMC10664287 DOI: 10.1186/s12966-023-01535-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To determine rates of compliance (i.e., supervised intervention attendance) and adherence (i.e., unsupervised physical activity completion) to high-intensity interval training (HIIT) among insufficiently active adults and adults with a medical condition, and determine whether compliance and adherence rates were different between HIIT and moderate-intensity continuous training (MICT). METHODS Articles on adults in a HIIT intervention and who were either insufficiently active or had a medical condition were included. MEDLINE, EMBASE, PsychINFO, SPORTDiscus, CINAHL, and Web of Science were searched. Article screening and data extraction were completed by two independent reviewers. Risk of bias was assessed using RoB 2.0 or ROBINS-I. Meta-analyses were conducted to discern differences in compliance and adherence between HIIT vs. MICT. Sensitivity analyses, publication bias, sub-group analyses, and quality appraisal were conducted for each meta-analysis. RESULTS One hundred eighty-eight unique studies were included (n = 8928 participants). Compliance to HIIT interventions averaged 89.4% (SD:11.8%), while adherence to HIIT averaged 63% (SD: 21.1%). Compliance and adherence to MICT averaged 92.5% (SD:10.6%) and 68.2% (SD:16.2%), respectively. Based on 65 studies included in the meta-analysis, compliance rates were not different between supervised HIIT and MICT interventions [Hedge's g = 0.015 (95%CI: - 0.088-0.118), p = .78]. Results were robust and low risk of publication bias was detected. No differences were detected based on sub-group analyses comparing medical conditions or risk of bias of studies. Quality of the evidence was rated as moderate over concerns in the directness of the evidence. Based on 10 studies, adherence rates were not different between unsupervised HIIT and MICT interventions [Hedge's g = - 0.313 (95%CI: - 0.681-0.056), p = .096]. Sub-group analysis points to differences in adherence rates dependent on the method of outcome measurement. Adherence results should be interpreted with caution due to very low quality of evidence. CONCLUSIONS Compliance to HIIT and MICT was high among insufficiently active adults and adults with a medical condition. Adherence to HIIT and MICT was relatively moderate, although there was high heterogeneity and very low quality of evidence. Further research should take into consideration exercise protocols employed, methods of outcome measurement, and measurement timepoints. REGISTRATION This review was registered in the PROSPERO database and given the identifier CRD42019103313.
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Affiliation(s)
- Alexandre Santos
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kyra Braaten
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Megan MacPherson
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Diego Vasconcellos
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mathew Vis-Dunbar
- Library, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Chris Lonsdale
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Lubans
- School of Education, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mary E Jung
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada.
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Jenkins DG, Devin JL, Weston KL, Jenkins JG, Skinner TL. Benefits beyond cardiometabolic health: the potential of frequent high intensity 'exercise snacks' to improve outcomes for those living with and beyond cancer. J Physiol 2023; 601:4691-4697. [PMID: 37732418 DOI: 10.1113/jp284985] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023] Open
Abstract
High intensity interval training (HIIT) has been shown to consistently elicit rapid and significant adaptations in a number of physiological systems, across many different healthy and clinical populations. In addition, there is increasing interest in how some acute, yet transient responses to high intensity exercise potentially reduce the risks of particular diseases. Recent work has shown that discrete, brief bouts of high intensity exercise (termed 'exercise snacks') can improve glucose control and vascular health and thus counter the negative cardiometabolic consequences of prolonged, uninterrupted periods of inactivity. In this brief review, we advance the case, using evidence available from pre-clinical studies in the exercise oncology literature, that brief, frequently completed bouts of high intensity exercise embedded within an individual's overall daily and weekly physical activity schedule, may transiently impact the tumour microenvironment and improve the health outcomes for those who have been diagnosed and treated for cancer.
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Affiliation(s)
- David G Jenkins
- University of the Sunshine Coast, Maroochydore, Australia
- Applied Sports Science Technology and Medicine Research Centre, Swansea University, Swansea, UK
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - James L Devin
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Kathryn L Weston
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Joseph G Jenkins
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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7
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Lopez P, Taaffe DR, Newton RU, Spry N, Joseph D, Tang C, Buffart LM, Galvão DA. Reporting Attendance and Resistance Exercise Compliance in Men with Localized Prostate Cancer. Med Sci Sports Exerc 2023; 55:354-364. [PMID: 36374564 DOI: 10.1249/mss.0000000000003069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Resistance exercise is a well-established intervention to counteract musculoskeletal and metabolic toxicities from prostate cancer treatment. In this study, we reported resistance exercise attendance and compliance, and examined if these variables can influence changes in outcomes of interest in men with localized or locally advanced prostate cancer. METHODS A total of 83 prostate cancer patients (age, 68.2 ± 7.0 yr; body mass index, 27.7 ± 3.8 kg·m -2 ) who had undergone 6 months of resistance-based exercise and had data available on exercise training from logbook records were examined. Attendance outcomes such as missed sessions, interruptions and permanent discontinuation, and metrics such as dosage completed (sessions × number of exercises × sets × repetitions × external load), compliance, tolerance, reductions, and escalations were assessed. Outcomes assessed were body composition, physical function, and muscle strength. RESULTS Median resistance exercise attendance was 80.6%, with a median resistance exercise compliance of 88.5% (interquartile range [IQR], 61.1%-107.1%) per participant. A median of 11 (IQR, 1-26) and 0 (IQR, 0-2) sessions were escalated or reduced, respectively. Significant improvements were observed in whole-body lean mass, 400-m walk, repeated chair rise, leg press, and chest press strength after 6 months of intervention ( P < 0.05) regardless of resistance exercise compliance ( Ptrend = 0.199-0.950). Participants with higher levels of resistance exercise compliance presented greater improvements in trunk fat mass ( Ptrend = 0.026) and appendicular lean mass ( Ptrend = 0.047). CONCLUSIONS A higher resistance exercise compliance led to greater improvements in regional fat and lean mass, whereas physical function and muscle strength improvements were achieved with lower compliance. In addition, patients experienced a high number of dose escalations during the intervention. These findings are important to improve the reproducibility/precision of exercise medicine prescription.
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Affiliation(s)
| | | | | | - Nigel Spry
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
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Murphy BT, Mackrill JJ, O'Halloran KD. Impact of cancer cachexia on respiratory muscle function and the therapeutic potential of exercise. J Physiol 2022; 600:4979-5004. [PMID: 36251564 PMCID: PMC10091733 DOI: 10.1113/jp283569] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/09/2022] [Indexed: 01/05/2023] Open
Abstract
Cancer cachexia is defined as a multi-factorial syndrome characterised by an ongoing loss of skeletal muscle mass and progressive functional impairment, estimated to affect 50-80% of patients and responsible for 20% of cancer deaths. Elevations in the morbidity and mortality rates of cachectic cancer patients has been linked to respiratory failure due to atrophy and dysfunction of the ventilatory muscles. Despite this, there is a distinct scarcity of research investigating the structural and functional condition of the respiratory musculature in cancer, with the majority of studies exclusively focusing on limb muscle. Treatment strategies are largely ineffective in mitigating the cachectic state. It is now widely accepted that an efficacious intervention will likely combine elements of pharmacology, nutrition and exercise. However, of these approaches, exercise has received comparatively little attention. Therefore, it is unlikely to be implemented optimally, whether in isolation or combination. In consideration of these limitations, the current review describes the mechanistic basis of cancer cachexia and subsequently explores the available respiratory- and exercise-focused literature within this context. The molecular basis of cachexia is thoroughly reviewed. The pivotal role of inflammatory mediators is described. Unravelling the mechanisms of exercise-induced support of muscle via antioxidant and anti-inflammatory effects in addition to promoting efficient energy metabolism via increased mitochondrial biogenesis, mitochondrial function and muscle glucose uptake provide avenues for interventional studies. Currently available pre-clinical mouse models including novel transgenic animals provide a platform for the development of multi-modal therapeutic strategies to protect respiratory muscles in people with cancer.
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Affiliation(s)
- Ben T Murphy
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - John J Mackrill
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Ken D O'Halloran
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
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Chang M, Wang J, Hashim HA, Xie S, Malik AA. Effect of high-intensity interval training on aerobic capacity and fatigue among patients with prostate cancer: a meta-analysis. World J Surg Oncol 2022; 20:348. [PMID: 36261844 PMCID: PMC9580114 DOI: 10.1186/s12957-022-02807-8] [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] [Received: 08/22/2022] [Accepted: 10/03/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study focused on evaluating whether high-intensity interval training (HIIT) had an effect on aerobic capacity and fatigue among patients with prostate cancer (PCa) and exploring its effect on the immune system of PCa patients. METHODS To investigate the potential effect of HIIT on patients with prostate cancer, a meta-analysis was carried out. From January 2012 to August 2022, studies that met predefined criteria were searched in the Scopus, PubMed, Web of Science, and EBSCO databases. Analysis of the standardized mean differences was performed using Review Manager 5.4.1 software with a 95% confidence interval. RESULTS This review examined a total of 6 articles. There were 215 male patients with PCa involved, and the mean age was 64.4 years. According to the results of the meta-analysis, the HIIT group (n = 63) had greater VO2peak (P<0.01) than the control group (CON) (n = 52) (P = 0.30, I2 = 19% in the heterogeneity test; MD, 1.39 [0.50, 2.27]). Moreover, fatigue was significantly different (P<0.01) between the HIIT (n = 62) and CON (n = 61) groups (P = 0.78, I2 = 0% in the heterogeneity test; SMD, -0.52 [-0.88, -0.16]). Furthermore, among PCa patients, HIIT showed higher efficacy (P < 0.01) in decreasing PSA than the CON regimen (P=0.22, I2 = 34% in the heterogeneity test; MD, -1.13 [-1.91, -0.34]). CONCLUSIONS HIIT improves aerobic capacity, fatigue, and PSA levels among PCa patients but does not significantly affect IL-6 or TNF-α content. Therefore, HIIT may be a novel and potent intervention scheme for PCa patients.
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Affiliation(s)
- Ming Chang
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Junguo Wang
- Department of Orthopaedics, Qingdao Hospital of Traditional Chinese Medicine (Hiser hospital), Qingdao, Shandong, China
| | - Hairul A Hashim
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Shihao Xie
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Adam A Malik
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia.
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10
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Kang DW, Boulé NG, Field CJ, Fairey AS, Courneya KS. Effects of supervised high-intensity interval training on motivational outcomes in men with prostate cancer undergoing active surveillance: results from a randomized controlled trial. Int J Behav Nutr Phys Act 2022; 19:126. [PMID: 36175907 PMCID: PMC9524100 DOI: 10.1186/s12966-022-01365-2] [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] [Received: 07/10/2022] [Accepted: 09/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background Understanding the motivational effects of supervised aerobic high-intensity interval training (HIIT) may help men with prostate cancer undergoing active surveillance initiate and maintain exercise behavior, however, few studies have addressed this question. This report explored exercise motivation in men with prostate cancer undergoing active surveillance participating in a randomized exercise trial. Methods The Exercise during Active Surveillance for Prostate Cancer (ERASE) trial randomized 52 men with prostate cancer on active surveillance to the HIIT exercise group or the usual care (UC) group. The exercise program was supervised aerobic HIIT conducted three times per week for 12 weeks. The motivation questions were developed using the Theory of Planned Behavior and included motivational constructs, anticipated and experienced outcomes, and barriers to HIIT during active surveillance. Results The HIIT group attended 96% of the planned exercise sessions with 100% compliance to the exercise protocol. Motivation outcome data were obtained in 25/26 (96%) participants in the HIIT group and 25/26 (96%) participants in the UC group. At baseline, study participants were generally motivated to perform HIIT. After the intervention, the HIIT group reported that HIIT was even more enjoyable (p < 0.001; d = 1.38), more motivating (p = 0.001; d = 0.89), more controllable (p < 0.001; d = 0.85), and instilled more confidence (p = 0.004; d = 0.66) than they had anticipated. Moreover, compared to UC, HIIT participants reported significantly higher perceived control (p = 0.006; d = 0.68) and a more specific plan (p = 0.032; d = 0.67) for performing HIIT over the next 6 months. No significant differences were found in anticipated versus experienced outcomes. Exercise barriers were minimal, however, the most often reported barriers included pain or soreness (56%), traveling to the fitness center (40%), and being too busy and having limited time (36%). Conclusion Men with prostate cancer on active surveillance were largely motivated and expected significant benefits from a supervised HIIT program. Moreover, the men assigned to the HIIT program experienced few barriers and achieved high adherence, which further improved their motivation. Future research is needed to understand long-term exercise motivation and behavior change in this setting. Trial registration Clinicaltrials.gov, NCT03203460. Registered on June 29, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01365-2.
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Affiliation(s)
- Dong-Woo Kang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Normand G Boulé
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Catherine J Field
- Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada
| | - Adrian S Fairey
- Division of Urology, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.
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Perera S, McDonald J, Williams I, O'Brien J, Murphy D, Lawrentschuk N. Active Surveillance versus non-radical treatment for low-risk men with prostate cancer; A Review. Prostate Int 2022; 10:117-122. [PMID: 36225285 PMCID: PMC9520502 DOI: 10.1016/j.prnil.2022.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
Low-risk prostate cancer has traditionally seen a preference towards avoiding treatment-related harms with active surveillance (AS) and multimodal monitoring protocols utilized to assess for disease progression. Large trials have shown variations in mortality and cancer survival benefit between AS and radical treatment, which has prompted further trials into the management of low-risk disease. Nonradical treatments for men on AS have been an emerging field and yet to enter mainstream guidelines or practice. These include pharmacological treatments, focal therapy, nutraceuticals, immunotherapy, and exercise. We present a review of all current major randomized clinical trials for nonradical treatment of men on AS and summarize their findings.
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Affiliation(s)
- Sachin Perera
- Department of Urology and Department of Surgery, Royal Melbourne Hospital University of Melbourne, Australia
- EJ Whitten Foundation Prostate Cancer Research Centre at Epworth, Melbourne, Australia
- Corresponding author. Department of Urology, The Royal Melbourne Hospital, 300 Grattan St, Parkville VIC 3050, Australia.
| | - Jodie McDonald
- Department of Urology and Department of Surgery, Royal Melbourne Hospital University of Melbourne, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Isabella Williams
- Department of Urology and Department of Surgery, Royal Melbourne Hospital University of Melbourne, Australia
| | - Jonathan O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Declan Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Urology and Department of Surgery, Royal Melbourne Hospital University of Melbourne, Australia
- EJ Whitten Foundation Prostate Cancer Research Centre at Epworth, Melbourne, Australia
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12
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Mavropalias G, Sim M, Taaffe DR, Galvão DA, Spry N, Kraemer WJ, Häkkinen K, Newton RU. Exercise medicine for cancer cachexia: targeted exercise to counteract mechanisms and treatment side effects. J Cancer Res Clin Oncol 2022; 148:1389-1406. [PMID: 35088134 PMCID: PMC9114058 DOI: 10.1007/s00432-022-03927-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/13/2022] [Indexed: 12/27/2022]
Abstract
Purpose Cancer-induced muscle wasting (i.e., cancer cachexia, CC) is a common and devastating syndrome that results in the death of more than 1 in 5 patients. Although primarily a result of elevated inflammation, there are multiple mechanisms that complement and amplify one another. Research on the use of exercise to manage CC is still limited, while exercise for CC management has been recently discouraged. Moreover, there is a lack of understanding that exercise is not a single medicine, but mode, type, dosage, and timing (exercise prescription) have distinct health outcomes. The purpose of this review was to examine the effects of these modes and subtypes to identify the most optimal form and dosage of exercise therapy specific to each underlying mechanism of CC. Methods The relevant literatures from MEDLINE and Scopus databases were examined. Results Exercise can counteract the most prominent mechanisms and signs of CC including muscle wasting, increased protein turnover, systemic inflammation, reduced appetite and anorexia, increased energy expenditure and fat wasting, insulin resistance, metabolic dysregulation, gut dysbiosis, hypogonadism, impaired oxidative capacity, mitochondrial dysfunction, and cancer treatments side-effects. There are different modes of exercise, and each mode has different sub-types that induce vastly diverse changes when performed over multiple sessions. Choosing suboptimal exercise modes, types, or dosages can be counterproductive and could further contribute to the mechanisms of CC without impacting muscle growth. Conclusion Available evidence shows that patients with CC can safely undertake higher-intensity resistance exercise programs, and benefit from increases in body mass and muscle mass.
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Affiliation(s)
- Georgios Mavropalias
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Institute for Nutrition Research, Edith Cowan University, Joondalup, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Nigel Spry
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - William J Kraemer
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Department of Human Sciences, Ohio State University, Columbus, USA
| | - Keijo Häkkinen
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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