Exercise Timing and Cancer Treatment: Avenues for Chronobiological Research

Abstract

Emerging evidence suggests that cancer chronotherapy, which involves timing drug administration in accordance with a patient's circadian/ internal time, can improve treatment tolerability and efficacy. However, as cancer, its treatments, and even hospitalization can cause circadian rhythm misalignment, cancer chronotherapy may be attenuated from the start. The adjunctive therapeutic strategy 'exercise' not only improves physical function and patient-reported outcomes, but specific effects are determined by the individual's internal time and it may act as a circadian time cue. Utilizing differentially timed exercise in terms of targeting time-specific homeostatic responses to the activity, accounting for the time of peak performance, and/or targeting potential circadian system effects of exercise could thus potentiate cancer chronotherapy or cancer treatment more generally. Herein, we briefly overview cancer chronotherapy and exercise medicine in oncology, highlight potential benefit of timed exercise in cancer treatment, and discuss research opportunities to assess these potentials benefits.

Tai Chi for cancer survivors: A systematic review toward consensus‐based guidelines

“… 41 Tai Chi, or exercise in general, could possibly improve sleep by regulating the circadian rhythm. 56 With respect to the etiology of treatment‐related fatigue, inflammation, altered immune response, and mitochondrial dysfunction are among the leading hypothesized biological mechanisms. 57 Tai Chi may have a direct positive impact on immune function and inflammation (Table S7 ) to reduce fatigue, and it may also indirectly affect these biological pathways through improving cardiorespiratory fitness.…”