Physical Activity as the Best Supportive Care in Cancer: The Clinician’s and the Researcher’s Perspectives

Abstract

Multidisciplinary supportive care, integrating the dimensions of exercise alongside oncological treatments, is now regarded as a new paradigm to improve patient survival and quality of life. Its impact is important on the factors that control tumor development, such as the immune system, inflammation, tissue perfusion, hypoxia, insulin resistance, metabolism, glucocorticoid levels, and cachexia. An increasing amount of research has been published in the last years on the effects of physical activity within the framework of oncology, marking the appearance of a new medical field, commonly known as “exercise oncology”. This emerging research field is trying to determine the biological mechanisms by which, aerobic exercise affects the incidence of cancer, the progression and/or the appearance of metastases. We propose an overview of the current state of the art physical exercise interventions in the management of cancer patients, including a pragmatic perspective with tips for routine practice. We then develop the emerging mechanistic views about physical exercise and their potential clinical applications. Moving toward a more personalized, integrated, patient-centered, and multidisciplinary management, by trying to understand the different interactions between the cancer and the host, as well as the impact of the disease and the treatments on the different organs, this seems to be the most promising method to improve the care of cancer patients.

Sex Differences in Inflammation and Muscle Wasting in Aging and Disease

“…For instance, the treatment with the common immunosuppressant rapamycin has sex-specific effects [15], highlighting the importance of taking into account sex differences for precision medicine. The same is true for physical exercise [205] as an intervention against cancer. The conclusion of a ponderous survey on the effectiveness, acceptability, and safety of exercise for cancer cachexia in adults is that "further high-quality randomized controlled trials are still required to test exercise alone or as part of a multimodal intervention to improve people's well-being throughout all phases of cancer care", suggesting that additional clinical and basic studies are needed to implement exercise efficacy [206].…”

The Mediterranean Lifestyle to Contrast Low-Grade Inflammation Behavior in Cancer

“…One of exercise’s primary effects is a decrease in plasma concentrations of the hormone estrogen. Inducing cell proliferation and progression, blocking apoptosis, and promoting angiogenesis are all ways in which estrogens promote breast carcinogenesis [ 32 ]. Several studies have revealed that menopausal women who engage in regular exercise have lower levels of free estrogen in their blood [ 33 , 34 , 35 ].…”

Tumorkachexie: die Bedeutung von Ernährung und Bewegung in der Onkologie

“…Neben den tumorpräventiven Effekten von regelmäßiger körperlicher Aktivität, die gut erforscht und anerkannt sind [47], gibt es aber auch eine stetig wachsende Evidenz für die wichtige Rolle von Sport und Bewegung innerhalb der multimodalen Tumortherapie. Denn während vor noch wenigen Jahren bei einer Krebserkrankung in der Regel strikte körperliche Schonung empfohlen wurde, zählt die Sportund Bewegungstherapie heute als eine der wichtigsten Supportivmaßnahmen in der onkologischen Komplementärtherapie [48].…”