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Thu 12 May 2011 11:33:38 PM EDT

Cancer and Exercise


March 20, 2011 Manish Chandra Pathak

Cancer and its treatment typically induces muscle atrophy due to perturbations in muscle protein metabolism, including
decreased muscle protein synthesis as well as increased muscle protein degradation. It has been shown that cancer
survivors are less likely than those with no cancer history to engage in strenuous exercise, which includes activities that
cause the heart to beat rapidly such as running or jogging. However, on a positive note, even moderate exercise has
shown modest increase in muscles in cancer survivors.

The common types of complementary and alternative medicine use includes exercise therapy which is viewed as a way
of mitigating the common side effects or symptoms of cancer treatment. This is believed to boost the immune system,
promote health and prevent recurrence.

Cancer patients often report impaired sleep quality. Impaired sleep quality may be due to increased levels of sleep-
mediating cytokines resulting from cancer treatment. Exercise has a positive influence on sleep-mediating cytokines,
such as interleukin-6, tumor necrosis factor-alpha, and soluble tumor necrosis factor-alpha receptor, which may
ultimately improve sleep quality. Cancer-related fatigue is the most commonly reported symptom in patients which has
a significant negative impact on quality of life. Its management could efficiently reduce the burden associated with the
treatment. The impact may not be direct but secondary by weight control, reduced risk of abnormal heart disease and
diabetes, hence overall by reducing the risk of premature death.

Moderate physical exercise has been shown to improve sleep quality in cancer survivors. Exercise is thought to improve
sleep quality through the regulation of proinflammatory cytokines that would other-wise stimulate the hypothalamic-
pituitary-adrenal axis and promote cortisol production. Regular exercise training reduces low-grade inflammation by
triggering the immediate but transient release of IL-6 from skeletal muscle. The observation that athletes have lower
levels of circulating testosterone than non-athletes, and the negative role of testosterone in relation to prostate and
testicular cancer, has led to the hypothesis that physical activities might protect against the development of prostate
and testicular cancer.

To improve the cancer treatment and survival process physical activity is absolutely necessary. Physical activity has
marked effects on many functions of the human body, which may influence overall cancer risk. These effects include
direct mechanical processes such as improved circulation, ventilation and bowel transit time, improved energy balance
and immune function, and possibly the capacity to perform DNA repair too.

Despite the limitations, the positive outcomes from exercise provide evidence supporting home based aerobic and
resistance exercise training during radiation treatment for nonmetastatic breast and prostate cancer patients. Meeting
physical activity recommendations are associated with better outcomes of physical and mental health. Exercise may
modify hypothesized biopsychosocial mechanisms in the adjustment to cancer (e.g., fitness, self-efficacy, social
interaction). In turn, changes in these mechanisms might alleviate or prevent the occurrence of many of the common
associated symptoms and its treatments (e.g., fatigue, insomnia, pain, anorexia) and hence improve overall quality of
life.

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