Cancer treatment-induced alterations in muscular fitness and quality of life: The role of exercise training

Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, Colorado 80639, USA.
Annals of Oncology (Impact Factor: 7.04). 01/2008; 18(12):1957-62. DOI: 10.1093/annonc/mdm364
Source: PubMed


Cancer survivors experience muscular weakness and reduced mobility, thereby compromising quality of life. This investigation utilized moderate prescriptive exercise to improve upper- and lower-body muscular fitness, flexibility, depression and quality of life in cancer patients.
One hundred and thirty-five breast and prostate cancer survivors received cancer and medical history screening and a medical examination, as well as assessments of muscular strength (handgrip dynamometer) and endurance (bench press, lateral pull-down, leg press, shoulder press and curl-up crunch test), flexibility (Modified Sit and Reach), depression (Beck Depression Inventory) and quality of life (Quality of Life Index). Following the exercise assessments, cancer survivors trained in resistance exercise for 6 months during treatment or following treatment based on their results from the assessments and health status.
Cancer survivors following treatment showed significant (P = 0.006) improvements in upper-body muscular endurance (+46.8%), lower-body muscular endurance (+67.1%), core muscular endurance (+32.5%) and flexibility (+6.2%), with concomitant improvements (P = 0.013) in depression (-25.6%) and total quality of life (+7.2%). Cancer survivors during treatment showed significant (P = 0.012) improvements in upper-body muscular endurance (+79.1%) and lower-body muscular endurance (+49.7%) while maintaining core endurance and flexibility in conjunction with improvements (P = 0.022) in depression (-43.0%) and quality of life (+11.5%).
Moderate-intensity individualized prescriptive exercise is a safe and efficacious means to augment muscular function and improve the quality of life of cancer survivors.

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    • "Exercise could potentially be a promising intervention strategy for the prevention and treatment of cancer-related cachexia. With the ability to increase FFM, muscle strength and function, cardiovascular fitness and decrease fatigue, ultimately resulting in an increased quality of life, exercise may be an ideal strategy in helping to manage cancer-related cachexia [68, 69]. There is evidence to suggest that forms of exercise can be effective in slowing the progression of cachexia through several molecular mechanisms and anti-inflammatory effects [70–72]. "
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    ABSTRACT: Cancer cachexia is a debilitating consequence of disease progression, characterised by the significant weight loss through the catabolism of both skeletal muscle and adipose tissue, leading to a reduced mobility and muscle function, fatigue, impaired quality of life and ultimately death occurring with 25-30 % total body weight loss. Degradation of proteins and decreased protein synthesis contributes to catabolism of skeletal muscle, while the loss of adipose tissue results mainly from enhanced lipolysis. These mechanisms appear to be at least, in part, mediated by systemic inflammation. Exercise, by virtue of its anti-inflammatory effect, is shown to be effective at counteracting the muscle catabolism by increasing protein synthesis and reducing protein degradation, thus successfully improving muscle strength, physical function and quality of life in patients with non-cancer-related cachexia. Therefore, by implementing appropriate exercise interventions upon diagnosis and at various stages of treatment, it may be possible to reverse protein degradation, while increasing protein synthesis and lean body mass, thus counteracting the wasting seen in cachexia.
    Full-text · Article · Dec 2012 · Journal of Cachexia, Sarcopenia and Muscle
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    • "poor exercise tolerance, fatigue, depression and anxiety [1] [2] [3] [4]. The benefits of physical exercise for cancer patients are described in a series of studies [5] [6] [7] [8] [9] [10] [11], most of which included patients with breast cancer and haematological neoplasias . The studies measured HRQOL and functional capacity and included patients groups with early stage disease. "
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    ABSTRACT: To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy. A prospective, single-arm intervention study of supervised, hospital based muscle and cardiovascular group training and individual home-based training. Peak oxygen consumption (VO(2peak)) was assessed using an incremental exercise test. Muscle strength was measured with one repetition maximum test (1RM). HRQOL was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. Twenty-five patients with non-small cell cancer (NSCLC) stage III-IV and four patients with extensive disease small cell lung cancer (SCLC-ED) were recruited. Six patients (20.7%) dropped out leaving 23 patients for analysis. Exercise adherence in the group training was 73.0% and 8.7% in the home-based training. There were improvements in estimated VO(2peak) and six-minute walk distance (6 MWD) as well as increased muscle strength measurements (p<0.05). There was significant improvement in the "emotional well-being" parameter (FACT-L) while there were no significant changes in HRQOL. Exercise training produces significant improvements in physiological indices and emotional HRQOL and is safe and feasible in patients with advanced stage lung cancer, undergoing chemotherapy. No analysis on home-based training was done because of low adherence.
    Full-text · Article · Aug 2011 · Lung cancer (Amsterdam, Netherlands)
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    • "During operation a surgeon then changes the anatomical conditions of axillary fossa (armpit). The cohesion between muscles, subcutaneous tissue and the skin of axillary fossa as well as the chest, directly influences functioning of a shoulder joint [7] [14] [21] [28] [33] [38] [39]. "
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    ABSTRACT: The aim of the work was to determine the activity of trunk muscles in the sagittal plane in relation to body posture type in women treated for breast cancer. Fifty women having undergone treatment for breast cancer, with an average age of 61, participated in the study. All patients were studied by application of the photogrammetric method in order to determine posture; on the basis of the compensation ratio (mu), the examined group was divided into three posture sub-groups: kyphotic (K), lordotic (L) and balanced (R). At Biodex Multi Joint 3 examination system for isokinetic tests, the functional evaluation of trunk flexor muscles and extensor muscles was performed. Women having undergone mastectomy who participate regularly in rehabilitation are characterized by diverse posture types: kyphotic, lordotic and balanced. Women with lordotic posture achieved the highest force-speed parameter values in the trunk muscles irrespective of the muscle group examined, while the lowest values were observed in women exhibiting kyphotic posture. The function of trunk muscles in women following mastectomy depends on body posture type.
    Full-text · Article · Jan 2010 · Journal of Back and Musculoskeletal Rehabilitation
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