Kanser ve Fiziksel Aktivite
Özet
Bu bölümde, fiziksel aktivitenin kanser bakım sürecindeki önemi, kanserin önlenmesinden sağkalıma kadar farklı aşamalarda ele alınmaktadır. Kanser öncesinde fiziksel aktivite, kolon, meme ve endometrium kanserleri gibi birçok kanser türünün riskini azaltma potansiyeline sahiptir. Bununla birlikte, fiziksel aktivitenin kanser insidansı üzerindeki etkilerini daha kapsamlı anlamak için randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.
Tedavi hazırlığı ve tedavi sürecinde fiziksel aktivitenin, hastaların fiziksel ve psikolojik sağlıklarını iyileştirdiği, tedaviye bağlı yan etkileri azalttığı ve tedavi etkinliğini desteklediği gösterilmiştir. Örneğin, egzersiz, kardiyotoksisiteyi azaltabilir, yorgunluğu yönetebilir ve tedavi tamamlanma oranını artırabilir. Ayrıca, ameliyat öncesi dönemde yapılan egzersizler, cerrahi sonrası iyileşme sürecine katkıda bulunabilir.
Tedavi sonrası dönemde fiziksel aktivite, hem akut hem de uzun vadeli tedavi toksisitelerini azaltmada, fiziksel fonksiyonu iyileştirmede ve yaşam kalitesini artırmada önemli bir role sahiptir. Ayrıca, fiziksel aktivitenin kanserin tekrarlama riskini azaltma ve ikinci bir kanser gelişimini önlemede etkili olabileceğine dair kanıtlar artmaktadır. Ancak, bu etkilerin tüm kanser türleri ve evreleri üzerindeki potansiyel faydalarını daha iyi anlamak için daha fazla çalışmaya ihtiyaç vardır.
Palyatif bakım bağlamında fiziksel aktivite, ileri evre kanser hastalarının semptomlarını yönetmek, hareket kabiliyetini korumak ve yaşam kalitesini artırmak için değerli bir araçtır. Ancak bu alanda daha fazla araştırma yapılması gerekmektedir. Özellikle ileri evre kanser hastalarında fiziksel aktivitenin hem faydalarını hem de olası zararlarını değerlendirmek önemlidir.
Sonuç olarak, fiziksel aktivite, kanser bakım sürecinin her aşamasında hastaların fiziksel ve psikolojik sağlıklarını destekleme potansiyeline sahiptir. Bununla birlikte, fiziksel aktivitenin türü, yoğunluğu ve sıklığı gibi unsurların daha iyi tanımlanması ve bireysel ihtiyaçlara göre uyarlanması için daha fazla araştırma gereklidir. Bu kapsamda, ulusal ve uluslararası kılavuzlar, fiziksel aktivitenin kanser kontrolündeki rolünü desteklemekte ve teşvik etmektedir.
This chapter examines the pivotal role of physical activity throughout the cancer care continuum, from prevention to survivorship. It highlights the potential of physical activity to reduce the risk of cancers such as colon, breast, and endometrial cancers, emphasizing the need for randomized controlled trials to better understand its impact on cancer incidence. During treatment preparation and active treatment phases, physical activity is shown to enhance physical and psychological health, alleviate treatment side effects, and improve treatment adherence and outcomes. Preoperative exercises contribute to postoperative recovery, while activities during treatment can mitigate fatigue, cardiotoxicity, and other complications.
In the post-treatment phase, physical activity aids in managing both acute and long-term toxicities, improving physical function, and enhancing quality of life. Evidence suggests its potential to reduce cancer recurrence risk and prevent secondary cancers, though further research is needed to substantiate these effects across various cancer types and stages.
In palliative care, physical activity offers a means to manage symptoms, maintain mobility, and improve quality of life for advanced cancer patients. However, research on its benefits and risks in this context remains limited. The chapter underscores the necessity of tailoring physical activity recommendations to individual needs and integrating them into cancer care guidelines to optimize patient outcomes across all stages of the disease trajectory.
Referanslar
WHO O: WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization 2020:1-582.
Piepoli M, Hoes A, Agewall S, Albus C, Brotons C, Catapano A, Cooney M, Corrà U, Cosyns B, Deaton C: ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016, 37:2315.
Lönnberg L, Ekblom-Bak E, Damberg M: Improved unhealthy lifestyle habits in patients with high cardiovascular risk: results from a structured lifestyle programme in primary care. Upsala journal of medical sciences 2019, 124:94-104.
Anazco D, Acosta A, Cathcart-Rake EJ, D'Andre SD, Hurtado MD: Weight-centric prevention of cancer. Obes Pillars 2024, 10:100106.
Peng W, Bai X, Yang Y, Cui J, Xu W, Song L, Yang H, He W, Zhang Y, Zhang X: Healthy lifestyle, statin, and mortality in people with high CVD risk: A nationwide population-based cohort study. American Journal of Preventive Cardiology 2024, 17:100635.
Savvakis I, Adamakidou T, Kleisiaris C: Physical-activity interventions to reduce fear of falling in frail and pre-frail older adults: a systematic review of randomized controlled trials. European geriatric medicine 2024, 15:333-344.
Taplin SH, Anhang Price R, Edwards HM, Foster MK, Breslau ES, Chollette V, Prabhu Das I, Clauser SB, Fennell ML, Zapka J: Introduction: Understanding and influencing multilevel factors across the cancer care continuum. J Natl Cancer Inst Monogr 2012, 2012:2-10.
Courneya KS, Friedenreich CM: Framework PEACE: an organizational model for examining physical exercise across the cancer experience. Ann Behav Med 2001, 23:263-272.
Courneya KS, Friedenreich CM: Physical activity and cancer control. Semin Oncol Nurs 2007, 23:242-252.
Population factsheets [https://gco.iarc.fr/today/en/fact-sheets-populations]
Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel AV, Andrews KS, Bandera EV, Spees CK, Robien K: American Cancer Society guideline for diet and physical activity for cancer prevention. CA: a cancer journal for clinicians 2020, 70:245-271.
Diao X, Ling Y, Zeng Y, Wu Y, Guo C, Jin Y, Chen X, Feng S, Guo J, Ding C: Physical activity and cancer risk: a dose‐response analysis for the global burden of disease study 2019. Cancer Communications 2023, 43:1229-1243.
Moore SC, Lee I-M, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, De Gonzalez AB, Hartge P: Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA internal medicine 2016, 176:816-825.
Chen F, Lin C, Gu X, Ning Y, He H, Qiang G: Exploring the link between walking and lung cancer risk: a two-stage Mendelian randomization analysis. BMC Pulmonary Medicine 2024, 24:129.
Yang L, Courneya KS, Friedenreich CM: The Physical Activity and Cancer Control (PACC) framework: update on the evidence, guidelines, and future research priorities. British Journal of Cancer 2024:1-13.
Hojman P, Gehl J, Christensen JF, Pedersen BK: Molecular mechanisms linking exercise to cancer prevention and treatment. Cell metabolism 2018, 27:10-21.
Matthews CE, Moore SC, Arem H, Cook MB, Trabert B, Håkansson N, Larsson SC, Wolk A, Gapstur SM, Lynch BM: Amount and intensity of leisure-time physical activity and lower cancer risk. Journal of Clinical Oncology 2020, 38:686-697.
Mazzilli KM, Matthews CE, Salerno EA, Moore SC: Weight training and risk of 10 common types of cancer. Medicine and science in sports and exercise 2019, 51:1845.
Nascimento W, Ferrari G, Martins CB, Rey-Lopez JP, Izquierdo M, Lee DH, Giovannucci EL, Rezende LF: Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies. International Journal of Behavioral Nutrition and Physical Activity 2021, 18:69.
Rezende LF, Lee DH, Keum N, Wu K, Eluf-Neto J, Tabung FK, Giovannucci EL: Resistance training and total and site-specific cancer risk: a prospective cohort study of 33,787 US men. British journal of cancer 2020, 123:666-672.
Pesta DH, Goncalves RL, Madiraju AK, Strasser B, Sparks LM: Resistance training to improve type 2 diabetes: working toward a prescription for the future. Nutrition & metabolism 2017, 14:1-10.
Calle MC, Fernandez ML: Effects of resistance training on the inflammatory response. Nutrition research and practice 2010, 4:259-269.
Kraemer WJ, Häkkinen K, Newton RU, Nindl BC, Volek JS, McCormick M, Gotshalk LA, Gordon SE, Fleck SJ, Campbell WW: Effects of heavy-resistance training on hormonal response patterns in younger vs. older men. Journal of applied physiology 1999, 87:982-992.
Friedenreich CM, Ryder‐Burbidge C, McNeil J: Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Molecular oncology 2021, 15:790-800.
PREHABILITATION, rehabilitation, and revocation in the Army. Br Med J 1946, 1:192-197.
Himbert C, Klossner N, Coletta AM, Barnes CA, Wiskemann J, LaStayo PC, Varghese TK, Jr., Ulrich CM: Exercise and lung cancer surgery: A systematic review of randomized-controlled trials. Crit Rev Oncol Hematol 2020, 156:103086.
Falz R, Bischoff C, Thieme R, Lässing J, Mehdorn M, Stelzner S, Busse M, Gockel I: Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol 2022, 148:2187-2213.
Cuijpers ACM, Linskens FG, Bongers BC, Stassen LPS, Lubbers T, van Meeteren NLU: Quality and clinical generalizability of feasibility outcomes in exercise prehabilitation before colorectal cancer surgery - A systematic review. Eur J Surg Oncol 2022, 48:1483-1497.
Briggs LG, Reitblat C, Bain PA, Parke S, Lam N-Y, Wright J, Catto JWF, Copeland RJ, Psutka SP: Prehabilitation Exercise Before Urologic Cancer Surgery: A Systematic and Interdisciplinary Review. European Urology 2022, 81:157-167.
Wade-Mcbane K, King A, Urch C, Jeyasingh-Jacob J, Milne A, Boutillier CL: Prehabilitation in the lung cancer pathway: a scoping review. BMC Cancer 2023, 23:747.
Geng E, Yin S, Yang Y, Ke C, Fang K, Liu J, Wang D: The effect of perioperative pelvic floor muscle exercise on urinary incontinence after radical prostatectomy: a meta-analysis. Int Braz J Urol 2023, 49:441-451.
Yang A, Sokolof J, Gulati A: The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: a systematic review. Int J Rehabil Res 2018, 41:189-196.
Malveiro C, Correia IR, Cargaleiro C, Magalhães JP, de Matos LV, Hilário S, Sardinha LB, Cardoso MJ: Effects of exercise training on cancer patients undergoing neoadjuvant treatment: A systematic review. J Sci Med Sport 2023, 26:586-592.
Garrone O, Paccagnella M, Abbona A, Ruatta F, Vanella P, Denaro N, Tomasello G, Croce N, Barbin F, Rossino MG, et al: Moderate physical activity during neoadjuvant chemotherapy in breast cancer patients: effect on cancer-related inflammation and pathological complete response—the Neo-Runner study. ESMO Open 2024, 9:103665.
Jones LW, Fels DR, West M, Allen JD, Broadwater G, Barry WT, Wilke LG, Masko E, Douglas PS, Dash RC, et al: Modulation of circulating angiogenic factors and tumor biology by aerobic training in breast cancer patients receiving neoadjuvant chemotherapy. Cancer Prev Res (Phila) 2013, 6:925-937.
de Boniface J, Altena R, Haddad Ringborg C, Bolam KA, Wengström Y: Physical exercise during neoadjuvant chemotherapy for breast cancer as a mean to increase pathological complete response rates: Trial protocol of the randomized Neo-ACT trial. PLoS One 2022, 17:e0274804.
Kjeldsted E, Ammitzbøll G, Jørgensen LB, Lodin A, Bojesen RD, Ceballos SG, Rosthøj S, Lænkholm A-V, Skou ST, Jack S, et al: Neo-train: study protocol and feasibility results for a two-arm randomized controlled trial investigating the effect of supervised exercise during neoadjuvant chemotherapy on tumour response in patients with breast cancer. BMC Cancer 2023, 23:777.
Brown JC, Ma C, Shi Q, Niedzwiecki D, Zemla T, Couture F, Kuebler P, Kumar P, Hopkins JO, Tan B, et al: Association between physical activity and the time course of cancer recurrence in stage III colon cancer. Br J Sports Med 2023, 57:965-971.
Yang L, Morielli AR, Heer E, Kirkham AA, Cheung WY, Usmani N, Friedenreich CM, Courneya KS: Effects of Exercise on Cancer Treatment Efficacy: A Systematic Review of Preclinical and Clinical Studies. Cancer Res 2021, 81:4889-4895.
García-Chico C, López-Ortiz S, Peñín-Grandes S, Pinto-Fraga J, Valenzuela PL, Emanuele E, Ceci C, Graziani G, Fiuza-Luces C, Lista S, et al: Physical Exercise and the Hallmarks of Breast Cancer: A Narrative Review. Cancers (Basel) 2023, 15.
Chiang CH, Chang YC, Haw Y, Tan JY, Chiang CH, Hsia YP, Chiang CH: The Effect of Exercise on Cardiotoxicity in Women with Breast Cancer Receiving Anthracycline-Based Chemotherapy: A Systematic Review and Meta-Analysis. Oncology 2024, 102:510-514.
Bellissimo MP, Canada JM, Jordan JH, Ladd AC, Reding KW, Moore TL, Ntim WO, Heiston EM, Brubaker P, Mihalko SL, et al: Physical Activity During Breast Cancer Therapy Associates With Preserved Exercise Capacity and Cardiac Function (WF97415). JACC CardioOncol 2023, 5:641-652.
Amin AM, Khlidj Y, Abuelazm M, Ibrahim AA, Tanashat M, Imran M, Nazir A, Shaikhkhalil H, Abdelazeem B: The efficacy and safety of exercise regimens to mitigate chemotherapy cardiotoxicity: a systematic review and meta-analysis of randomized controlled trials. Cardiooncology 2024, 10:10.
Recover [https://www.cancer.gov/publications/dictionaries/cancer-terms/def/recover]
Rehabilitation [https://www.cancer.gov/publications/dictionaries/cancer-terms/search/rehabilitation/?searchMode=Begins]
Goldschmidt S, Schmidt ME, Steindorf K: Long-term effects of exercise interventions on physical activity in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2023, 31:130.
Rendeiro JA, Rodrigues C, de Barros Rocha L, Rocha RSB, da Silva ML, da Costa Cunha K: Physical exercise and quality of life in patients with prostate cancer: systematic review and meta-analysis. Support Care Cancer 2021, 29:4911-4919.
Machado P, Morgado M, Raposo J, Mendes M, Silva CG, Morais N: Effectiveness of exercise training on cancer-related fatigue in colorectal cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2022, 30:5601-5613.
Teba PP, Esther MG, Raquel SG: Association between physical activity and patient-reported outcome measures in patients with lung cancer: a systematic review and meta-analysis. Qual Life Res 2022, 31:1963-1976.
Wang S, Yang T, Qiang W, Shen A, Zhao Z, Chen X, Xi C, Liu H, Guo F: Effectiveness of physical exercise on the cardiovascular system in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2021, 44:101426.
Abbasi F, Pourjalali H, do Nascimento IJB, Zargarzadeh N, Mousavi SM, Eslami R, Milajerdi A: The effects of exercise training on inflammatory biomarkers in patients with breast cancer: A systematic review and meta-analysis. Cytokine 2022, 149:155712.
Kong L, Gao R: Aerobic exercise combined with resistance exercise training improves cardiopulmonary function and blood lipid of patients with breast cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2022, 101:e32391.
Kang DW, Lee J, Suh SH, Ligibel J, Courneya KS, Jeon JY: Effects of Exercise on Insulin, IGF Axis, Adipocytokines, and Inflammatory Markers in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2017, 26:355-365.
Sarfati D, Koczwara B, Jackson C: The impact of comorbidity on cancer and its treatment. CA Cancer J Clin 2016, 66:337-350.
Institute NC: Palliative Care. 2024.
Toohey K, Chapman M, Rushby AM, Urban K, Ingham G, Singh B: The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv 2023, 17:399-415.
Tanriverdi A, Ozcan Kahraman B, Ergin G, Karadibak D, Savci S: Effect of exercise interventions in adults with cancer receiving palliative care: a systematic review and meta-analysis. Support Care Cancer 2023, 31:205.
Langbaum T, Smith TJ: Time to Study Metastatic-Cancer Survivorship. N Engl J Med 2019, 380:1300-1302.
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, et al: Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010, 363:733-742.
Campbell KL, Cormie P, Weller S, Alibhai SMH, Bolam KA, Campbell A, Cheville AL, Dalzell MA, Hart NH, Higano CS, et al: Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals. JCO Oncol Pract 2022, 18:e697-e709.
Courneya KS, Booth CM: Exercise as cancer treatment: A clinical oncology framework for exercise oncology research. Front Oncol 2022, 12:957135.
McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko R, Buchner D, Pescatello LS, Bloodgood B, Tennant B, Vaux-Bjerke A, et al: Physical Activity in Cancer Prevention and Survival: A Systematic Review. Med Sci Sports Exerc 2019, 51:1252-1261.
Cao C, Friedenreich CM, Yang L: Association of Daily Sitting Time and Leisure-Time Physical Activity With Survival Among US Cancer Survivors. JAMA Oncol 2022, 8:395-403.
Friedenreich CM, Vallance JK, McNeely ML, Culos-Reed SN, Matthews CE, Bell GJ, Mackey JR, Kopciuk KA, Dickau L, Wang Q, et al: The Alberta moving beyond breast cancer (AMBER) cohort study: baseline description of the full cohort. Cancer Causes Control 2022, 33:441-453.
Friedenreich CM, Morielli AR, Lategan I, Ryder-Burbidge C, Yang L: Physical Activity and Breast Cancer Survival-Epidemiologic Evidence and Potential Biologic Mechanisms. Curr Nutr Rep 2022, 11:717-741.
Continuous Update Project Expert Report 2018.Physical Activity and the Risk of Cancer [https://www.wcrf.org/wp-content/uploads/2024/10/Physical-activity.pdf]
Physical Activity Guidelines for Americans [https://odphp.health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines/scientific-report]
Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel AV, Andrews KS, Bandera EV, Spees CK, Robien K, et al: American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin 2020, 70:245-271.
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, et al: World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020, 54:1451-1462.
Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, Irwin ML, Late M, Mansfield S, Marshall TF, et al: Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol 2022, 40:2491-2507.
Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, McCarthy S, Murnane A, Patchell S, Adams D: Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 2018, 209:184-187.
Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, et al: Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc 2019, 51:2375-2390.
Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ, Neuhouser ML, Bandera EV, Wang Y, Robien K, et al: American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin 2022, 72:230-262.
Morishita S, Hamaue Y, Fukushima T, Tanaka T, Fu JB, Nakano J: Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2020, 19:1534735420917462.
