Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Curr Oncol Rep. 2018 Mar 10;20(3):27. doi: 10.1007/s11912-018-0681-2.
Cancer patients nearly universally experience a decline in quality of life, with fatigue and reduced exercise tolerance as cardinal reflections. A routine exercise program can improve these signs and symptoms as well as overall outcomes. The review provides an updated overview of the field and its translation to clinical practice.
A wealth of clinical studies have documented the safety and benefits of exercise after and during cancer therapy, and pilot and larger-scale studies are currently ongoing to integrate exercise into the treatment program for cancer patients undergoing active therapy (EXACT pilot, OptiTrain, and TITAN study). More recently, efforts have emerged to commence exercise programs before the start of cancer therapy, so-called pre-habilitation. The concept of increasing the cardiovascular reserve beforehand is intuitively attractive. In agreement, preclinical studies support exercise as an effective preventive means before and during cardiotoxic drug exposure. Assuming that a pronounced drop in exercise tolerance will occur during cancer therapy, pre-habilitation can potentially curtail or raise the nadir level of exercise tolerance. Furthermore, such efforts might serve as pre-conditioning efforts in reducing not only the nadir, but even the magnitude of drop in cardiovascular reserve. Initiated beforehand, cancer patients are also more likely to continue these efforts during cancer therapy. Finally, an active exercise routine (≥ 150 min/week moderate intensity or ≥ 75 min/week vigorous intensity or combination) in conjunction with the other six American Heart Association's cardiovascular health metrics (BMI < 25 kg/m, blood pressure < 120/80 mmHg, fasting plasma glucose < 100 mg/dL, total cholesterol < 200 mg/dL, 4-5 component healthy diet, no smoking) reduces not only the cardiovascular but also the cancer disease risk. Exercise can reduce the risks of developing cancer, the detrimental effects of its treatment on the cardiovascular system, and overall morbidity and mortality. Exercise should become an integral part of the care for every cancer patient.
癌症患者的生活质量普遍下降，疲劳和运动耐量降低是主要表现。常规运动方案可以改善这些症状和整体预后。本综述提供了该领域的最新概述及其向临床实践的转化。
大量临床研究已经证明了癌症治疗后和治疗期间运动的安全性和益处，目前正在进行试点和更大规模的研究，将运动纳入正在接受积极治疗的癌症患者的治疗方案中（EXACT 试点、OptiTrain 和 TITAN 研究）。最近，人们努力在癌症治疗开始前开始运动方案，即所谓的预康复。事先增加心血管储备的概念是直观的吸引力。一致的是，临床前研究支持在接触心脏毒性药物之前和期间进行运动作为有效的预防手段。假设在癌症治疗期间运动耐量会显著下降，预康复可能会限制或提高运动耐量的最低点。此外，这些努力可能作为减少心血管储备下降最低点甚至下降幅度的预处理措施。提前开始，癌症患者在癌症治疗期间也更有可能继续这些努力。最后，积极的运动方案（每周至少 150 分钟中等强度或每周至少 75 分钟剧烈强度或两者结合），加上美国心脏协会的其他六个心血管健康指标（BMI<25kg/m、血压<120/80mmHg、空腹血糖<100mg/dL、总胆固醇<200mg/dL、4-5 种成分健康饮食、不吸烟）不仅可以降低心血管疾病风险，还可以降低癌症疾病风险。运动可以降低患癌症的风险、癌症治疗对心血管系统的不利影响以及整体发病率和死亡率。运动应该成为每个癌症患者护理的一个组成部分。
