Hardee Justin P, Counts Brittany R, Carson James A
Department of Exercise Science (JPH, BRC, JAC), University of South Carolina, Columbia, South Carolina.
Center for Colon Cancer Research (JAC), University of South Carolina, Columbia, South Carolina.
Am J Lifestyle Med. 2017 Aug 17;13(1):46-60. doi: 10.1177/1559827617725283. eCollection 2019 Jan-Feb.
Cachexia, the unintentional loss of body weight, is prevalent in many cancer types, and the associated skeletal muscle mass depletion increases patient morbidity and mortality. While anorexia can be present, cachexia is not reversible with nutritional therapies alone. Pharmacological agents have been proposed to treat this condition, but there are currently no approved treatments. Nonetheless, the hallmark characteristics associated with cancer cachexia remain viable foundations for future therapies. Regular physical activity holds a promising future as a nonpharmacological alternative to improve patient survival through cachexia prevention. Evidence suggests exercise training is beneficial during cancer treatment and survival. However, the mechanistic examination of cachectic skeletal muscle's response to exercise is both needed and justified. The primary objective of this review is to discuss the role of exercise for the prevention and treatment of cancer-associated muscle wasting. Initially, we provide an overview of systemic alterations induced by cancer and their role in the regulation of wasting processes during cachexia progression. We then discuss how exercise could alter disrupted regulatory pathways related to growth and metabolism during cancer-induced muscle atrophy. Last, we outline current exercise prescription guidelines and how exercise could be a potential behavioral therapy to curtail cachexia development in cancer patients.
恶病质,即非自愿性体重减轻,在多种癌症类型中普遍存在,与之相关的骨骼肌质量消耗会增加患者的发病率和死亡率。虽然可能存在厌食症状,但仅靠营养疗法无法逆转恶病质。已经提出了用药物治疗这种病症,但目前尚无获批的治疗方法。尽管如此,与癌症恶病质相关的标志性特征仍是未来治疗的可行基础。定期进行体育活动作为一种非药物替代方法,有望通过预防恶病质来提高患者生存率。有证据表明,运动训练在癌症治疗和生存期间有益。然而,对恶病质骨骼肌对运动反应的机制研究既必要又合理。本综述的主要目的是讨论运动在预防和治疗癌症相关肌肉萎缩中的作用。首先,我们概述癌症引起的全身改变及其在恶病质进展过程中对消瘦过程调节的作用。然后,我们讨论运动如何改变癌症诱导的肌肉萎缩期间与生长和代谢相关的失调调节途径。最后,我们概述当前的运动处方指南以及运动如何成为减少癌症患者恶病质发展的潜在行为疗法。