Adamek Michaela Ute, Bergmann Laura, Adamek Henning Ernst
Lehrstuhl für Sportmedizin, Fakultät für Human- und Sozialwissenschaften, Bergische Universität Wuppertal, Wuppertal, Germany.
Med. Klinik 2, Klinikum Leverkusen gGmbH, Leverkusen, Germany.
Z Gastroenterol. 2023 Jul;61(7):818-826. doi: 10.1055/a-2099-9658. Epub 2023 Jul 10.
Colorectal carcinoma is a leading cause of cancer diseases in Europe. Due to modern therapies survival rate is increasing. Nevertheless, cancer and its treatment is associated with significant morbidity. Physical activity appears as having a positive impact on cancer risk, as well as, reducing peri- and postoperative morbidity and mortality.
We searched pubmed and googlescholar for English- and German-language studies from inception to September 2022. The search terms physical activity, colon cancer, colorectal cancer, diet, survivors. prehabilitation, postoperative morbidity, quality of life and outcome were used. Guidelines of national advisory commmittees and Cochrane reviews were included.
There is considerable evidence that physical activity is associated with reduced risk of colon cancer, epigenetic mechanisms play a central role in connection. Different studies showed a risk reduction of 12 to 27 percent. A prehabilitation programme consisting of exercise, nutritional intervention, and psychosocial rehabilitation can reduce peri- and postoperative complications. Aerobic exercise and strength training can improve survival rates and overall mortality. However, a causal relationship between nutritional treatment and cancer related symptoms (e.g. fatigue) is missing.
There is a wide range of scientific papers on the influence of physical activity and nutrition; nevertheless, its influence on the various stages of colorectal disease are not addressed adequately. Recommendations concerning prehabilitation and tertiary prevention can only be given on the basis of heterogeneous trial data.
在欧洲,结直肠癌是癌症相关疾病的主要病因之一。由于现代治疗方法的应用,生存率正在提高。然而,癌症及其治疗会带来显著的发病率。体育活动似乎对癌症风险有积极影响,同时还能降低围手术期和术后的发病率及死亡率。
我们在PubMed和谷歌学术上搜索了从创刊到2022年9月的英文和德文研究。使用的搜索词包括体育活动、结肠癌、结直肠癌、饮食、幸存者、术前康复、术后发病率、生活质量和结局。纳入了国家咨询委员会的指南和Cochrane综述。
有大量证据表明体育活动与降低结肠癌风险相关,表观遗传机制在其中起着核心作用。不同研究显示风险降低了12%至27%。一个由运动、营养干预和心理社会康复组成的术前康复计划可以减少围手术期和术后并发症。有氧运动和力量训练可以提高生存率和总体死亡率。然而,营养治疗与癌症相关症状(如疲劳)之间的因果关系尚不明确。
关于体育活动和营养影响的科学论文众多;然而,其对结直肠疾病各个阶段的影响并未得到充分探讨。关于术前康复和三级预防的建议只能基于异质性的试验数据给出。