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The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 50691

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Special Issue Editor

Dr. Justin C. Brown

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Guest Editor

Division of Population and Public Health Science, LSU Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
Interests: Cancer Prevention and Control; Epidemiology; Metabolism; Obesity; Physiology

Special Issue Information

Dear Colleagues,

Physical activity, diet, and body composition are important determinants of cancer risk and prognosis. However, our understanding of the mechanisms through which these factors influence cancer initiation and progression remains incomplete. Such mechanisms may include, but are not limited to, direct effects on the tumor, indirect effects on the tumor microenvironment, and improved delivery of anti-cancer treatment.

This Special Issue of Cancers will include articles that describe novel discoveries which clarify our understanding of how physical activity, diet, and body composition impact cancer initiation and progression. Basic, translational, and clinical studies on all tumor types will be included. This Special Issue will inform the development of future lifestyle, pharmacotherapy, and surgical interventions for cancer prevention and control.

Dr. Justin C. Brown
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

biomarkers
body composition
dietary patterns
energy expenditure
exercise
metabolism
obesity

Published Papers (14 papers)

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Research

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18 pages, 1038 KiB

Open AccessArticle

The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial

by Amber S. Kleckner, Jennifer E. Reschke, Ian R. Kleckner, Allison Magnuson, Andrea M. Amitrano, Eva Culakova, Michelle Shayne, Colleen S. Netherby-Winslow, Susan Czap, Michelle C. Janelsins, Karen M. Mustian and Luke J. Peppone

Cancers 2022, 14(17), 4202; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14174202 - 30 Aug 2022

Cited by 9 | Viewed by 2637

Abstract

Cancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I–III cancer and at least six weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence (score 0–14), dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and four weeks. Participants (n = 33) were 51.0 ± 14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at four and eight weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8 (ES = 0.31, 0.25, respectively). For those with a baseline MedDiet score <5 (n = 21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES = −0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (p < 0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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13 pages, 1744 KiB

Open AccessArticle

Metabolic Biomarkers Assessed with PET/CT Predict Sex-Specific Longitudinal Outcomes in Patients with Diffuse Large B-Cell Lymphoma

by Shama Jaswal, Vanessa Sanders, Priyanka Pullarkat, Stephanie Teja, Amber Salter, Marcus P. Watkins, Norman Atagu, Daniel R. Ludwig, Joyce Mhlanga, Vincent M. Mellnick, Linda R. Peterson, Nancy L. Bartlett, Brad S. Kahl, Todd A. Fehniger, Armin Ghobadi, Amanda F. Cashen, Neha Mehta-Shah and Joseph E. Ippolito

Cancers 2022, 14(12), 2932; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14122932 - 14 Jun 2022

Cited by 5 | Viewed by 1965

Abstract

In many cancers, including lymphoma, males have higher incidence and mortality than females. Emerging evidence demonstrates that one mechanism underlying this phenomenon is sex differences in metabolism, both with respect to tumor nutrient consumption and systemic alterations in metabolism, i.e., obesity. We wanted to determine if visceral fat and tumor glucose uptake with fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) could predict sex-dependent outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis of 160 patients (84 males; 76 females) with DLBCL who had imaging at initial staging and after completion of therapy. CT-based relative visceral fat area (rVFA), PET-based SUVmax normalized to lean body mass (SULmax), and end-of-treatment FDG-PET 5PS score were calculated. Increased rVFA at initial staging was an independent predictor of poor OS only in females. At the end of therapy, increase in visceral fat was a significant predictor of poor survival only in females. Combining the change in rVFA and 5PS scores identified a subgroup of females with visceral fat gain and high 5PS with exceptionally poor outcomes. These data suggest that visceral fat and tumor FDG uptake can predict outcomes in DLBCL patients in a sex-specific fashion. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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16 pages, 625 KiB

Open AccessArticle

Associations of Computed Tomography Image-Assessed Adiposity and Skeletal Muscles with Triple-Negative Breast Cancer

by Livingstone Aduse-Poku, Jiang Bian, Dheeraj R. Gopireddy, Mauricio Hernandez, Chandana Lall, Sara M. Falzarano, Shahla Masood, Ara Jo and Ting-Yuan David Cheng

Cancers 2022, 14(7), 1846; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14071846 - 06 Apr 2022

Cited by 1 | Viewed by 2252

Abstract

Obesity measured by anthropometrics is associated with increased risk of triple-negative breast cancer (TNBC). It is unclear to what extent specific adipose tissue components, aside from muscle, are associated with TNBC. This retrospective study included 350 breast cancer patients who received treatment between October 2011 and April 2020 with archived abdominal or pelvic computed tomography (CT) images. We measured the areas of adipose tissue and five-density levels of skeletal muscle on patients’ third lumbar vertebra (L3) image. Logistic regression was performed to examine the associations of specific adiposity and skeletal muscles components and a four-category body composition phenotype with the TNBC subtype. Results showed that higher vs. lower areas (3rd vs. 1st tertiles) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were associated with increased odds of TNBC vs. non-TNBC after adjusting for age, race, stage, tumor grade, tumor size, and skeletal muscle areas (adjusted odds ratio [AOR], 11.25 [95% CI = 3.46–36.52]) and (AOR, 10.34 [95% CI = 2.90–36.90]) respectively. Higher areas of low density muscle was also associated with increased odds of TNBC (AOR, 3.15 [95% CI = 1.05–10.98]). Compared to normal body composition (low adipose tissue/high muscle), high adiposity/high muscle was associated with higher odds of TNBC (AOR, 5.54 [95% CI = 2.12–14.7]). These associations were mainly in premenopausal women and among patients with the CT performed after breast cancer surgery. Specific adipose tissue and low-density muscle can be associated with the TNBC subtype in breast cancer patients. The direction of association warrants confirmation by prospective studies. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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15 pages, 756 KiB

Open AccessArticle

Clinical and Lifestyle-Related Prognostic Indicators among Esophageal Adenocarcinoma Patients Receiving Treatment at a Comprehensive Cancer Center

by Shruti G. Dighe, Li Yan, Sarbajit Mukherjee, Cailey S. McGillicuddy, Karen L. Hulme, Steven N. Hochwald, Saikrishna Yendamuri, Andrew J. Bain, Kevin T. Robillard, Kirsten B. Moysich, Christine B. Ambrosone, Amy E. Millen and Matthew F. Buas

Cancers 2021, 13(18), 4653; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13184653 - 16 Sep 2021

Cited by 6 | Viewed by 2016

Abstract

Purpose: The incidence of esophageal adenocarcinoma (EAC) has risen substantially in recent decades, while the average 5-year survival remains only ~20%. Disease stage and treatment are the strongest prognostic factors. The role of lifestyle factors in relation to survival remains uncertain, with a handful of studies to date investigating associations with obesity, smoking, physical activity, diet, or medications. Methods: This study included patients diagnosed with primary adenocarcinoma of the esophagus, gastroesophageal junction, or cardia (N = 371) at Roswell Park Comprehensive Cancer Center between 2003 and 2019. Leveraging extensive data abstracted from electronic medical records, epidemiologic questionnaires, and a tumor registry, we analyzed clinical, behavioral, and environmental exposures and evaluated stage-specific associations with survival. Survival distributions were visualized using Kaplan–Meier curves. Cox proportional hazards regression models adjusted for age, sex, stage, treatment, and comorbidities were used to estimate the association between each exposure and all-cause or cancer-specific mortality. Results: Among patients presenting with localized/regional tumors (stages I–III), current smoking was associated with increased overall mortality risk (HR = 2.5 [1.42–4.53], p = 0.002), while current physical activity was linked to reduced risk (HR = 0.58 [0.35–0.96], p = 0.035). Among patients with stage IV disease, individuals reporting pre-diagnostic use of statins (HR = 0.62 [0.42–0.92], p = 0.018) or NSAIDs (HR = 0.61 [0.42–0.91], p = 0.016) had improved overall survival. Exploratory analyses suggested that high pre-diagnostic dietary consumption of broccoli, carrots, and fiber correlated with prolonged overall survival in patients with localized/regional disease. Conclusion: Our data suggest that lifestyle exposures may be differentially associated with EAC survival based on disease stage. Future investigation of larger, diverse patient cohorts is essential to validate these findings. Our results may help inform the development of lifestyle-based interventions to improve EAC prognosis and quality of life. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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13 pages, 1458 KiB

Open AccessArticle

Association of Physical Activity with the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B

by Ho Soo Chun, Sojeong Park, Minjong Lee, Yuri Cho, Ha Sung Kim, A Reum Choe, Hwi Young Kim, Kwon Yoo and Tae Hun Kim

Cancers 2021, 13(14), 3424; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13143424 - 08 Jul 2021

Cited by 5 | Viewed by 2401

Abstract

Background and Aims: In the general population, previous studies reported that physical activity was associated with risk of hepatocellular carcinoma (HCC) development. However, it is unclear whether physical activity is associated with risk of HCC development in patients with chronic hepatitis B (CHB). We aimed to elucidate the association between physical activity and risk of HCC development in CHB patients. Methods: This nationwide cohort study involved treatment-naive patients with CHB (n = 9727) who started treatment with entecavir or tenofovir and answered self-reported questionnaires between January 2012 and December 2017, using data from the Korean National Health Insurance Service database. The primary endpoint was development of HCC. Multivariable Cox regression and competing risk analyses were used. Results: During a median follow-up of 3.1 years, cumulative HCC incidence rates were 8.3%. There was an inverse association between physical activity and the risk of HCC (p < 0.001). Patients with 1000–1500 metabolic equivalent task (MET)-min/week, compared to those without physical activity, showed a significantly lower risk of HCC in both patients without cirrhosis (adjusted hazard ratio [aHR] 0.66, p = 0.02) and patients with cirrhosis (aHR 0.61, p = 0.02). In patients who were younger (<60), male, without diabetes, and with high BMI, amounts of physical activity of 1000–1500 MET-min/week showed an inverse association with the risk of HCC (aHR 0.65, 0.63, 0.65, and 0.64, respectively, all p < 0.05). Conclusion: Physical activity was significantly associated with a low risk of HCC in CHB patients treated with entecavir or tenofovir. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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23 pages, 7762 KiB

Open AccessArticle

The Consumption of Cholesterol-Enriched Diets Conditions the Development of a Subtype of HCC with High Aggressiveness and Poor Prognosis

by Arturo Simoni-Nieves, Soraya Salas-Silva, Lisette Chávez-Rodríguez, Alejandro Escobedo-Calvario, Matthis Desoteux, Leticia Bucio, Verónica Souza, Roxana U. Miranda-Labra, Linda E. Muñoz-Espinosa, Cédric Coulouarn, María Concepción Gutiérrez-Ruiz, Jens U. Marquardt and Luis E. Gomez-Quiroz

Cancers 2021, 13(7), 1721; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13071721 - 06 Apr 2021

Cited by 13 | Viewed by 4351

Abstract

Non-alcoholic fatty liver disease (NAFLD) and progression to non-alcoholic steatohepatitis (NASH) result as a consequence of diverse conditions, mainly unbalanced diets. Particularly, high-fat and cholesterol content, as well as carbohydrates, such as those commonly ingested in Western countries, frequently drive adverse metabolic alterations in the liver and promote NAFLD development. Lipid liver overload is also one of the main risk factors for initiation and progression of hepatocellular carcinoma (HCC), but detailed knowledge on the relevance of high nutritional cholesterol remains elusive. We were aimed to characterize HCC development in mice fed with a Western diet (high in lipids and cholesterol) and to identify molecular alterations that define a subtype of liver cancer induced by lipid overload. Mice under western or high cholesterol diets more frequently developed tumors with a more aggressive phenotype than animals fed with a chow diet. Associated changes involved macrophage infiltration, angiogenesis, and stemness features. RNA-seq revealed a specific gene expression signature (Slc41a; Fabp5; Igdcc4 and Mthfd1l) resembling the adverse phenotypic features and poor clinical outcomes seen in patients with HCC. In conclusion; consumption of lipid enriched diets; particularly cholesterol; could accelerate HCC development with an aggressive phenotype and poor prognosis Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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13 pages, 807 KiB

Open AccessArticle

Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients

by Evertine Wesselink, Harm van Baar, Moniek van Zutphen, Meilissa Tibosch, Ewout A. Kouwenhoven, Eric T.P. Keulen, Dieuwertje E. Kok, Henk K. van Halteren, Stephanie O. Breukink, Johannes H. W. de Wilt, Matty P. Weijenberg, Marlou-Floor Kenkhuis, Michiel G. J. Balvers, Renger F. Witkamp, Fränzel J. B. van Duijnhoven, Ellen Kampman, Sandra Beijer, Martijn J. L. Bours and Renate M. Winkels

Cancers 2020, 12(12), 3701; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers12123701 - 09 Dec 2020

Cited by 14 | Viewed by 3934

Abstract

Fatigue is very common among colorectal cancer (CRC) patients. We examined the association between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations and fatigue among stage I-III CRC patients, and whether inflammation mediated this association. Data from two prospective cohort studies were used. Adherence to the WCRF/AICR recommendations was expressed as a score ranging from 0–7, and assessed shortly after diagnosis. Six months post-diagnosis, fatigue was assessed with the European Organization for Research and Treatment of Cancer quality of life questionnaire C30 (EORTC QLQ-C30), and in a subpopulation, the plasma levels of inflammation markers (IL6, IL8, TNFα, and hsCRP) were assessed. Multiple linear regression analyses were performed to investigate the association between adherence to the WCRF/AICR recommendations and fatigue. To test mediation by inflammation, the PROCESS analytic tool developed by Hayes was used. A higher WCRF/AICR adherence score was associated with less fatigue six months after diagnosis (n = 1417, β −2.22, 95%CI −3.65; −0.78). In the population of analysis for the mediation analyses (n = 551), the total association between lifestyle and fatigue was (β −2.17, 95% CI −4.60; 0.25). A statistically significant indirect association via inflammation was observed (β −0.97, 95% CI −1.92; −0.21), explaining 45% of the total association between lifestyle and fatigue (−0.97/−2.17 × 100). Thus, inflammation is probably one of the underlying mechanisms linking lifestyle to fatigue. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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13 pages, 563 KiB

Open AccessArticle

Effect of High-Dose vs Standard-Dose Vitamin D₃ Supplementation on Body Composition among Patients with Advanced or Metastatic Colorectal Cancer: A Randomized Trial

by Justin C. Brown, Michael H. Rosenthal, Chao Ma, Sui Zhang, Halla S. Nimeiri, Nadine J. McCleary, Thomas A. Abrams, Matthew B. Yurgelun, James M. Cleary, Douglas A. Rubinson, Deborah Schrag, Andrea J. Bullock, Jill Allen, Dan Zuckerman, Emily Chan, Jennifer A. Chan, Brian Wolpin, Michael Constantine, Douglas J. Weckstein, Meredith A. Faggen, Christian A. Thomas, Chryssanthi Kournioti, Chen Yuan, Hui Zheng, Bruce W. Hollis, Charles S. Fuchs, Kimmie Ng and Jeffrey A. Meyerhardt Show full author list Hide full author list

Cancers 2020, 12(11), 3451; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers12113451 - 20 Nov 2020

Cited by 7 | Viewed by 2424

Abstract

Skeletal muscle and adipose tissue express the vitamin D receptor and may be a mechanism through which vitamin D supplementation slows cancer progression and reduces cancer death. In this exploratory analysis of a double-blind, multicenter, randomized phase II clinical trial, 105 patients with advanced or metastatic colorectal cancer who were receiving chemotherapy were randomized to either high-dose vitamin D₃ (4000 IU) or standard-dose (400 IU) vitamin D₃. Body composition was measured with abdominal computed tomography at enrollment (baseline) and after cycle 8 of chemotherapy (16 weeks). As compared with standard-dose vitamin D₃, high-dose vitamin D₃ did not significantly change body weight [−0.7 kg; (95% CI: −3.5, 2.0)], body mass index [−0.2 kg/m²; (95% CI: −1.2, 0.7)], muscle area [−1.7 cm²; (95% CI: −9.6, 6.3)], muscle attenuation [−0.4 HU; (95% CI: −4.2, 3.2)], visceral adipose tissue area [−7.5 cm²; (95% CI: −24.5, 9.6)], or subcutaneous adipose tissue area [−8.3 cm²; (95% CI: −35.5, 18.9)] over the first 8 cycles of chemotherapy. Among patients with advanced or metastatic colorectal cancer, the addition of high-dose vitamin D₃, vs standard-dose vitamin D₃, to standard chemotherapy did not result in any changes in body composition. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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Review

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30 pages, 1177 KiB

Open AccessEditor’s ChoiceReview

Dietary Interventions in Cancer Treatment and Response: A Comprehensive Review

by Benjamin D. Mercier, Eemon Tizpa, Errol J. Philip, Qianhua Feng, Ziyi Huang, Reeny M. Thomas, Sumanta K. Pal, Tanya B. Dorff and Yun R. Li

Cancers 2022, 14(20), 5149; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14205149 - 20 Oct 2022

Cited by 9 | Viewed by 6137

Abstract

Chemotherapy and radiotherapy are first-line treatments in the management of advanced solid tumors. Whereas these treatments are directed at eliminating cancer cells, they cause significant adverse effects that can be detrimental to a patient’s quality of life and even life-threatening. Diet is a modifiable risk factor that has been shown to affect cancer risk, recurrence, and treatment toxicity, but little information is known how diet interacts with cancer treatment modalities. Although dietary interventions, such as intermittent fasting and ketogenic diets, have shown promise in pre-clinical studies by reducing the toxicity and increasing the efficacy of chemotherapeutics, there remains a limited number of clinical studies in this space. This review surveys the impact of dietary interventions (caloric restriction, intermittent and short-term fasting, and ketogenic diet) on cancer treatment outcomes in both pre-clinical and clinical studies. Early studies support a complementary role for these dietary interventions in improving patient quality of life across multiple cancer types by reducing toxicity and perhaps a benefit in treatment efficacy. Larger, phase III, randomized clinical trials are ultimately necessary to evaluate the efficacy of these dietary interventions in improving oncologic or quality of life outcomes for patients that are undergoing chemotherapy or radiotherapy. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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18 pages, 4810 KiB

Open AccessReview

Obesity Management in the Primary Prevention of Hepatocellular Carcinoma

by Elizabeth R. M. Zunica, Elizabeth C. Heintz, Christopher L. Axelrod and John P. Kirwan

Cancers 2022, 14(16), 4051; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14164051 - 22 Aug 2022

Cited by 12 | Viewed by 2852

Abstract

Hepatocellular carcinoma (HCC) is the most frequent primary hepatic malignancy and a leading cause of cancer-related death globally. HCC is associated with an indolent clinical presentation, resulting in frequent advanced stage diagnoses where surgical resection or transplant therapies are not an option and medical therapies are largely ineffective at improving survival. As such, there is a critical need to identify and enhance primary prevention strategies to mitigate HCC-related morbidity and mortality. Obesity is an independent risk factor for the onset and progression of HCC. Furthermore, obesity is a leading cause of nonalcoholic steatohepatitis (NASH), the fasting growing etiological factor of HCC. Herein, we review evolving clinical and mechanistic associations between obesity and hepatocarcinogenesis with an emphasis on the therapeutic efficacy of prevailing lifestyle/behavioral, medical, and surgical treatment strategies for weight reduction and NASH reversal. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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27 pages, 1183 KiB

Open AccessReview

Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy

by Kaitlin H. Chung, Susanna B. Park, Fiona Streckmann, Joachim Wiskemann, Nimish Mohile, Amber S. Kleckner, Luana Colloca, Susan G. Dorsey and Ian R. Kleckner

Cancers 2022, 14(5), 1224; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14051224 - 26 Feb 2022

Cited by 20 | Viewed by 4865

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of neurotoxic antineoplastic agents commonly used to treat cancer. Patients with CIPN experience debilitating signs and symptoms, such as combinations of tingling, numbness, pain, and cramping in the hands and feet that inhibit their daily function. Among the limited prevention and treatment options for CIPN, exercise has emerged as a promising new intervention that has been investigated in approximately two dozen clinical trials to date. As additional studies test and suggest the efficacy of exercise in treating CIPN, it is becoming more critical to develop mechanistic understanding of the effects of exercise in order to tailor it to best treat CIPN symptoms and identify who will benefit most. To address the current lack of clarity around the effect of exercise on CIPN, we reviewed the key potential mechanisms (e.g., neurophysiological and psychosocial factors), mediators (e.g., anti-inflammatory cytokines, self-efficacy, and social support), and moderators (e.g., age, sex, body mass index, physical fitness, exercise dose, exercise adherence, and timing of exercise) that may illuminate the relationship between exercise and CIPN improvement. Our review is based on the studies that tested the use of exercise for patients with CIPN, patients with other types of neuropathies, and healthy adults. The discussion presented herein may be used to (1) guide oncologists in predicting which symptoms are best targeted by specific exercise programs, (2) enable clinicians to tailor exercise prescriptions to patients based on specific characteristics, and (3) inform future research and biomarkers on the relationship between exercise and CIPN. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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19 pages, 1474 KiB

Open AccessReview

Current Evidence of the Role of the Myokine Irisin in Cancer

by Evangelia Tsiani, Nicole Tsakiridis, Rozalia Kouvelioti, Alina Jaglanian and Panagiota Klentrou

Cancers 2021, 13(11), 2628; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13112628 - 27 May 2021

Cited by 17 | Viewed by 4333

Abstract

Cancer is a disease associated with extreme human suffering, a huge economic cost to health systems, and is the second leading cause of death worldwide. Regular physical activity is associated with many health benefits, including reduced cancer risk. In the past two decades, exercising/contracting skeletal muscles have been found to secrete a wide range of biologically active proteins, named myokines. Myokines are delivered, via the circulation, to different cells/tissues, bind to their specific receptors and initiate signaling cascades mediating the health benefits of exercise. The present review summarizes the existing evidence of the role of the myokine irisin in cancer. In vitro studies have shown that the treatment of various cancer cells with irisin resulted in the inhibition of cell proliferation, survival, migration/ invasion and induced apoptosis by affecting key proliferative and antiapoptotic signaling pathways. However, the effects of irisin in humans remains unclear. Although the majority of the existing studies have found reduced serum irisin levels in cancer patients, a few studies have shown the opposite. Similarly, the majority of studies have found increased levels of irisin in cancer tissues, with a few studies showing the opposite trend. Clearly, further investigations are required to determine the exact role of irisin in cancer. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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30 pages, 1477 KiB

Open AccessReview

Physical Activity as an Imperative Support in Breast Cancer Management

by Miguel A. Ortega, Oscar Fraile-Martínez, Cielo García-Montero, Leonel Pekarek, Luis G. Guijarro, Alejandro J. Castellanos, Lara Sanchez-Trujillo, Natalio García-Honduvilla, Melchor Álvarez-Mon, Julia Buján, Álvaro Zapico, Guillermo Lahera and Miguel A. Álvarez-Mon

Cancers 2021, 13(1), 55; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13010055 - 28 Dec 2020

Cited by 20 | Viewed by 5687

Abstract

Breast cancer (BC) is the most common malignancy and the second cause of cancer-related death among women. It is estimated that 9 in 10 cases of BC are due to non-genetic factors, and approximately 25% to 30% of total breast cancer cases should be preventable only by lifestyle interventions. In this context, physical activity represents an excellent and accessible approach not only for the prevention, but also for being a potential support in the management of breast cancer. The present review will collect the current knowledge of physical activity in the background of breast cancer, exploring its systemic and molecular effects, considering important variables in the training of these women and the evidence regarding the benefits of exercise on breast cancer survival and prognosis. We will also summarize the various effects of physical activity as a co-adjuvant therapy in women receiving different treatments to deal with its adverse effects. Finally, we will reveal the impact of physical activity in the enhancement of quality of life of these patients, to conclude the central role that exercise must occupy in breast cancer management, in an adequate context of a healthy lifestyle. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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Other

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18 pages, 2895 KiB

Open AccessSystematic Review

Supervised and Non-Supervised Exercise Programs for the Management of Cancer-Related Fatigue in Women with Breast Cancer: A Systematic Review and Meta-Analysis

by Gonzalo Reverte-Pagola, Horacio Sánchez-Trigo, John Saxton and Borja Sañudo

Cancers 2022, 14(14), 3428; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14143428 - 14 Jul 2022

Cited by 5 | Viewed by 2268

Abstract

Physical exercise is considered to be a non-pharmacological strategy for reducing symptoms of cancer-related fatigue (CRF) in women with breast cancer (BC). This systematic review and meta-analysis aims to assess the effects of non-supervised exercise programs in comparison with the effects of supervised exercise interventions for CRF in BC patients. Randomized controlled trials that investigated the effect of exercise on CRF in women were searched for until 29 June 2022. Inclusion criteria comprised women diagnosed with BC; exercise-based interventions; trials comparing at least one exercise group vs. a control group; trials that assessed exercise effects on CRF. Thirty-one studies met the inclusion criteria (n = 2964). Both non-supervised and supervised exercise programs significantly reduced CRF (standard mean difference (SMD) = −0.46, confidence interval (CI) = (−0.64, −0.28), p < 0.0001 and SMD = −0.74, CI = (−0.99, −0.48), p < 0.0001, respectively), without statistical difference (p = 0.09). However, a short-term training program subgroup analyses showed significant differences between supervised and non-supervised training programs (p = 0.01), showing that supervised training programs have a greater effect (SMD = −1.33, CI = (−1.92, −0.73), p < 0.0001) than non-supervised ones (SMD = −0.44, CI = (−0.78, −0.11), p = 0.009). Both supervised and non-supervised exercise programs may reduce CRF in BC patients; however, in the short-term, supervised exercise may have a greater effect on CRF in BC patients. Full article

(This article belongs to the Special Issue The Mechanisms of Physical Activity, Diet, and Body Composition in Cancer Prevention and Control)

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