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Deutsche Zeitschrift für Onkologie 2018; 50(04): 158-162
DOI: 10.1055/a-0635-2899
Forschung
© Georg Thieme Verlag KG Stuttgart · New York

Ernährung und Bewegung: Die Bedeutung der Lebensführung für Krebs

Diet and Exercise: The Importance of Living for Cancer
Ulrich R. Kleeberg
1   Hämatologisch Onkologische Praxis Altona, Hamburg,Zentrum Ambulante Onkologie im Struenseehaus
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Publication History

Publication Date:
07 January 2019 (online)

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Zusammenfassung

Die Lebensumstände (exogene Faktoren), Konstitution und Alter sind entscheidend für die Inzidenz und Progredienz maligner Erkrankungen. Sozio-ökonomische Faktoren beeinflussen die Lebensführung maßgeblich, Übergewicht und Trägheit fördern malignes Wachstum. Wachstumsfaktoren (WF) exokrin (Wirt) & autokrin (Tumor) promovieren Krebs, Fettgewebe und Muskulatur sind aktive endokrine Organe: Weißes Fettgewebe (WAT) ist Hauptproduzent tumor-stimulierender, inflammatorischer WF. Die Bildung dieser WF wird durch Bewegung gemindert, wodurch Krebswachstum gehemmt wird.

Körperliche Aktivität und Reduktion von Übergewicht wirken antientzündlich. Gewichtsabnahme bei Übergewicht mindert Krebsinzidenz und -progredienz. Bewegung und Ernährung beeinflussen die Prognose signifikant. Gesundheitspolitik hat die Verpflichtung zu konzertierten präventiven Initiativen. Lebensführung ist die zentrale Aufgabe tertiärer Prävention für Nachsorge, gemäß dem modernen Konzept zu Survivorship. Entscheidend sind nachhaltige Anleitungen zu täglicher Bewegung von wöchentlich mindestens 3 bis 5 Stunden, entsprechend 9 metabolisch äquivalenten Aufgaben (MET) und einer obst- und gemüsereichen sowie fett- und fleischarmen Ernährung.

Abstract

The way of life, and living conditions as exogenous factors, as well as the physical condition, and age are critical for the incidence and progression of cancer. Also, socioeconomic factors affect the way of life considerably, overweight and physical inertia promote neoplastic growth. Growth factors (GF), exocrine produced by the host, and autocrine by the tumor itself, both promote cancer. White adipose tissue (WAT) and the muscular system are active glandular structures: WAT is the main producer of tumor-stimulating, inflammatory GF. Physical movement to the contrary diminishes these pro-neoplastic GF, thereby inhibiting tumor growth.

Physical activity and the reduction of overweight are effective in neutralizing inflammatory processes. Weight loss in overweight people decreases cancer incidence and progression, physical activity and diet are critical for the prognoses to a significant degree. Health policy is obligated to concerted initiatives in prevention. To improve the way of life is the central task for tertiary prevention according to the modern concept of survivorship. Crucial are the enduring guidance in daily physical activity, three to five hours at least, equivalent to 9 metabolic tasks (MET), and a well-balanced diet rich in fruit and vegetables, with low meat and fat content.

Schlüsselwörter

Mammakarzinom - körperliche Aktivität - Ernährung - Insulin - Insulin-artige Wachstumsfaktoren (IGF) - Komplementärmedizin

Key words

Breast carcinoma - physical activity - nutrition - insulin - insulin-like growth factors (IGF) - complementary medicine
 

  • Literatur

  • 1 Pitt JM, Marabelle A, Eggermont A. et al. Targeting the tumor microenvironment: removing obstruction to anticancer immune responses and immunotherapy. Ann Oncol 2016; 27: 1482-1492
    CrossrefPubMedSearch in Google Scholar
  • 2 Jones LW. Precision oncology framework for investigation of exercise as treatment for cancer. J Clin Oncol 2015; 33: 4134-4137
    CrossrefPubMedSearch in Google Scholar
  • 3 Völzke H, Itterman T, Schmidt CO. et al. Ostdeutsche leben heute gesünder. Dtsch Ärztebl 2015; 112: 185-192
    PubMedSearch in Google Scholar
  • 4 Renehan AG, Tyson M, Egger M. et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008; 371: 569-578
    CrossrefPubMedSearch in Google Scholar
  • 5 Lauby-Secretan B, Scoccianti C, Loomis D. et al. Body fatness and cancer – viewpoint of the IARC Working Group. N Engl J Med 2016; 375: 794-798
    CrossrefPubMedSearch in Google Scholar
  • 6 Calle EE, Rodriguez E, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348: 1625-1638
    CrossrefPubMedSearch in Google Scholar
  • 7 Hung RJ, Ulrich CM, Gode EL. et al. Cross cancer genomic investigation of inflammation pathway for five common cancers: lung, ovary, prostate, breast, and colorectal cancer. J Natl Cancer Inst 2015; 107: 1-10
    CrossrefPubMedSearch in Google Scholar
  • 8 Iyengar NM, Gucalp A, Dannenberg AJ, Hudis CA. Obesity and cancer mechanisms: tumor microenvironment and inflammation. J Clin Oncol 2016; 34: 4270-4276
    CrossrefPubMedSearch in Google Scholar
  • 9 Hopkins BD, Goncalves MD, Cantley LC. Obesity and cancer mechanisms: cancer metabolism. J Clin Oncol 2016; 34: 4277-4283
    CrossrefPubMedSearch in Google Scholar
  • 10 Lohmann AE, Goodwin PJ, Chlebowski RT. et al. Association of obesity-related metabolic disruptions with cancer risk and outcome. J Clin Oncol 2016; 34: 4249-4255
    CrossrefPubMedSearch in Google Scholar
  • 11 Onstad MA, Schmandt RE, Lu KH. Adressing the role of obesity in endometrial cancer risk, prevention, and treatment. J Clin Oncol 2016; 34: 4225-4230
    CrossrefPubMedSearch in Google Scholar
  • 12 Laird BJ, Fallon M, Hjermstad MJ. et al. Quality of life in patients with advanced cancer: differential association with performance status and systemic inflammatory response. J Clin Oncol 2016; 34: 2769-2775
    CrossrefPubMedSearch in Google Scholar
  • 13 Claussnitzer M, Dankel SN, Kim KH. et al. FTO obesity variant circuitry and adipocyte browning in humans. N Engl J Med 2015; 373: 895-907
    CrossrefPubMedSearch in Google Scholar
  • 14 Sinha G. Homing in on the fat and cancer connection. JNCI 2012; 104: 966-968
    PubMedSearch in Google Scholar
  • 15 Pedersen L, Idorn M, Olofsson GH. et al. Voluntary running suppresses tumor growth through epinephrine- and Il6 – dependent NK cell mobilization and redistribution. Cell Metab 2016; 23: 554-562
    CrossrefPubMedSearch in Google Scholar
  • 16 Garatachea N, Santos-Lozano A, Sanchis-Gomar F. et al. Elite athletes live longer than the general population: A metaanalysis. Mayo Clin Proc 2014; 89: 1195-1200
    CrossrefPubMedSearch in Google Scholar
  • 17 Otto S. Präventive körperliche Aktivität. Geburtshilfe Frauenheilkd 2016; 76: 23-25
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Vogelstein B, Kinzler KW. The path to cancer: Three strikes and you are out. N Engl J Med 2015; 373: 1895-1896
    CrossrefPubMedSearch in Google Scholar
  • 19 Pedersen BK. A muscular twist on the fate of fat. N Engl J Med 2012; 366: 1544-1546
    CrossrefPubMedSearch in Google Scholar
  • 20 Hojman P, Dethlefsen C, Brandt C. et al. Exercise-induced muscle-derived cytokines inhibit mammary cancer cell growth. Am J Physiol Endocrinol Metab 2011; 301: E504-E510
    CrossrefPubMedSearch in Google Scholar
  • 21 Lucia A, Ramírez M. Muscling in on cancer. N Engl J Med 2016; 375: 892-894
    CrossrefPubMedSearch in Google Scholar
  • 22 Basaria S, Bhasin S. Targeting the skeletal muscle-metabolism axis in prostate-cancer therapy. N Engl J Med 2012; 367: 965-967
    CrossrefPubMedSearch in Google Scholar
  • 23 Sanchis-Gomar F. The skeletal muscle-metabolism axis in prostate-cancer therapy. N Engl J Med 2012; 367: 2257-2258
    CrossrefPubMedSearch in Google Scholar
  • 24 Khan S, Shukla S, Sinha S, Meeran SM. Role of adipokines and cytokines in obesity-associated breast cancer: therapeutic targets. Cytokine Growth Factor Rev 2013; 24: 503-513
    CrossrefPubMedSearch in Google Scholar
  • 25 van Gemert WA, May AM, Schuit AJ et al. Effect of weight loss with or without exercise on inflammatory markers and adipokines in postmenopausal women: the SHAPE-2 Trial. A randomized controlled trial. Cancer Epidemiol Biomarkers Prev 2016 pii: cebp.1065.2015
    PubMed
  • 26 De Simone V, Franzè E, Ronchetti G. et al. Th17-type cytokines, IL-6 and TNF-α synergistically activate STAT3 and NF-kB to promote colorectal cancer cell growth. Oncogene 2015; 34: 3493-3503
    CrossrefPubMedSearch in Google Scholar
  • 27 Neilson HK, Friedenreich CM, Brockton NT, Millikan RC. Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev 2009; 18: 11-27
    CrossrefPubMedSearch in Google Scholar
  • 28 Thompson HJ, Sedlacek SM, Wolfe P. et al. Impact of weight loss on plasma leptin and adiponectin in overweight-to-obese post menopausal breast cancer survivors. Nutrients 2015; 7: 5156-5176
    CrossrefPubMedSearch in Google Scholar
  • 29 Gebhardt C, Riehl A, Durchdewald M. et al. RAGE signaling sustains inflammation and promotes tumor development. J Exp Med 2008; 205: 275-285
    CrossrefPubMedSearch in Google Scholar
  • 30 Dougan M, Dranoff G. Inciting inflammation: the RAGE about tumor promotion. J Exp Med 2008; 205: 267-270
    CrossrefPubMedSearch in Google Scholar
  • 31 Chlebowski RT. Obesity and breast cancer outcome. J Clin Oncol 2011; 29: 126-127
    PubMedSearch in Google Scholar
  • 32 Chlebowski RT, Pettinger M, Stefanick ML. et al. Insulin, physical activity, and caloric intake in postmenopausal women: breast cancer implications. J Clin Oncol 2004; 22: 4507-4513
    CrossrefPubMedSearch in Google Scholar
  • 33 Meyerhardt JA, Sato K, Niedzwiecki D. et al. Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: Findings from CALGB 89803. J Natl Cancer Inst 2012; 104: 1702-1711
    CrossrefPubMedSearch in Google Scholar
  • 34 Llanos AA, Krok JL, Peng J. et al. Effects of a walking intervention using mobile technology and interactive voice response on serum adipokines among postmenopausal women at increased breast cancer risk. Horm Cancer 2014; 5: 98-103
    CrossrefPubMedSearch in Google Scholar
  • 35 Abbenhardt C, McTiernan A, Alfano CM. et al. Effects of individual and combined dietary weight loss and exercise interventions in postmenopausal women on adiponectin and leptin levels. J Intern Med 2013; 274: 163-175
    CrossrefPubMedSearch in Google Scholar
  • 36 Ligibel J. Life style factors in cancer survivorship. J Clin Oncol 2012; 30: 3697-3704
    CrossrefPubMedSearch in Google Scholar
  • 37 Shlomai G, Neel B, LeRoith D, Gallagher EJ. Type 2 diabetes mellitus and cancer: the role of pharmacotherapy. J Clin Oncol 2016; 34: 4261-4269
    CrossrefPubMedSearch in Google Scholar
  • 38 Keum N, Greenwood DC, Lee DH. et al. Adult weight gain and adiposity-related cancers: A dose-response meta-analysis of prospective observational studies. J Natl Cancer Inst 2015; 107: djv088
    PubMedSearch in Google Scholar
  • 39 Boffetta P, Couto E, Wichmann J. et al. Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 2010; 102: 529-537
    CrossrefPubMedSearch in Google Scholar
  • 40 Pierce JP, Stefanick ML, Flatt SW. et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol 2007; 25: 2345-2351
    CrossrefPubMedSearch in Google Scholar
  • 41 Campbell KL, Foster-Schubert KE, Alfano CM. et al. Reduced-calorie dietary weight loss, exercise, and sex hormones in postmenopausal women: randomized controlled trial. J Clin Oncol 2012; 30: 2314-2326
    CrossrefPubMedSearch in Google Scholar