Sport und Bewegung mit und nach Krebs – wer profitiert, was ist gesichert?

Zusammenfassung

Die Diagnose „Krebs“ und die anschließende medizinische Therapie verleiten viele Patienten dazu ihre körperlichen Aktivitäten einzuschränken. Doch gerade Sport und bewegungstherapeutische Programme sind effektive supportive Maßnahmen im Kampf gegen den Krebs und manche Nebenwirkungen. Zudem haben die Betroffenen eine einzigartige Chance, selbst aktiv an ihrem Genesungsprozess mitzuarbeiten. Was zu berücksichtigen ist, zeigt dieser Beitrag.

Abstract

A growing number of literature reports positive effects of physical activity and exercise. These effects concern prevention, mortality and progress of cancer. Furthermore they show a reduction of disease- and treatment-specific side effects, which implies a better patients’ quality of life. Evidence shows a decreased mortality risk in patients with physically active cancer of colon, breast, ovaries and prostate. Activity recommendations for patients with cancer do not differ from those for healthy persons. However, a decrease in physical activity can be observed in many cancer patients after diagnosis, and this fact concludes to a reduced physical capacity – although just physical capacity helps to overcome the burden of medical treatment and to recover. In fact, tailored exercise programs can counteract a decrease in physical capacity successfully. Further they reduce side effects such as fatigue, incontinence and lymphedema. Moreover, first studies report a positive influence on: chemotherapy-induced polyneuropathies, cancer-related cognitive impairments, bone health and sleep. Finally, an enormous number of investigations showed that exercise interventions can improve psychosocial factors (e. g. mood and self-esteem).

Except for very few conditions, such as extremely impaired blood cell counts and days when cardio- or nephrotoxic drugs are given, physical activity should be recommended. Especially during medical treatment, physicians and therapists are prompted to interact closely in order to prevent general activity prohibitions. Physical activity and exercise programs represent a unique and low-cost chance for cancer patients to influence the course of their own disease positively. More effort is necessary to improve professional activity offers for cancer patients and survivors and to specify activity recommendations.

Schlüsselwörter

Sport - Bewegung - Krebs - Überleben - Nebenwirkungen

Key words

exercise - physical activity - cancer - survival - side effects

• Literatur

• 1 Leitzmann M, Powers H, Anderson AS. et al. European Code against Cancer 4th Edition: Physical activity and cancer. Cancer Epidemiol 2015; 39: S46-S55 doi:10.1016/j.canep.2015.03.009
• 2 Cormie P, Zopf EM, Zhang X. et al. The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiol Rev 2017; 39: 71-92 doi:10.1093/epirev/mxx007
• 3 Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol 2014; 25: 1293-1311 doi:10.1093/annonc/mdu012
• 4 Hojman P. Exercise protects from cancer through regulation of immune function and inflammation. Biochem Soc Trans 2017; 45: 905-911 doi:10.1042/bst20160466
• 5 Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2008; DOI: 10.1002/14651858.CD006145.pub2.
• 6 Mustian KM, Alfano CM, Heckler C. et al. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol 2017; 3: 961-968 doi:10.1001/jamaoncol.2016.6914
• 7 Schmidt ME, Wiskemann J, Armbrust P. et al. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: A randomized controlled trial. Int J Cancer 2015; 137: 471-480 doi:10.1002/ijc.29383
• 8 Steindorf K, Schmidt ME, Klassen O. et al. Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 2014; 25: 2237-2243 doi:10.1093/annonc/mdu374
• 9 Baumann FT, Zopf EM, Bloch W. Clinical exercise interventions in prostate cancer patients–a systematic review of randomized controlled trials. Support Care Cancer 2012; 20: 221-233 doi:10.1007/s00520-011-1271-0
• 10 Centemero A, Rigatti L, Giraudo D. et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomized controlled study. Eur Urol 2010; 57: 1039-1043 doi:10.1016/j.eururo.2010.02.028
• 11 Rogan S, Taeymans J, Luginbuehl H. et al. Therapy modalities to reduce lymphoedema in female breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat 2016; 159: 1-14 doi:10.1007/s10549-016-3919-4
• 12 Streckmann F, Zopf EM, Lehmann HC. et al. Exercise intervention studies in patients with peripheral neuropathy: a systematic review. Sports Med 2014; 44: 1289-1304 doi:10.1007/s40279-014-0207-5
• 13 Zimmer P, Baumann FT, Oberste M. et al. Effects of exercise interventions and physical activity behavior on cancer related cognitive impairments: a systematic review. BioMed Research Int 2016; 2016: 1820954 doi:10.1155/2016/1820954
• 14 Fornusek CP, Kilbreath SL. Exercise for improving bone health in women treated for stages I-III breast cancer: a systematic review and meta-analyses. J Cancer Surviv 2017; 11: 525-541 doi:10.1007/s11764-017-0622-3
• 15 Steindorf K, Wiskemann J, Ulrich CM. et al. Effects of exercise on sleep problems in breast cancer patients receiving radiotherapy: a randomized clinical trial. Breast Cancer Res Treat 2017; 162: 489-499 doi:10.1007/s10549-017-4141-8
• 16 Buffart LM, Kalter J, Sweegers MG. et al. Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev 2017; 52: 91-104 doi:10.1016/j.ctrv.2016.11.010
• 17 Mishra SI, Scherer RW, Snyder C. et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. The Cochrane Database Syst Rev 2012; 8: CD008465 doi:10.1002/14651858.CD008465.pub2
• 18 Mishra SI, Scherer RW, Geigle PM. et al. Exercise interventions on health-related quality of life for cancer survivors. The Cochrane Database Syst Rev 2012; 8: CD007566. doi:10.1002/14651858.CD007566.pub2
• 19 Schmitz KH, Courneya KS, Matthews C. et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010; 42: 1409-1426 doi:10.1249/MSS.0b013e3181e0c112
• 20 Winningham ML, MacVicar MG, Burke CA. Exercise for cancer patients: guidelines and precautions. Phys Sportsmed 1986; 14: 125-134 doi:10.1080/00913847.1986.11709201
• 21 Elter T, Stipanov M, Heuser E. et al. Is physical exercise possible in patients with critical cytopenia undergoing intensive chemotherapy for acute leukaemia or aggressive lymphoma?. Int J Hematol 2009; 90: 199-204 doi:10.1007/s12185-009-0376-4
• 22 Riemann JF, Ebert M. Positionspapier: Sport (Bewegung) und (Darm-)Krebs. Forum 2017; 32: 187-191 doi:10.1007/s12312-017-0250