Exercise and Cancer Survivorship (eBook)

Impact on Health Outcomes and Quality of Life

Amanda Daley, John Saxton (Herausgeber)

eBook Download: PDF

2010 | 2010
XVI, 244 Seiten
Springer New York (Verlag)
978-1-4419-1173-5 (ISBN)

Infos

An increasing number of exercise scientists are applying their skills collaboratively (with medics and physiotherapists) to clinical populations and investigating the effects of exercise in relation to wide-ranging clinical, pathophysiological and psycho-social outcomes.

The book is aimed at final year Undergraduate and Master's level students of Exercise Science, who are interested in working with clinical populations such as cancer patients. Many university Sport and Exercise Science courses in the UK and USA now have modules which are focused on exercise for health, and cover aspects of exercise science which are appropriate for clinical populations. The book would also be a very valuable resource for Undergraduate and Postgraduate Physiotherapy courses and a very useful resource for students of Exercise Science and Physiotherapy, as well as practitioners working with cancer patients.There are an increasing amount of research opportunities for exercise scientists who are interested in working with clinical populations. Furthermore, a considerable amount of Government and Charity research funding is being targeted at active lifestyles and this is helping to generate a new culture of collaboration between exercise scientists and medics. Hence, it is highly likely that an increasing number of students from Sport and Exercise Science courses will pursue careers within the clinical realm in the future. Practicing exercise therapists, clinical exercise physiologists and physiotherapists would also find lots of useful up-to-date knowledge to support their evidence-based clinical practice. This book would also be of interest to informed readers who are themselves undergoing or recovering from cancer treatment.

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An increasing number of exercise scientists are applying their skills collaboratively (with medics and physiotherapists) to clinical populations and investigating the effects of exercise in relation to wide-ranging clinical, pathophysiological and psycho-social outcomes. This book would be a very useful resource for students of Exercise Science and Physiotherapy, as well as practitioners working with cancer patients.The book is aimed at final year Undergraduate and Master's level students of Exercise Science, who are interested in working with clinical populations such as cancer patients. Many university Sport and Exercise Science courses in the UK and USA now have modules which are focused on exercise for health, and cover aspects of exercise science which are appropriate for clinical populations. The book would also be a very valuable resource for Undergraduate and Postgraduate Physiotherapy courses. There are an increasing amount of research opportunities for exercise scientists who are interested in working with clinical populations. Furthermore, a considerable amount of Government and Charity research funding is being targeted at active lifestyles and this is helping to generate a new culture of collaboration between exercise scientists and medics. Hence, it is highly likely that an increasing number of students from Sport and Exercise Science courses will pursue careers within the clinical realm in the future. Practicing exercise therapists, clinical exercise physiologists and physiotherapists would also find lots of useful up-to-date knowledge to support their evidence-based clinical practice. This book would also be of interest to informed readers who are themselves undergoing or recovering from cancer treatment. This means that the potential market in the UK, USA and other English-speaking nations is huge. Here is a list of the books currently in use in these courses:ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities (American College of Sport Medicine).ACSM's Resources for Clinical Exercise Physiology (American College of Sport Medicine).Clinical Exercise Physiology, Edited by Ehrman JK, Gordon PM, Visich PS, Keteyian SJ. (Human Kinetics). Clinical Exercise Physiology: Applications and Physiological Principles, edited by LeMura LM, von Dullivard SP (Lippincott, Williams and Wilkins).Clinical Exercise Testing and Prescription, Edited by Roberts SO, Robergs RA, Hanson P (CRC Press, LLC).

Inhalt

Foreword 5
Contents 7
Contributors 9
List of Abbreviations 12
1 Introduction 15
1.1 The Burden of Cancer 15
1.2 Stages of the Cancer Experience 17
1.3 Exercise and the Cancer Survivor 19
1.3.1 Cancer as a 'Teachable Moment' 19
1.3.2 Health Benefits of Exercise 19
1.3.3 Exercise Terminology 20
1.3.4 Exercise Guidelines for Cancer Survivors 22
1.4 Levels of Evidence 23
1.4.1 General Overview 23
1.4.2 Observational Studies 23
1.4.3 Qualitative Studies 24
1.4.4 Randomized Controlled Trials 24
1.5 DoseResponse Issues 25
1.6 Aims of This Book 27
References 28
2 Exercise and Cancer-Related Fatigue Syndrome 30
2.1 Introduction 30
2.1.1 Incidence of Cancer-Related Fatigue 31
2.1.2 Etiology of Cancer-Related Fatigue 31
2.1.3 Conceptual Framework for the Study of Cancer-Related Fatigue 31
2.2 Assessment of Cancer-Related Fatigue 32
2.2.1 Clinical Syndrome of Cancer-Related Fatigue 32
2.2.2 Cancer-Related Fatigue-Specific Measurement Instruments 32
2.3 Management Strategies For Cancer-Related Fatigue 35
2.3.1 Pharmacological Interventions 35
2.3.2 Psychosocial Interventions 35
2.3.3 Exercise Interventions 36
2.3.3.1 Breast Cancer 39
2.3.3.2 Prostate Cancer 39
2.3.3.3 Hematopoietic Stem Cell Transplantation (HSCT) 39
2.3.3.4 Advanced Cancer 40
2.3.4 Combined Interventions for Cancer-Related Fatigue 40
2.4 Special Considerations for Exercise Testing and Programming 41
2.4.1 Screening for Exercise Participation 41
2.4.2 Exercise Testing 42
2.4.3 Exercise Programming 42
2.4.3.1 Prescription Considerations for Patients with Poor Functional Capacity 43
2.4.3.2 Intermittent or Interval Exercise Training 43
2.4.3.3 Muscular Fitness Training 44
2.4.3.4 The Training Index 44
2.4.3.5 Pacing 45
2.5 Summary and Conclusions 45
References 46
3 Exercise as an Intervention During Breast Cancer Treatment 50
3.1 Introduction 50
3.1.1 Impact of Breast Cancer Treatment 50
3.1.2 Physical Activity Behaviours 51
3.2 The Evidence Base for Exercise: A Systematic Review 52
3.2.1 Methods of the Systematic Review 53
3.2.2 Description of Studies 54
3.2.3 Effects 55
3.2.3.1 Physical and Mental Health 55
3.2.3.2 Adverse Events 56
3.2.4 Exercise Adherence and Maintenance 57
3.2.5 Quality of the Evidence 59
3.2.6 Applicability of the Evidence to the Breast Cancer Population 60
3.2.7 Implications for Research 60
3.3 Implementation and Dissemination 61
3.4 Summary 62
References 62
4 Exercise After Treatment for Breast Cancer: Effects on Quality of Life 65
4.1 Introduction 65
4.1.1 Incidence and Survival from Breast Cancer 65
4.1.2 Consequences of Breast Cancer 66
4.1.3 Psychological and Psychosocial Interventions 66
4.2 The Potential Role of Exercise After Treatment for Breast Cancer 66
4.3 Chapter Overview 67
4.4 Is Exercise an Effective Quality of Life Intervention After Treatment for Breast Cancer? Summary of the Evidence 67
4.4.1 Setting the Scene: Early Intervention Studies 68
4.4.2 The 'Boom' Years 68
4.4.2.1 Trials of Supervised Aerobic Exercise 68
4.4.2.2 Weight Training and Resistance-Based Exercise Interventions 70
4.4.2.3 Combined Aerobic Exercise and Resistance Training Interventions 71
4.4.2.4 Pragmatic Home-Based Exercise Interventions 72
4.4.2.5 Alternative Modes of Exercise 75
4.4.2.6 Exercise Versus Other QoL Interventions 75
4.5 Reviews and Meta-analyses 76
4.6 Whats It Like? Cancer Survivors Experiences of Exercise 76
4.7 What Next? 78
4.8 Summary and Conclusions 79
References 80
5 The Importance of Controlling Body Weight After a Diagnosis of Breast Cancer: The Role of Diet and Exercise in Breast Cancer Patient Management 85
5.1 Trends in Breast Cancer Incidence and Mortality 85
5.2 Current Recommended Treatments 86
5.3 The Problem of Excess Body Weight in Breast Cancer Patients 86
5.3.1 Prevalence of Overweight and Obesity Amongst Breast Cancer Patients 86
5.3.2 Weight Gain After a Diagnosis of Breast Cancer 87
5.3.3 Impact of Obesity and Weight Gain on Breast Cancer Recurrence and Breast Cancer-Specific Mortality 89
5.3.4 The Effects of Weight Gain and Weight Loss After Diagnosis 90
5.3.5 Effects of Obesity on Prognosis in Women Receiving Adjuvant Endocrine Therapy 90
5.3.6 Effects of Obesity on Prognosis in Women Receiving Adjuvant Chemotherapy 91
5.3.7 Effects of Obesity on Prognosis in Women with Metastatic Breast Cancer 91
5.3.8 Obesity and Contra-Lateral Breast Cancer 91
5.3.9 The Effect of Central Obesity and Insulin Resistance on Prognosis 92
5.4 Body Weight and Lymphoedema 92
5.5 Obesity-Related Co-morbidities in Breast Cancer Patients 93
5.6 Interventions for Weight Control Amongst Breast Cancer Patients 94
5.6.1 Diet and Exercise Interventions 94
5.6.2 Diet and Exercise Recommendations for Breast Cancer Patients 95
5.6.3 Delivery of Weight-Management Programs for Breast Cancer Patients 96
5.6.4 Pharmacotherapy 97
5.6.5 Monitoring Patients in Weight-Loss Interventions 98
5.7 Weight Loss and Bone Health 98
5.8 Weight Loss and Quality of Life 98
5.9 What Advice Do Patients Want About Diet and Weight Control? 99
5.10 HealthCare Professional Survey: Current Roles and Attitudes to Delivering Diet, Exercise and Weight Control Advice to Early Breast Cancer Patients 101
5.10.1 Current Practice 101
5.10.2 Beliefs 101
5.11 Summary and Conclusions 102
References 103
6 The Biological Mechanisms by Which Physical Activity Might Have an Impact on Outcome/Prognosis After a Breast Cancer Diagnosis 109
6.1 Introduction 109
6.2 Physical Activity and Breast Cancer Survival 110
6.3 Biological Mechanisms by Which Physical Activity May Impact upon Breast Cancer Survival 111
6.3.1 Obesity and Weight Gain 111
6.3.2 Fasting Insulin and Insulin-Like Growth Factor Levels 113
6.3.3 Sex Hormones 115
6.3.4 Adipokines 117
6.3.5 Inflammation 118
6.4 Other Potential Mechanisms Mediating an Effect Between Physical Activity and Breast Cancer Survival 120
6.5 Summary and Conclusions 120
References 121
7 Exercise After Prostate Cancer Diagnosis 124
7.1 Introduction 124
7.1.1 Screening 125
7.1.2 Tumor, Node, Metastasis Staging 125
7.1.3 Histopathological Grading 125
7.1.4 Treatment 126
7.2 Exercise and Prostate Cancer Prevention 127
7.2.1 Mechanisms of Prevention 128
7.3 Exercise Post-diagnosis of Prostate Cancer 128
7.3.1 Exercise for Early Stage, Localized Disease 129
7.3.1.1 Radical Prostatectomy 129
7.3.1.2 Radiation Therapy 138
7.3.2 Exercise for Locally Advanced and Hormone-Sensitive Metastatic Disease 139
7.3.3 Exercise for Hormone-Refractory Metastatic Disease 142
7.4 Limitations of Current Research 143
7.5 Future Directions for Exercise and Prostate Cancer Research 144
7.6 Exercise Recommendations 144
7.7 Summary and Conclusions 145
References 146
8 Exercise for Prevention and Treatment of Prostate Cancer: Cellular Mechanisms 151
8.1 Introduction 151
8.2 Possible Mechanisms for the Value of Exercise 153
8.2.1 Tumor Growth and Apoptosis 153
8.2.2 Angiogenesis, Invasion, and Metastasis 158
8.3 Summary and Conclusions 159
9 Physical Activity Before and After Diagnosis of ColorectalCancer 163
9.1 Introduction 163
9.2 Physical Activity and the Risk of Colorectal Cancer 165
9.2.1 Dose--Response 166
9.3 Physical Activity, Recurrence of and Survival from Colorectal Cancer 166
9.3.1 Quality of Life Issues 169
9.3.2 Co-morbidities 169
9.4 Physical Activity, Response Pathways and Biomarkers of Colorectal Cancer 170
9.4.1 Gastrointestinal Transit-Time 170
9.4.2 Chronic Inflammation 170
9.4.3 Immune Function 172
9.4.4 Insulin 173
9.4.4.1 Insulin-Like Growth Factor 173
9.4.5 Genetic Mutations 174
9.4.6 Obesity 175
9.5 Summary and Conclusions 176
References 176
10 Exercise-Based Rehabilitation in Patients with Lung Cancer 183
10.1 Introduction 183
10.2 Classification of Lung Cancer 184
10.3 Presenting Symptoms of Lung Cancer 184
10.4 Diagnosis and Staging of Lung Cancer 184
10.5 Medical Treatment of Lung Cancer 185
10.5.1 NSCLC Treatment for Early Stage and Localised Disease 185
10.5.2 Treatment for Loco-Regional Advanced Disease 185
10.5.3 Treatment for Advanced and Metastatic Disease 186
10.5.4 Treatment of Small Cell Lung Cancer 186
10.6 Pulmonary Rehabilitation 186
10.6.1 Rationale for Pulmonary Rehabilitation in Lung Cancer Patients 187
10.6.1.1 Pre-operative Exercise Intolerance 187
10.6.1.2 Peri- and Post-operative Exercise Intolerance 188
10.6.1.3 Peri- and Post-operative Quality of Life 189
10.6.2 Evidence for the Impact of Exercise Rehabilitation Before Surgical Treatment 189
10.6.3 Evidence for the Impact of Exercise Rehabilitation After Surgical Treatment 190
10.6.3.1 Conventional Exercise Modalities 190
10.6.3.2 Neuromuscular Electrical Stimulation 192
10.7 Future Recommendations 193
10.8 Summary and Conclusions 193
References 194
11 Exercise and Cancer Mortality 198
11.1 Introduction 199
11.2 Evidence from Prospective Cohort Studies 200
11.3 Cardiopulmonary Fitness, Physical Activity and Overall Cancer Mortality in Initially Healthy Individuals 201
11.3.1 Is Cardiopulmonary Fitness Associated with the Risk of Future Cancer Mortality? 201
11.3.2 Is Physical Activity Associated with the Risk of Future Cancer Mortality? 202
11.4 Pre-diagnosis Physical Activity and Mortality in Breast and Colorectal Cancer Survivors 203
11.5 Post-diagnosis Physical Activity and Mortality in Breast and Colorectal Cancer Survivors 206
11.5.1 Breast Cancer Survivors 207
11.5.2 Colorectal Cancer Survivors 210
11.6 Does Physical Activity Have a Role in Prostate Cancer Mortality? 212
11.7 Physical Activity and Cardiovascular Mortality in Prostate Cancer Patients 215
11.8 Summary and Conclusions 215
References 217
12 Ready to Change Lifestyle? The Feasibility of Exercise Interventions in Cancer Patients 220
12.1 Introduction 220
12.2 Physical Activity Recommendations 221
12.3 Group Exercise 222
12.4 Home Exercise 222
12.5 Long-Term Behaviour Change 222
12.6 Physical Activity Barriers 224
12.7 Advanced Cancer Patients 225
12.8 Risks 225
12.9 Summary and Conclusions 226
References 226
13 Cardiorespiratory Exercise Testing in Adult Cancer Patients 231
13.1 Introduction 231
13.2 Exercise Testing Methodology in Adult Cancer Patients 232
13.2.1 Pre-test Procedures 232
13.2.2 Exercise Testing Modality 232
13.2.2.1 Purpose 234
13.2.2.2 Setting 235
13.2.2.3 Patient Population 236
13.2.3 Exercise Testing Safety 236
13.2.3.1 Eligibility Criteria 237
13.2.3.2 Exercise Test Conduct/Methodology 238
13.3 Exercise Test Results Reporting 240
13.4 Summary and Conclusions 241
References 241
Subject Index 245

Produkt-Details

• Erscheint lt. Verlag: 8.1.2010
• Zusatzinfo: XVI, 244 p.
• Verlagsort: New York
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Onkologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Pharmakologie / Pharmakotherapie
• Themenwelt: Medizin / Pharmazie ► Studium
• Schlagworte: fatigue • Fitness • Physiology • physiotherapy • Rehabilitation • Transplantation
• ISBN-10: 1-4419-1173-1 / 1441911731
• ISBN-13: 978-1-4419-1173-5 / 9781441911735