TARGETED EXERCISE PRESCRIPTION FOR SPECIFIC CANCERS AND TREATMENT SIDE EFFECTS

Transcription

1 TARGETED EXERCISE PRESCRIPTION FOR SPECIFIC CANCERS AND TREATMENT SIDE EFFECTS Presented by: Robert U. Newton, PhD, FESSA, AEP University of Queensland Centre for Clinical Research

2 PHYSICAL ACTIVITY AND EXERCISE World Health Organisa2on defines physical ac2vity as any bodily movement produced by skeletal muscles that requires energy expenditure. WHO is explicit that the term physical ac2vity should not be used interchangeably with exercise.

3 EXERCISE Exercise, is a subcategory of physical ac2vity that is planned, structured, repe22ve, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objec2ve.

4 EXERCISE MEDICINE Exercise medicine is the physical assessment and prescrip2on of exercise specifically for the preven2on or treatment of injury or illness. Specific exercise drives endogenous medicine Hormones and cytokines Direct structural adapta2on and repair Facilitates other therapies

5 Treatment Design ADT (24% Radiation) RCT Sample 57 Intervention Protocol Primary endpoint 12-week (2x) resistance & aerobic 2-4 sets 6-12RM min 60-85%MHR 10-13RPE lean mass Galvão et al. J Clinical Oncology 2010;10;28(2):340-7

6 Summary of key Results Lean Mass! ~1kg! EX>CO! Muscle Strength! 5-31kg! EX>CO! Aerobic Capacity! -7 sec! EX>CO! Dynamic Balance! -4 sec! EX>CO! General Health! +12! EX>CO! Vitality! +12! EX>CO! Fatigue! -11! EX>CO! CRP! -3.5 mg/l! EX>CO! NO change in PSA or testosterone in either group Galvão, Newton et al. J Clinical Oncology 2010;10;28(2):340-7

7 Edith Cowan University IMPACT EXERCISE FOR BONE HEALTH

8 HIGHLY SPECIFIC ADAPTATION Newton et al. Australasian Prostate Cancer Conference, 2011.

9 Edith Cowan University BONE METASTASES FUNDED PCFA

10 INTERFERENCE Interference phenomenon may be greater in cancer pa2ents due to compromised immune, endocrine and body composi2on status. ASCO 2014: Galvao et al. J Clin Oncol 32:5s, 2014 (suppl; abstr 5037).

11 Edith Cowan University National/International Position Stands Exercise and Cancer Generic Every Week to Tailored Prescription Important minutes start given moderate majority to of vigorous cancer survivors aerobic sedentary exercise However 2 or more resistance greater effectiveness training sessions and compliance for all major with targeted muscle groups medicine exercise Polypharmacy? Exercise Sports Science Australia American College of Sports Medicine American Cancer Society

12 EXERCISE IS NOT A SINGLE MEDICINE Mode, dosage, recovery, periodisa2on, nutri2on Create large contrasts in acute responses and chronic adapta2ons of the body systems Are we prescribing an2bio2cs for contracep2on! Expand and u2lize the endogenous pharmacy Pedersen, B. K. & Febbraio, M. A. Nature Reviews Endocrinology, 8, (Aug2012)

13 EXERCISE MECHANISMS: SURVIVAL AND TUMOUR BIOLOGY Endocrine Insulin/Glucose Immune Oxidative Stress Inflammation Adipokines/Myokines Epigenetic Platelet Cloaking Telomere Cholesterol

14 Edith Cowan University Research Par4cipants Research Team: Daniel Galvão Nigel Spry Dennis Taaffe David Joseph Frank Gardiner Suzanne Chambers Prue Cormie Carolyn McIntyre Support Team: Cailyn Rogers Catherine Bell Lynne Thornton Mark Trevaskis Courtney Ishiguchi Kelly Vibert Our Research Students ACKNOWLEDGEMENTS Clinician Collaborators: Nigel Spry David Joseph Frank Gardiner Christobel Saunders Anna Nowak James Denham David Lamb Akhlil Hamid Dickon Hayne Thomas Shannon Evan Ng Raphael Chee Jerard Ghossein Siobhan Ng Yvonne Zissiadis Research Support:

15 Thank You