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| LETTERS TO EDITOR |
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| Year : 2021 | Volume
: 4
| Issue : 1 | Page : 142-143 |
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Efficacy of physical activity in mitigating cancer metastasis
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| Date of Submission | 29-Dec-2020 |
| Date of Decision | 03-Feb-2021 |
| Date of Acceptance | 04-Feb-2021 |
| Date of Web Publication | 26-Mar-2021 |
Correspondence Address:
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome
Italy
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/crst.crst_372_20
How to cite this article:
Okechukwu CE. Efficacy of physical activity in mitigating cancer metastasis. Cancer Res Stat Treat 2021;4:142-3 |
Regmi et al. advocated that intensive physical activity, depending on the duration, can produce high shear stress that may kill malignant cells in the vascular system.[1] Moreover, sustained extreme shear stress treatment, which can be induced by long-duration intensive training, can effectively kill the metastatic cancer cells, thereby preventing cancer metastasis.[1] However, Van Doorslaer de Ten Ryen and Deldicque specified that chronic adaptations to moderate-intensity endurance exercise at 60%–70% maximal oxygen consumption (VO2 max) appear to be the most active means to reduce extreme stress and increase the effect of exercise on cancer metastasis; however, high-intensity exercise at >60%–70% VO2 max was postulated to increase tumor metastasis in some cases.[2] Moderate-intensity exercise could be the therapeutic dose for mitigating tumor metastasis, as it has the potential to decrease the level of expression of metastasis-promoting and immunosuppressive genes, thereby reducing tumor growth and attenuating metastatic progression.[3]
Based on the studies conducted in animal cancer models, it is reported that exercise induces a protective effect in the tumor microenvironment, and the tumor microenvironment appears to exert a significant effect on metastatic progression.[4] Exercise influences several metabolic hormones, such as glucagon, insulin, and epinephrine, which regulate metabolic activities via the AMP-activated protein kinase signaling pathways.[5] The modulation of metabolic pathways by physical exercise could play a vital role in decreasing tumor growth.[5] Physical exercise-induced increase in the formation of new blood vessels may also improve the oxygen supply to the tumor, which in turn can stimulate the mobilization and infiltration of immune cells.[5] In addition to the natural killer cells, a stretch of intense exercise can mobilize cytotoxic T-cells into the circulation along with neutrophils, monocytes, and macrophages, as well as anti-inflammatory cytokines and immunosuppressive factors, which can help in controlling tumor progression.[5] Exercise increases the release of epinephrine, norepinephrine, and myokines, which improve tumor perfusion and oxygen supply, decrease intra-tumoral metabolic stress and stimulate various signaling pathways involved in the prevention of cancer metastasis.[5] Exercise could be a potential adjunctive therapy for decreasing immune suppression, cancer progression, and metastasis in patients with cancer, though the mechanisms behind these beneficial effects of exercise are yet to be established.[6]
In conclusion, physical activity has been shown to stimulate immunologic changes in the tumor microenvironment, thus mitigating cancer progression and metastasis. However, further studies are required to substantiate the efficacy of physical activity in mitigating cancer growth and metastasis and to clarify how different types, intensity, frequency, and duration of physical activity affect cancer progression and metastasis.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Regmi S, Fu A, Luo KQ. High shear stresses under exercise condition destroy circulating tumor cells in a microfluidic system. Sci Rep 2017;7:39975.  |
| 2. | van Doorslaer de Ten Ryen S, Deldicque L. The Regulation of the Metastatic Cascade by Physical Activity: A Narrative Review. Cancers (Basel) 2020;12:153. |
| 3. | Turbitt WJ, Xu Y, Sosnoski DM, Collins SD, Meng H, Mastro AM, et al. Physical activity plus energy restriction prevents 4T1.2 mammary tumor progression, MDSC accumulation, and an immunosuppressive tumor microenvironment. Cancer Prev Res (Phila) 2019;12:493-506. |
| 4. | Holmen Olofsson G, Jensen AWP, Idorn M, Thor Straten P. Exercise Oncology and Immuno-Oncology; A (Future) Dynamic Duo. Int J Mol Sci 2020;21:3816. |
| 5. | Rincón-Castanedo C, Morales JS, Martín-Ruiz A, Valenzuela PL, Ramírez M, Santos-Lozano A, et al. Physical exercise effects on metastasis: A systematic review and meta-analysis in animal cancer models. Cancer Metastasis Rev 2020;39:91-114. |
| 6. | Wennerberg E, Lhuillier C, Rybstein MD, Dannenberg K, Rudqvist NP, Koelwyn GJ, et al. Exercise reduces immune suppression and breast cancer progression in a preclinical model. Oncotarget 2020;11:452-61. |
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