Oncology Learning Objectives (L33)

Question 1

Regular aerobic exercise will have what effect cancer risk? What cellular adaptations are responsible?

Answer 1

May reduce cancer risk via;
a) Enhances NK cell activity (immuno-surveillance)
- NK cells are responsible for identifying and destroying abnormal cells, including cancer cells
b) Reduces age-related T-cell decline
- T-cells identify and eliminate cells that display abnormal antigens, such as cancer cells.

Question 2

How can exercise medicine inhibit cancer cell growth?

Answer 2

Exercise can:
1. Improve the immune function (t-cells and NK cells)
2. Epigenetic alterations: Alters gene expression to suppress oncogenes and activate tumour suppressor genes
3. Hormone receptor adaptations: Regulates hormones and their receptors, reducing the growth of hormone-sensitive tumours.
4. Improve vascularisation of tumour: Improves tumour blood flow and oxygenation, enhancing treatment efficacy and potentially reducing tumour growth.

Question 3

What are the roles for exercise pre-cancer treatment?

Answer 3

Prehabilitation – increase treatment tolerance

Question 4

What are the roles for exercise during cancer treatment?

Answer 4

– Reduce deconditioning
– Preserve tissues and function
– Cope with side effects

Question 5

What are the roles for exercise post-cancer treatment?

Answer 5

Reconditioning

Question 6

What are the roles for exercise when receiving palliative care?

Answer 6

Slow decline, decrease fatigue, increase QoL

Question 7

Do most cancer treatments cause damage to healthy cells/tissues?

Answer 7

Yes

Question 8

What is a major indication for post-cancer exercise therapy in a 75y/o, overweight male who has received androgen deprivation therapy as part of his treatment?

Answer 8

Androgen deprivation therapy is used to combat cancer by reducing testosterone which promotes cancer growth.
Major consequence is a decrease in muscle mass.
A decrease in muscle mass can increase the risk of falls and T2DM, which could further cause CVD complications

Question 9

Is exercise feasible and safe for cancer patients receiving palliative care?

Answer 9

Yes

Question 10

What sort of reduction in relative mortality risk is associated with engaging in PA post-diagnosis (cancer). What intensity?

Answer 10

30-50% Reduction. ≥9 MET-h per/week.

Question 11

List some disease risks that might be indicated following cancer treatment

Answer 11

CVD
Obesity
T2DM
Osteoporosis
Other cancers

Question 12

How would we control for an increase risk of facture in cancer patients during exercise?

Answer 12

Avoid high impact/contact sports with bone metastases/osteoporosis risk

Question 13

How would we control for an increase risk of infection in cancer patients during exercise?

Answer 13

Avoid high intensity/volume & public places while white blood cell counts are low / immunosuppressed

Question 14

For cancer patients, what sorts of things would be contraindicated against swimming as a form of exercise?

Answer 14

catheters
tubes
radiation