Saxton / Delay / Daley Exercise and Cancer Survivorship

Impact on Health Outcomes and Quality of Life
1. Auflage 2010
ISBN: 978-1-4419-1173-5
Verlag: Springer-Verlag
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 244 Seiten

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.

Autoren/Hrsg.

Saxton, John

Delay, Amanda

Daley, Amanda

Inhaltsverzeichnis

1;Foreword;5
2;Contents;7
3;Contributors;9
4;List of Abbreviations;12
5;1 Introduction;15
5.1;1.1 The Burden of Cancer;15
5.2;1.2 Stages of the Cancer Experience;17
5.3;1.3 Exercise and the Cancer Survivor;19
5.3.1;1.3.1 Cancer as a 'Teachable Moment';19
5.3.2;1.3.2 Health Benefits of Exercise;19
5.3.3;1.3.3 Exercise Terminology;20
5.3.4;1.3.4 Exercise Guidelines for Cancer Survivors;22
5.4;1.4 Levels of Evidence;23
5.4.1;1.4.1 General Overview;23
5.4.2;1.4.2 Observational Studies;23
5.4.3;1.4.3 Qualitative Studies;24
5.4.4;1.4.4 Randomized Controlled Trials;24
5.5;1.5 DoseResponse Issues;25
5.6;1.6 Aims of This Book;27
5.7; References ;28
6;2 Exercise and Cancer-Related Fatigue Syndrome;30
6.1;2.1 Introduction;30
6.1.1;2.1.1 Incidence of Cancer-Related Fatigue;31
6.1.2;2.1.2 Etiology of Cancer-Related Fatigue;31
6.1.3;2.1.3 Conceptual Framework for the Study of Cancer-Related Fatigue;31
6.2;2.2 Assessment of Cancer-Related Fatigue;32
6.2.1;2.2.1 Clinical Syndrome of Cancer-Related Fatigue;32
6.2.2;2.2.2 Cancer-Related Fatigue-Specific Measurement Instruments;32
6.3;2.3 Management Strategies For Cancer-Related Fatigue;35
6.3.1;2.3.1 Pharmacological Interventions;35
6.3.2;2.3.2 Psychosocial Interventions;35
6.3.3;2.3.3 Exercise Interventions;36
6.3.3.1;2.3.3.1 Breast Cancer;39
6.3.3.2;2.3.3.2 Prostate Cancer;39
6.3.3.3;2.3.3.3 Hematopoietic Stem Cell Transplantation (HSCT);39
6.3.3.4;2.3.3.4 Advanced Cancer;40
6.3.4;2.3.4 Combined Interventions for Cancer-Related Fatigue;40
6.4;2.4 Special Considerations for Exercise Testing and Programming;41
6.4.1;2.4.1 Screening for Exercise Participation;41
6.4.2;2.4.2 Exercise Testing;42
6.4.3;2.4.3 Exercise Programming;42
6.4.3.1;2.4.3.1 Prescription Considerations for Patients with Poor Functional Capacity;43
6.4.3.2;2.4.3.2 Intermittent or Interval Exercise Training;43
6.4.3.3;2.4.3.3 Muscular Fitness Training;44
6.4.3.4;2.4.3.4 The Training Index;44
6.4.3.5;2.4.3.5 Pacing;45
6.5;2.5 Summary and Conclusions;45
6.6;References;46
7;3 Exercise as an Intervention During Breast Cancer Treatment;50
7.1;3.1 Introduction;50
7.1.1;3.1.1 Impact of Breast Cancer Treatment;50
7.1.2;3.1.2 Physical Activity Behaviours;51
7.2;3.2 The Evidence Base for Exercise: A Systematic Review;52
7.2.1;3.2.1 Methods of the Systematic Review;53
7.2.2;3.2.2 Description of Studies;54
7.2.3;3.2.3 Effects;55
7.2.3.1;3.2.3.1 Physical and Mental Health;55
7.2.3.2;3.2.3.2 Adverse Events;56
7.2.4;3.2.4 Exercise Adherence and Maintenance;57
7.2.5;3.2.5 Quality of the Evidence;59
7.2.6;3.2.6 Applicability of the Evidence to the Breast Cancer Population;60
7.2.7;3.2.7 Implications for Research;60
7.3;3.3 Implementation and Dissemination;61
7.4;3.4 Summary;62
7.5;References;62
8;4 Exercise After Treatment for Breast Cancer: Effects on Quality of Life;65
8.1;4.1 Introduction;65
8.1.1;4.1.1 Incidence and Survival from Breast Cancer;65
8.1.2;4.1.2 Consequences of Breast Cancer;66
8.1.3;4.1.3 Psychological and Psychosocial Interventions;66
8.2;4.2 The Potential Role of Exercise After Treatment for Breast Cancer;66
8.3;4.3 Chapter Overview;67
8.4;4.4 Is Exercise an Effective Quality of Life Intervention After Treatment for Breast Cancer? Summary of the Evidence;67
8.4.1;4.4.1 Setting the Scene: Early Intervention Studies;68
8.4.2;4.4.2 The 'Boom' Years;68
8.4.2.1;4.4.2.1 Trials of Supervised Aerobic Exercise;68
8.4.2.2;4.4.2.2 Weight Training and Resistance-Based Exercise Interventions;70
8.4.2.3;4.4.2.3 Combined Aerobic Exercise and Resistance Training Interventions;71
8.4.2.4;4.4.2.4 Pragmatic Home-Based Exercise Interventions;72
8.4.2.5;4.4.2.5 Alternative Modes of Exercise;75
8.4.2.6;4.4.2.6 Exercise Versus Other QoL Interventions;75
8.5;4.5 Reviews and Meta-analyses;76
8.6;4.6 Whats It Like? Cancer Survivors Experiences of Exercise;76
8.7;4.7 What Next?;78
8.8;4.8 Summary and Conclusions;79
8.9;References;80
9;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
9.1;5.1 Trends in Breast Cancer Incidence and Mortality;85
9.2;5.2 Current Recommended Treatments;86
9.3;5.3 The Problem of Excess Body Weight in Breast Cancer Patients;86
9.3.1;5.3.1 Prevalence of Overweight and Obesity Amongst Breast Cancer Patients;86
9.3.2;5.3.2 Weight Gain After a Diagnosis of Breast Cancer;87
9.3.3;5.3.3 Impact of Obesity and Weight Gain on Breast Cancer Recurrence and Breast Cancer-Specific Mortality;89
9.3.4;5.3.4 The Effects of Weight Gain and Weight Loss After Diagnosis;90
9.3.5;5.3.5 Effects of Obesity on Prognosis in Women Receiving Adjuvant Endocrine Therapy;90
9.3.6;5.3.6 Effects of Obesity on Prognosis in Women Receiving Adjuvant Chemotherapy;91
9.3.7;5.3.7 Effects of Obesity on Prognosis in Women with Metastatic Breast Cancer;91
9.3.8;5.3.8 Obesity and Contra-Lateral Breast Cancer;91
9.3.9;5.3.9 The Effect of Central Obesity and Insulin Resistance on Prognosis;92
9.4;5.4 Body Weight and Lymphoedema;92
9.5;5.5 Obesity-Related Co-morbidities in Breast Cancer Patients;93
9.6;5.6 Interventions for Weight Control Amongst Breast Cancer Patients;94
9.6.1;5.6.1 Diet and Exercise Interventions;94
9.6.2;5.6.2 Diet and Exercise Recommendations for Breast Cancer Patients;95
9.6.3;5.6.3 Delivery of Weight-Management Programs for Breast Cancer Patients;96
9.6.4;5.6.4 Pharmacotherapy;97
9.6.5;5.6.5 Monitoring Patients in Weight-Loss Interventions;98
9.7;5.7 Weight Loss and Bone Health;98
9.8;5.8 Weight Loss and Quality of Life;98
9.9;5.9 What Advice Do Patients Want About Diet and Weight Control?;99
9.10;5.10 HealthCare Professional Survey: Current Roles and Attitudes to Delivering Diet, Exercise and Weight Control Advice to Early Breast Cancer Patients;101
9.10.1;5.10.1 Current Practice;101
9.10.2;5.10.2 Beliefs;101
9.11;5.11 Summary and Conclusions;102
9.12;References;103
10;6 The Biological Mechanisms by Which Physical Activity Might Have an Impact on Outcome/Prognosis After a Breast Cancer Diagnosis;109
10.1;6.1 Introduction;109
10.2;6.2 Physical Activity and Breast Cancer Survival;110
10.3;6.3 Biological Mechanisms by Which Physical Activity May Impact upon Breast Cancer Survival;111
10.3.1;6.3.1 Obesity and Weight Gain;111
10.3.2;6.3.2 Fasting Insulin and Insulin-Like Growth Factor Levels;113
10.3.3;6.3.3 Sex Hormones;115
10.3.4;6.3.4 Adipokines;117
10.3.5;6.3.5 Inflammation;118
10.4;6.4 Other Potential Mechanisms Mediating an Effect Between Physical Activity and Breast Cancer Survival;120
10.5;6.5 Summary and Conclusions;120
10.6;References;121
11;7 Exercise After Prostate Cancer Diagnosis;124
11.1;7.1 Introduction;124
11.1.1;7.1.1 Screening;125
11.1.2;7.1.2 Tumor, Node, Metastasis Staging;125
11.1.3;7.1.3 Histopathological Grading;125
11.1.4;7.1.4 Treatment;126
11.2;7.2 Exercise and Prostate Cancer Prevention;127
11.2.1;7.2.1 Mechanisms of Prevention;128
11.3;7.3 Exercise Post-diagnosis of Prostate Cancer;128
11.3.1;7.3.1 Exercise for Early Stage, Localized Disease;129
11.3.1.1;7.3.1.1 Radical Prostatectomy;129
11.3.1.2;7.3.1.2 Radiation Therapy;138
11.3.2;7.3.2 Exercise for Locally Advanced and Hormone-Sensitive Metastatic Disease;139
11.3.3;7.3.3 Exercise for Hormone-Refractory Metastatic Disease;142
11.4;7.4 Limitations of Current Research;143
11.5;7.5 Future Directions for Exercise and Prostate Cancer Research;144
11.6;7.6 Exercise Recommendations;144
11.7;7.7 Summary and Conclusions;145
11.8;References ;146
12;8 Exercise for Prevention and Treatment of Prostate Cancer: Cellular Mechanisms;151
12.1;8.1 Introduction;151
12.2;8.2 Possible Mechanisms for the Value of Exercise;153
12.2.1;8.2.1 Tumor Growth and Apoptosis;153
12.2.2;8.2.2 Angiogenesis, Invasion, and Metastasis;158
12.3;8.3 Summary and Conclusions;159
13;9 Physical Activity Before and After Diagnosis of ColorectalCancer;163
13.1;9.1 Introduction;163
13.2;9.2 Physical Activity and the Risk of Colorectal Cancer;165
13.2.1;9.2.1 Dose--Response;166
13.3;9.3 Physical Activity, Recurrence of and Survival from Colorectal Cancer;166
13.3.1;9.3.1 Quality of Life Issues;169
13.3.2;9.3.2 Co-morbidities;169
13.4;9.4 Physical Activity, Response Pathways and Biomarkers of Colorectal Cancer;170
13.4.1;9.4.1 Gastrointestinal Transit-Time;170
13.4.2;9.4.2 Chronic Inflammation;170
13.4.3;9.4.3 Immune Function;172
13.4.4;9.4.4 Insulin;173
13.4.4.1;9.4.4.1 Insulin-Like Growth Factor;173
13.4.5;9.4.5 Genetic Mutations;174
13.4.6;9.4.6 Obesity;175
13.5;9.5 Summary and Conclusions;176
13.6;References;176
14;10 Exercise-Based Rehabilitation in Patients with Lung Cancer;183
14.1;10.1 Introduction;183
14.2;10.2 Classification of Lung Cancer;184
14.3;10.3 Presenting Symptoms of Lung Cancer;184
14.4;10.4 Diagnosis and Staging of Lung Cancer;184
14.5;10.5 Medical Treatment of Lung Cancer;185
14.5.1;10.5.1 NSCLC Treatment for Early Stage and Localised Disease;185
14.5.2;10.5.2 Treatment for Loco-Regional Advanced Disease;185
14.5.3;10.5.3 Treatment for Advanced and Metastatic Disease;186
14.5.4;10.5.4 Treatment of Small Cell Lung Cancer;186
14.6;10.6 Pulmonary Rehabilitation;186
14.6.1;10.6.1 Rationale for Pulmonary Rehabilitation in Lung Cancer Patients;187
14.6.1.1;10.6.1.1 Pre-operative Exercise Intolerance;187
14.6.1.2;10.6.1.2 Peri- and Post-operative Exercise Intolerance;188
14.6.1.3;10.6.1.3 Peri- and Post-operative Quality of Life;189
14.6.2;10.6.2 Evidence for the Impact of Exercise Rehabilitation Before Surgical Treatment;189
14.6.3;10.6.3 Evidence for the Impact of Exercise Rehabilitation After Surgical Treatment;190
14.6.3.1;10.6.3.1 Conventional Exercise Modalities;190
14.6.3.2;10.6.3.2 Neuromuscular Electrical Stimulation;192
14.7;10.7 Future Recommendations;193
14.8;10.8 Summary and Conclusions;193
14.9;References;194
15;11 Exercise and Cancer Mortality;198
15.1;11.1 Introduction;199
15.2;11.2 Evidence from Prospective Cohort Studies;200
15.3;11.3 Cardiopulmonary Fitness, Physical Activity and Overall Cancer Mortality in Initially Healthy Individuals;201
15.3.1;11.3.1 Is Cardiopulmonary Fitness Associated with the Risk of Future Cancer Mortality?;201
15.3.2;11.3.2 Is Physical Activity Associated with the Risk of Future Cancer Mortality?;202
15.4;11.4 Pre-diagnosis Physical Activity and Mortality in Breast and Colorectal Cancer Survivors;203
15.5;11.5 Post-diagnosis Physical Activity and Mortality in Breast and Colorectal Cancer Survivors;206
15.5.1;11.5.1 Breast Cancer Survivors;207
15.5.2;11.5.2 Colorectal Cancer Survivors;210
15.6;11.6 Does Physical Activity Have a Role in Prostate Cancer Mortality?;212
15.7;11.7 Physical Activity and Cardiovascular Mortality in Prostate Cancer Patients;215
15.8;11.8 Summary and Conclusions;215
15.9;References;217
16;12 Ready to Change Lifestyle? The Feasibility of Exercise Interventions in Cancer Patients;220
16.1;12.1 Introduction;220
16.2;12.2 Physical Activity Recommendations;221
16.3;12.3 Group Exercise;222
16.4;12.4 Home Exercise;222
16.5;12.5 Long-Term Behaviour Change;222
16.6;12.6 Physical Activity Barriers;224
16.7;12.7 Advanced Cancer Patients;225
16.8;12.8 Risks;225
16.9;12.9 Summary and Conclusions;226
16.10;References;226
17;13 Cardiorespiratory Exercise Testing in Adult Cancer Patients;231
17.1;13.1 Introduction;231
17.2;13.2 Exercise Testing Methodology in Adult Cancer Patients;232
17.2.1;13.2.1 Pre-test Procedures;232
17.2.2;13.2.2 Exercise Testing Modality;232
17.2.2.1;13.2.2.1 Purpose;234
17.2.2.2;13.2.2.2 Setting;235
17.2.2.3;13.2.2.3 Patient Population;236
17.2.3;13.2.3 Exercise Testing Safety;236
17.2.3.1;13.2.3.1 Eligibility Criteria;237
17.2.3.2;13.2.3.2 Exercise Test Conduct/Methodology;238
17.3;13.3 Exercise Test Results Reporting;240
17.4;13.4 Summary and Conclusions;241
17.5;References;241
18;Subject Index;245