Commentary - (2022) Volume 8, Issue 7
Received: 06-Jul-2022, Manuscript No. IPGOCR-22-14241; Editor assigned: 08-Jul-2022, Pre QC No. IPGOCR-22-14241 (PQ); Reviewed: 20-Jul-2022, QC No. IPGOCR-22-14241 (Q); Revised: 25-Jul-2022, Manuscript No. IPGOCR-22-14241 (R); Published: 01-Aug-2022, DOI: 10.36648/2471-8165.8.7.35
All stages of survival benefit from physical activity, which also improves physical functionality, cancer-related symptoms, and quality of life. High levels of physical activity may also benefit cancer outcomes, such as survival, according to observational studies, but further research is needed. Randomized controlled trials of exercise therapies in oncology patients with survival outcomes as the primary endpoint are required. Based on the available data, this review's main focus is on the contribution of physical activity to breast and gynecologic cancer survivorship. It underlines the role of the clinician in promoting physical activity, examines particular guidelines for exercise prescription, and offers helpful resources for cancer survivors.
Exercise's role in enhancing quality of life
Physical activity is beneficial at all stages of survival and enhances physical functionality, cancer-related symptoms, and quality of life [1]. Observational studies suggest that high levels of physical exercise may help improve cancer outcomes, such as survival, although further research is required. Exercise therapy for cancer patients must be evaluated in randomised controlled trials with survival rates as the main objective. This review's primary focus is on how physical exercise affects breast and gynecologic cancer survivorship based on the data that are currently available [2,3]. It highlights the role of the clinician in encouraging physical activity, looks at specific prescription guidelines for exercise, and provides cancer survivors with useful resources.
Exercise during active treatment reduces cancer-related fatigue, depressive symptoms, anxiety, insomnia, poor quality of life, and impairment of physical function. Following active therapy, exercise interventions enhance overall health-related QOL and QOL domains like sexual functioning, social functioning, and emotional well-being while also reducing pain, anxiety, and exhaustion. Exercise reduced a number of treatment-related symptoms in a recent comprehensive evaluation of 40 metaanalyses and 23 RCTs on cancer survivors published after 2010 (both during and after treatment), with the evidence being especially high for fatigue and psychological distress. Exercise significantly increased QOL in their assessment of meta-analyses specifically pertaining to breast cancer. Evidence did not show that QOL would improve for gynecologic cancer survivors, most likely as a result of the few and small number of research that were conducted. In a systematic review and meta-analysis of lifestyle interventions to increase physical activity and their effects on QOL in gynecologic cancer survivors, which included three RCTs, it was discovered that while these interventions enhanced physical functioning, lessened fatigue, and caused weight loss, they did not improve overall QOL [4].
The big RCT of home-based exercise in 144 ovarian cancer survivors, which shown considerable gains in QOL, was excluded from our study (discussed below). Exercise may also help lymphedema. In an RCT, breast cancer survivors with stable lymphedema at baseline were randomized to either a one-year slowly progressive weight training programme or a control group; the weight training group experienced fewer exacerbations and reduced symptoms of lymphedema.
Ovarian cancer survivors
The viability of low-to-moderate intensity exercise during chemotherapy for ovarian cancer has been shown in a number of modest single-arm pilot studies (N=17 to 30), with typically more than two-thirds of patients sticking to the intervention/ exercise aim. A recent large RCT assigned 144 physically inactive ovarian cancer survivors who were not receiving chemotherapy to a 6-month moderate-intensity home exercise programme or a control group. The average weekly exercise for intervention participants was 166 minutes, and 65% of them met the weekly target of N150 minutes of moderate-intensity exercise [5]. Compared to the control group, women in the intervention group saw a significant improvement in their physical healthrelated QOL.
Exercise's role in enhancing cancer survival
The highest vs. lowest levels of post-diagnosis physical activity were shown to be related with a 48% decrease in risk of all-cause mortality, according to estimates from a 2015 meta-analysis of eight cohorts of breast cancer survivors (RR 0.52, 95% CI 0.43- 0.64). The highest vs. lowest levels of post-diagnosis physical activity were linked to a 38% lower risk of breast cancer-specific mortality, according to a 2016 meta-analysis of ten cohorts (RR 0.62, 95% CI 0.48-0.80) [6]. The incidence of recurrence was considerably decreased in four cohorts and one trial that collected recurrence data, according to the latter analysis (RR 0.68, 95% CI 0.58- 0.80).
The prospect of reverse causation, wherein the worse outcomes seen in less active persons could be explained by the fact that cancer patients with occult recurrence may be less inclined to be physically active due to disease symptoms, is a significant limitation of these observational studies. Reverse causality, however, is less likely because the majority of the cohort studies included in meta-analyses excluded cancer patients who underwent recurrence or passed away soon after physical activity evaluation [7]. Lower activity levels may be indicative of other underlying factors for a bad prognosis, even though included research largely accounted for several confounding variables. Potential misreporting of physical activity and the fact that several studies only examined current activity levels, which could not accurately reflect levels of habitual exercise, are other limitations.
Benefits of exercise for cancer survivors
The ACSM acknowledged that cancer survivors may need to modify their exercise regimen depending on their health status, medical history, and expected course of the disease [8]. Prior to beginning an exercise programme, they advise people to consult their doctor, but they came to the conclusion that the majority of cancer survivors without significant co-morbidities can start exercising without stress testing or a thorough medical evaluation. However, they do recommend general evaluation for peripheral neuropathy and musculoskeletal morbidities, which may require modification of an exercise program, and individuals with metastatic disease to the bone or known cardiac conditions require medical assessment to determine the safety of exercising. The risk of an exercise-related event such as sudden cardiac death or myocardial infarction is greatest in individuals performing unaccustomed exercise and during vigorous exercise.
Guidelines for exercise prescription
While the advantages of exercise for cancer patients are obvious, there are still a lot of unresolved issues surrounding the best exercise regimen for raising physical functioning and QOL. In a recent meta-analysis, information from 66 RCTs (mainly involving breast cancer survivors) was combined to assess the effects of exercise interventions on physical function and QOL before, during, and after cancer treatment [9]. Between cancer kinds, the timing of the intervention, or the length of the intervention, there was no discernible difference in the intervention's impact on QOL or physical functioning. Additionally, there were no discernible variations in the outcomes of interventions including different levels of exercise frequency, intensity, kind, and time..
The author has no conflicts of interest to declare.
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Citation: Aluwalia K (2022) Effects of Exercise on Breast and Gynecologic Cancer Survivability. Gynecol Obstet Case Rep. Vol.8 No.7:35.
Copyright: © Aluwalia K. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
