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Immunological and hormonal effects of exercise: implications for cancer cachexia

Maddocks, Matthewa; Jones, Lee W.b; Wilcock, Andrewc

Current Opinion in Supportive and Palliative Care: December 2013 - Volume 7 - Issue 4 - p 376–382
doi: 10.1097/SPC.0000000000000010
CACHEXIA, NUTRITION AND HYDRATION: Edited by Aminah Jatoi and Florian Strasser

Purpose of review There is increasing interest in the use of therapeutic exercise for cancer cachexia. Apart from the directly beneficial effects on muscle, exercise has the potential to attenuate some of the immunological and hormonal abnormalities found in cachexia. This review summarizes the findings of recent studies, which have explored such effects in patients with cancer, and discusses their relevance to patients with cancer cachexia.

Recent findings Our search identified 11 studies in patients with breast, colorectal, lung, and prostate cancer, predominantly with early stage disease or following primary curative treatment. Overall, exercise was associated with reduced levels of C-reactive protein (CRP), but not other markers of systemic inflammation. There was no consistent impact on levels of glucose, insulin or measures of insulin sensitivity or, in patients with prostate cancer, on levels of testosterone.

Summary There is limited scope to extrapolate these findings to patients with cancer cachexia, who are more likely to have advanced disease, higher levels of systemic inflammation, and greater degrees of metabolic dysfunction. Studies specific to this group are required to explore what, if any, changes exercise can make to levels of CRP and other immune and hormonal biomarkers, along with their potential clinical relevance.

aDepartment of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, Bessemer Road, Denmark Hill, London, United Kingdom

bDuke Cancer Institute, Durham, North Carolina, USA

cHayward House Specialist Palliative Care Unit, Nottingham University Hospitals NHS Trust and Department of Palliative Medicine, University of Nottingham, Hucknall Road, Nottingham, United Kingdom

Correspondence to Dr Matthew Maddocks, King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Bessemer Road, Denmark Hill, London SE5 9PJ, United Kingdom. Tel: +44 (0)20 7848 5242; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins