20 January 2020

Cancer therapies: exercise to protect the heart

esercizio-fisico-per-proteggere-il-cuore_upmcchianciano_exercise to protect the heart

Physical exercise to protect the heart from the negative effects of cancer therapy: a study published in the European Journal of Preventive Cardiology

An article on the beneficial effects of exercise on cardiovascular health and its ability to counteract the side effects of cancer therapies on the heart was recently published in the European Journal of Preventive Cardiology . The authors of the study titled “The benefits of exercise in cancer patients and the criteria for exercise prescription in cardio-oncology” include:

  • Flavio D’Ascenzi, assistant professor at the University of Siena, associate professor at the University of Pittsburgh, and a consultant at UPMC Institute for Health Chianciano Terme for the Cardiology and Heart Rehabilitation program and research projects
  • Roberta Mannucci, nutritionist at UPMC Institute for Health Chianciano Terme.

Data about cancer and cardiovascular diseases

Cancer and cardiovascular diseases are currently the leading causes of death in high-income countries. The Global Initiative for Cancer Registry Development estimated 18.1 million new cancer cases in 2018 and 9.6 million cancer-related deaths. Cancer and cardiovascular diseases have several risk factors in common, for example:

  • sedentary lifestyle
  • unhealthy diet
  • smoking
  • alcohol abuse

As already widely demonstrated, regular physical exercise can help prevent cardiovascular diseases and cancer.

Physical exercise to protect the heart from the negative effects of cancer therapy

The article published in the European Journal of Preventive Cardiology underlines how physical exercise is not only key for primary prevention, but also to reduce recurrences and therapy-associated chronic diseases. Cancer therapies, especially chemotherapy, can lead to cardiovascular complications as a result of the toxicity induced by cancer therapy drugs, the so-called “cardio-toxicity”. Preliminary evidence shows physical activity can contrast the negative effects of cancer therapies (such as fatigue, pulmonary and immune system dysfunction, lymphedema) and prevent cardio-toxicity, even before its clinical manifestation. Not to mention that some of these issues can present even after many years, when the tumor is in full remission and the patient is considered completely cured.

A personalized program

Therefore, given the fundamental role played by physical exercise during all stages of cancer treatment, the study underlines the need to establish a real “sports therapy”. in other words, a program to be prescribed to cancer patients just as chemotherapy, radiotherapy, immunotherapy are prescribed, and also to support these. So, physical activity becomes an integrated part of the multidisciplinary care of cancer patients, which should involve the oncologist, nutritionist, cardiologist, and physical therapist planning a training program with the patient. Moreover, the research underscores also that exercise should be tailored according to:

  • patient’s individual characteristics
  • clinical conditions (e.g., tumor specificity)
  • administered drugs
  • cancer therapy
  • personal history
  • cardiac response to exercise.

In conclusion, exercise prescription must be based on an accurate cardiological evaluation, including exercise testing with specific stress tests, which, by determining exercise thresholds, allow patients to obtain the most benefit from exercise.