New paper below [1].
".. recent studies reveal that exercise may also directly influence tumour physiology that could beneficially affect the response to radiotherapy."
"Preclinical research has shown that exercise can reduce intratumoral hypoxia-a major limiting factor in radiotherapy-by improving tumour perfusion and vascularisation. In addition, preliminary evidence suggests that exercise training can improve radiotherapy treatment outcomes by increasing natural killer cell infiltration in a murine PCa model."
"Exercise is a potentially promising adjunct therapy for men with PCa undergoing radiotherapy that may increase its effectiveness. However, exercise-induced tumour radiosensitisation remains to be confirmed in preclinical and clinical trials, as does the optimal exercise prescription to elicit such effects."
Yes, the response to hypoxia is the major reason for treatment resistance. Cancer does not "hate" oxygen, as many people seem to believe. The response to hypoxia has little to do with actual treatment. It is a survival response to inadequate oxygen, with angiogenesis as a major aim.
The hypoxia response can be forestalled or maybe reversed if more oxygen can be delivered. I use a nitroglycerine patch for that purpose.
I discussed the idea of frequent hyperbaric oxygen sessions with my alt-doc a year or so ago. He said that I could pick up a reconditioned chamber for not a lot of money. There is no data on benefit in PCa, of course. Some might be thinking that I have finally lost the plot, but here is what the Mayo says [2]:
"Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a hazard of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, bubbles of air in your blood vessels, and wounds that won't heal as a result of diabetes or radiation injury.
"In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure.
"Your blood carries this oxygen throughout your body. This helps fight bacteria and stimulate the release of substances called growth factors and stem cells, which promote healing."
& inhibits hypoxia &, specifically: hypoxia inducible factor 1alpha [HIF-1alpha, HIF-1α or HIF-1A].
Or one could exercise, I suppose.
-Patrick
[1] pubmed.ncbi.nlm.nih.gov/326...
Review Prostate Cancer Prostatic Dis
. 2020 Jul 6. doi: 10.1038/s41391-020-0245-z. Online ahead of print.
Exercise Modulation of Tumour Perfusion and Hypoxia to Improve Radiotherapy Response in Prostate Cancer
Oliver Schumacher 1 2 , Daniel A Galvão 3 4 , Dennis R Taaffe 3 4 5 , Raphael Chee 3 4 6 , Nigel Spry 3 4 6 , Robert U Newton 3 4 5
Affiliations expand
PMID: 32632128 DOI: 10.1038/s41391-020-0245-z
Abstract
Background: An increasing number of studies indicate that exercise plays an important role in the overall care of prostate cancer (PCa) patients before, during and after treatment. Historically, research has focused on exercise as a modulator of physical function, psychosocial well-being as well as a countermeasure to cancer- and treatment-related adverse effects. However, recent studies reveal that exercise may also directly influence tumour physiology that could beneficially affect the response to radiotherapy.
Methods: In this narrative review, we provide an overview of tumour vascular characteristics that limit the effect of radiation and establish a rationale for exercise as adjunct therapy during PCa radiotherapy. Further, we summarise the existing literature on exercise as a modulator of tumour perfusion and hypoxia and outline potential future research directions.
Results: Preclinical research has shown that exercise can reduce intratumoral hypoxia-a major limiting factor in radiotherapy-by improving tumour perfusion and vascularisation. In addition, preliminary evidence suggests that exercise training can improve radiotherapy treatment outcomes by increasing natural killer cell infiltration in a murine PCa model.
Conclusions: Exercise is a potentially promising adjunct therapy for men with PCa undergoing radiotherapy that may increase its effectiveness. However, exercise-induced tumour radiosensitisation remains to be confirmed in preclinical and clinical trials, as does the optimal exercise prescription to elicit such effects.
Pravastatin vs. Simvastatin
