Extracts from two papers on exercise ... - Advanced Prostate...

Advanced Prostate Cancer

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Extracts from two papers on exercise and cancer. Paper 1 investigates the blood from 25 patients with mCRPC exercising. Paper 2 is a review.

Graham49 profile image
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The first paper indicates that a phase 3 trial INTERVAL-GAP4 is recruiting. I have not checked this. The patients used in this study were recruited to the INTERVAL-GAP4 trial (2016- 2020). I include the Abstract and the section about the exercise program used.

I include the extract from the second paper because it indicates that exercise might need to be done at least as frequent as every 24 hours to get optimum results.

Open Access

Published: 12 February 2022

Exercise in advanced prostate cancer elevates myokine levels and suppresses in-vitro cell growth

Jin-Soo Kim1,2,

Dennis R. Taaffe ORCID: orcid.org/0000-0001-6381-15971,2,

Daniel A. Galvão ORCID: orcid.org/0000-0002-8209-22811,2,

Nicolas H. Hart1,2,3,

Elin Gray2,4,

Charles J. Ryan ORCID: orcid.org/0000-0002-2081-35575,

Stacey A. Kenfield ORCID: orcid.org/0000-0002-1585-73526,

Fred Saad ORCID: orcid.org/0000-0003-2986-56177 na1 &

Robert U. Newton ORCID: orcid.org/0000-0003-0302-61291,2 na1

Prostate Cancer and Prostatic Diseases volume 25, pages 86–92 (2022)Cite this article

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Subjects

Prostate cancer

Translational research

Abstract

Background

Altering the systemic milieu through exercise has been proposed as a potential mechanism underlying exercise-driven tumour suppression. It is not yet known whether men with advanced prostate cancer can elicit such adaptations following a program of exercise. The purpose is to examine myokine levels of serum acquired from metastatic castrate-resistant prostate cancer (mCRPC) patients recruited to the INTERVAL-GAP4 trial before and after 6 months of exercise and its tumour-suppressive effect.

Methods

Twenty-five men with mCRPC (age = 74.7 ± 7.1 yrs) were randomised to supervised multimodal (aerobic and resistance) exercise (EX) or self-directed exercise control group (CON). Body composition was assessed using dual-energy x-ray absorptiometry (DXA), and fasting blood in a rested state was collected at baseline and at 6 months. Serum levels of myokines (SPARC, OSM, decorin, IGF-1, and IGFBP-3) were measured. Serum was applied to the prostate cancer cell line DU145, and growth was assessed for 72 h.

Results

No significant change in body composition was observed. Adjusted serum OSM (P = 0.050) and relative OSM (P = 0.083), serum SPARC (P = 0.022) and relative SPARC (P = 0.025) increased in EX compared to CON. The area under curve (AUC) over 72 h showed a significant reduction in DU145 growth after applying post-intervention serum from the EX vs CON (P = 0.029).

Conclusion

Elevated myokine expressions and greater tumour-suppressive effects of serum after 6 months of periodised and autoregulated supervised exercise was observed in men with mCRPC. Exercise-induced systemic changes may slow disease progression in men with advanced prostate cancer.

"Participants and exercise program

Serum was collected from 25 men with mCRPC (EX, n = 13; CON, n = 12) who were recruited for the INTERVAL-GAP4 trial (Clinical Trials Registry: NCT02730338) [6] from March 2016 to May 2020 at the Exercise Medicine Research Institute (EMRI; Edith Cowan University (ECU); WA, Australia) which was used for analysis (Fig. 1). The recruitment and randomisation of patients were undertaken as previously described [6]. Briefly, patients who had been identified as mCRPC (adenocarcinoma of the prostate with systemic metastatic disease despite castrate levels of testosterone (<50 ng/dl) due to orchiectomy or luteinising hormone-releasing hormone (LHRH) agonist, undergoing ADT (gonadotropin-releasing hormone (GnRH) agonist/antagonist or prior bilateral orchiectomy)), and capable of performing exercise were recruited by clinician referrals.

Patients were randomly allocated to supervised exercise (EX) or a self-directed exercise control group (CON). The current study examines the initial 6 months of resistance and aerobic training completed thrice weekly as previously described [6], as the protocol for INTERVAL GAP4 initially commences with full supervision before transitioning to home-based exercise. Briefly, in the first and third exercise session of the week, structured resistance exercise (6 exercises, 2–5 sets, 6–12 RM intensity adjusted using repetition maximum (RM)) with a combination of high-intensity interval training (HIIT) (aerobic exercise, 6 x 60 s, intensity adjusted to a rating of perceived exertion (RPE) of 8 on 0–10 Borg scale) was prescribed, and 30–40 min of moderate-intensity continuous aerobic training (MICT) (cycling/walking) was undertaken at an intensity adjusted to RPE 6 in the second exercise session of the week. The exercise program was periodised and autoregulated across the week, month and 3-month cycles and autoregulated so that intensity, volume and exercise selection was adjusted depending on the patient’s readiness on the day. CON were provided with the American College of Sports Medicine (ACSM) guidelines for cancer survivors [36]. The study was funded by the Movember Foundation and ethically approved by the Human Research Ethics Committee at Edith Cowan University (ID: 13236 NEWTON). Written informed consent was obtained from all patients before inclusion."

Published: 17 April 2021

Anti-carcinogenic effects of exercise-conditioned human serum: evidence, relevance and opportunities

Richard S. Metcalfe ORCID: orcid.org/0000-0003-0980-29771,

Rachael Kemp1,

Shane M. Heffernan1,

Rachel Churm1,

Yung-Chih Chen2,

José S. Ruffino3,

Gillian E. Conway4,

Giusy Tornillo5 &

Samuel T. Orange6

European Journal of Applied Physiology volume 121, pages 2107–2124 (2021)Cite this article

This is a very long paper. I include only the Conclusions.

"Conclusions

A number of tentative conclusions can be drawn from the current review (summarised in Fig. 3). First, in humans, acute exercise appears to be associated with serological changes that suppress cancer cell growth but do not induce apoptosis in vitro. It remains unclear how long after exercise cessation the anti-growth effect persists; it is almost certainly observed immediately post-exercise with a variety of aerobic and HIIE protocols, but some studies report that the effect is lost soon after exercise and some have observed the effect for up to 24 h post-exercise (Table 1). Importantly, there appears to be no effect of exercise training on serum-stimulated cancer cell proliferation when blood samples are taken at a time point when the acute effects of the last bout of exercise have subsided (i.e. > 24 h post exercise). Taken together, these findings suggest that the serological effects of exercise may be an important mechanism underlying the beneficial effects of physical activity and exercise on cancer risk and outcome. The presence of an acute but not a training effect may have important practical implications for exercise prescription for cancer prevention and treatment, suggesting that a high frequency of exercise may be important to maximise the effects."

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Graham49
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4 Replies
dhccpa profile image
dhccpa

Do doctors buy into exercise? I ask because many doctors seem horribly out of shape.

London441 profile image
London441 in reply todhccpa

Of course they buy into it. Buying into it infers believing it’s beneficial, which has nothing to do with actually doing it.

MateoBeach profile image
MateoBeach

If someone still needed another reason to exercise in some manner nearly every day, well there you go. Too bad they didn’t note any apoptosis (cell death) of the PC cells though. Going for my hike.

j-o-h-n profile image
j-o-h-n

Pulling your pudding...... best excer-SIZE

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 06/25/2022 2:57PM DST

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