Effects of presurgical exercise training on systemic inflammatory markers among patients with malignant lung lesions

Abstract

Systemic inflammation plays an important role in the initiation, promotion, and progression of lung carcinogenesis. The effects of interventions to lower inflammation have not been explored. Accordingly, we conducted a pilot study to explore the effects of exercise training on changes in biomarkers of systemic inflammation among patients with malignant lung lesions. Using a single-group design, 12 patients with suspected operable lung cancer were provided with structured exercise training until surgical resection. Participants underwent cardiopulmonary exercise testing, 6 min walk testing, pulmonary function testing, and blood collection at baseline and immediately prior to surgical resection. Systemic inflammatory markers included intracellular adhesion molecule (ICAM)-1, macrophage inflammatory protein-1alpha, interleukin (IL)-6, IL-8, monocyte chemotactic protein-1, C-reactive protein, and tumor necrosis factor-alpha. The overall exercise adherence rate was 78%, with patients completing a mean of 30 +/- 25 sessions. Mean peak oxygen consumption increased 2.9 mL.kg-1.min-1 from baseline to presurgery (p = 0.016). Results indicate that exercise training resulted in a significant reduction in ICAM-1 (p = 0.041). Changes in other inflammatory markers did not reach statistical significance. Change in cardiorespiratory fitness was not associated with change in systemic inflammatory markers. This exploratory study provides an initial step for future studies to elucidate the potential role of exercise, as well as identify the underlying mechanisms of action, as a means of modulating the relationship between inflammation and cancer pathogenesis.

Effects of the community-based Wellspring Cancer Exercise Program on functional and psychosocial outcomes in cancer survivors

“…Since the early trials, numerous studies have found that interval training provides benefits for a number of cancer survivors, including those receiving chemotherapy 38 or stem-cell transplantation 52 , those with anemia (hemoglobin: 80-110 g/L) 53 , and those awaiting lung resection for non-small-cell lung cancer 54 . Dimeo et al 55 examined the effect of an in-hospital interval-training program for patients with a mix of cancers (n = 70) undergoing highdose chemotherapy and autologous peripheral stem-cell transplantation.…”

Effect of total-body prehabilitation on postoperative outcomes: a systematic review and meta-analysis

“…An important remaining question is whether surgery should be postponed to allow for prehabilitation. Studies have demonstrated that the moderate delays in treatment for non-small-cell lung cancer patients are not associated with worsened long-term prognosis [39,40], and postponing surgery for long enough to reach pre-operative fitness targets may improve postoperative risk profiles [6]. However, this issue has not been studied formally in RCTs or across other diseases.…”

“…Out of a maximum score of 6 (higher scores indicate lower risk of bias), one study achieved a score of 6 [31], three studies achieved a score of 4 [13,25,26], seven studies achieved a score of 3 [14,16,18,20,24,27,33], four studies achieved a score of 2 [21,40], three studies achieved a score of 1 [15,17,23], and three studies achieved a score of 0 [19,29,32].…”

Exercise therapy across the lung cancer continuum

“…The results indicated that exercise training resulted in a signifi cant reduction in ICAM-1 (P = 0.041), a cell surface glycoprotein essential for controlling cell migration, cancer cell invasion, and metastasis. Change in exercise capacity was not associated with change in systemic infl ammatory markers [29].…”