Habitual physical activity modulates cardiometabolic health in long-term testicular cancer survivors

Abstract

Purposes Physical activity (PA) may mitigate late cardiometabolic toxicity of cisplatin-based chemotherapy in testicular germ cell tumor (TGCT) long-term survivors. In this cross-sectional study, we evaluated the effects of habitual PA on metabolic syndrome (MetS) prevalence, and on the markers of cardiometabolic health and chronic inflammation in a population of long-term TGCT survivors. Methods MetS prevalence was evaluated, and habitual PA was assessed using Baecke’s habitual PA questionnaire in TGCT survivors (n=195, age=41.1±8.1years, 11.7±5.2years post-therapy) and healthy male controls (n=41, age=38.2±8.8years). Participants were stratified into low- and high-PA groups based on median values. Differences were examined between low- and high-PA groups (in the entire sample, TGCT survivor sub-samples differing in disease stage, and healthy controls), and between TGCT survivors and controls. Next, TGCT survivors were stratified into age- and BMI-matched sub-groups based on post-treatment time (5–15/15/30years) and number of chemotherapy cycles (≤3/>3), allowing us to detect age- and BMI-independent effects of habitual PA on cardiometabolic health in the given TGCT survivor sub-populations. A correlation matrix of habitual PA and sport activity with cardiometabolic and pro-inflammatory markers was generated. Results TGCT survivors had higher MetS prevalence than controls. Patients with high habitual PA had lower waist circumference and Systemic Inflammation Index. Habitual PA scores correlated positively with HDL-cholesterol and negatively with waist circumference and atherogenic risk. Furthermore, cardiometabolic benefits of habitual PA were more pronounced in patients with disease stages 1 and 2. Effects of habitual PA on patients sub-populations stratified by chemotherapy dose and post-treatment time clearly showed that higher levels of habitual PA were associated with lower numbers of MetS components, except for patients who received more than 3 chemotherapy cycles and were examined more than15 years post-therapy. Conclusions Higher levels of habitual PA effectively mitigated cardiometabolic toxicity in TGCT survivors. Patients with higher cumulative doses of chemotherapy may need structured exercise interventions involving higher-intensity physical activity to achieve significant improvements in cardiometabolic health.

Immunomodulatory effects of exercise in cancer prevention and adjuvant therapy: a narrative review

“…Multiple human studies have established the beneficial effects of exercise in lowering the risk of cancer development ( Amiri et al, 2023 ; Pelzer et al, 2023 ; Rogers et al, 2023 ). Leisure-time exercise reduces 13 cancer types as suggested by an epidemiological study ( Moore et al, 2016 ).…”

“…Similarly, esophageal, renal, uterine, and stomach cancers can be reduced through exercise ( Behrens and Leitzmann, 2013 ; Kitson et al, 2022 ; Lavery et al, 2023 ). Some of the studies in humans show a positive influence of exercising on habit formation, as people under a regime of physical activity are also more likely to lead a healthy lifestyle ( Kenfield et al, 2011 ; Amiri et al, 2023 ). The general consensus is that exercise is a critical lifestyle habit that has the potential to lower the risk of different cancer types.…”