Welche Effekte hat körperliche Bewegung auf das Krebsrisiko und auf den Krankheitsverlauf nach einer Krebsdiagnose?

Leitthema

Zusammenfassung

Zahlreiche epidemiologische Studien zeigen, dass regelmäßige körperliche Bewegung das Risiko für Kolonkrebs überzeugend, für Endometrium- und postmenopausalen Brustkrebs wahrscheinlich und für prämenopausalen Brustkrebs, Prostata-, Lungen- und Pankreaskrebs vermutlich verringert. Das Ausmaß der relativen Risikoreduktion liegt zwischen 10 und 30%. Absolut gehen 9 bis 19% der häufigsten Tumore auf einen Mangel an hinreichender Bewegung zurück. Damit weist körperliche Bewegung als veränderbarer Lebensstilfaktor ein substanzielles Potenzial für die bevölkerungsbezogene Krebsprävention auf. Gegenwärtige Empfehlungen legen nahe, täglich mindestens 30 bis 60 Minuten moderat körperlich aktiv zu sein. Auch in der Krebsnachsorge gewinnt der Faktor Bewegung zunehmend an Bedeutung. Es gilt als wahrscheinlich, dass körperliche Bewegung in fast allen Stadien einer Krebserkrankung möglich, sicher und sogar empfehlenswert ist. Kontrollierte und randomisierte Studien deuten darauf hin, dass negative krankheits- und therapiebedingte Symptome wie Fatigue, Schlafstörungen und Depressionen, die teilweise jahrelang die Lebensqualität der Betroffenen einschränken, durch körperliche Bewegung reduzierbar sind. Zu den Effekten körperlicher Aktivität auf die krankheitsspezifische Mortalität und die Gesamtmortalität liegen noch keine klinischen Studien vor; erste Beobachtungsstudien haben jedoch Risikoreduktionen bei Brust-, Darm- und Prostatakrebs gezeigt.

Schlüsselwörter

Bewegung Krebs Körperliche Aktivität Krankheitsverlauf Prävention 

Effects of physical activity on cancer risk and disease progression after cancer diagnosis

Abstract

Numerous epidemiologic studies have demonstrated that regular physical activity convincingly reduces risk for colon cancer, probably for endometrium and postmenopausal breast cancer, and possibly for premenopausal breast, prostate, lung, and pancreas cancer. Relative risk reductions range from 10–30%. On the absolute scale about 9–19% of the most frequent cancers can be attributed to a lack of sufficient physical activity. Thus, exercise, as a modifiable health behavior, has a strong potential for primary cancer prevention. Current recommendations call for at least 30–60 min of moderate to vigorous activity daily. Physical activity is also increasingly gaining importance in cancer treatment and is now considered to be feasible, safe, and even recommended in almost all stages of disease. Randomized-controlled trials show that disease- and treatment-related symptoms, such as fatigue, sleep disorders, and depression which sometimes limit quality of life in cancer patients over years, can be reduced by physical activity. For disease-specific and total mortality, clinical studies are not yet available. However, preliminary observational studies with breast, colon, and prostate cancer patients show risk reductions.

Keywords

Exercise Cancer Physical activity Disease progression Prevention 

Literatur

  1. 1.
    Husemann B, Neubauer MG, Duhme C (1980) Sitzende Tätigkeit und Rektum-Sigma-Karzinom. Onkologie 3:168–171PubMedCrossRefGoogle Scholar
  2. 2.
    IARC (2002) IARC Handbooks of cancer prevention, volume 6; Weight control and physical activity. IARC, LyonGoogle Scholar
  3. 3.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global prospective. AICR, Washington DCGoogle Scholar
  4. 4.
    Courneya KS, Friedenreich CM (2011) Physical activity and cancer. Springer, HeidelbergGoogle Scholar
  5. 5.
    Wolin KY, Yan Y, Colditz GA, Lee IM (2009) Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer 100(4):611–616PubMedCrossRefGoogle Scholar
  6. 6.
    Wolin KY, Tuchman H (2011) Physical activity and gastrointestinal cancer prevention. Recent Results Cancer Res 186:73–100PubMedCrossRefGoogle Scholar
  7. 7.
    Frisch RE, Wyshak G, Albright NL et al (1985) Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non-athletes. Br J Cancer 52(6):885–891PubMedCrossRefGoogle Scholar
  8. 8.
    Lynch BM, Neilson HK, Friedenreich CM (2011) Physical activity and breast cancer prevention. Recent Results Cancer Res 186:13–42PubMedCrossRefGoogle Scholar
  9. 9.
    Monninkhof EM, Elias SG, Vlems FA et al (2007) Physical activity and breast cancer, a systematic review of current evidence. Epidemiology 18:137–157PubMedCrossRefGoogle Scholar
  10. 10.
    Voskuil DW, Monninkhof EM, Elias SG et al (2007) Physical activity and endometrial cancer risk, a systematic review of current evidence. Cancer Epidemiol Biomarkers Prev 16(4):639–648PubMedCrossRefGoogle Scholar
  11. 11.
    Cust AE, Armstrong BK, Friedenreich CM et al (2007) Physical activity and endometrial cancer risk: a review of the current evidence, biologic mechanisms and the quality of physical activity assessment methods. Cancer Causes Control 18(3):243–258PubMedCrossRefGoogle Scholar
  12. 12.
    Emaus A, Thune I (2011) Physical activity and lung cancer prevention. Recent Results Cancer Res 186:101–133PubMedCrossRefGoogle Scholar
  13. 13.
    Tardon A, Lee WJ, Delgado-Rodriguez M et al (2005) Leisure-time physical activity and lung cancer: a meta-analysis. Cancer Causes Control 16(4):389–397PubMedCrossRefGoogle Scholar
  14. 14.
    Leitzmann MF (2011) Physical activity and genitourinary cancer prevention. Recent Results Cancer Res 186:43–71PubMedCrossRefGoogle Scholar
  15. 15.
    Bao Y, Michaud DS (2008) Physical activity and pancreatic cancer risk: a systematic review. Cancer Epidemiol Biomarkers Prev 17(10):2671–2682PubMedCrossRefGoogle Scholar
  16. 16.
    O’Rorke MA, Cantwell MM, Cardwell CR et al (2010) Can physical activity modulate pancreatic cancer risk? A systematic review and meta-analysis. Int J Cancer 126(12):2957–2968Google Scholar
  17. 17.
    Robert Koch-Institut (2010) Verbreitung von Krebserkrankungen in Deutschland. Entwicklung der Prävalenzen zwischen 1990 und 2010. Beiträge zur Gesundheitsberichterstatung des Bundes. BerlinGoogle Scholar
  18. 18.
    Sjostrom M, Oja P, Hagstromer M et al (2006) Health-enhancing physical activity across European Union Countries: the EUROBAROMETER study. J Public Health 14:291–300CrossRefGoogle Scholar
  19. 19.
    Friedenreich CM, Neilson HK, Lynch BM (2010) State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer 46(14):2593–2604PubMedCrossRefGoogle Scholar
  20. 20.
    Barnes BB, Steindorf K, Hein R et al (2011) Population attributable risk of invasive postmenopausal breast cancer and breast cancer subtypes for modifiable and non-modifiable risk factors. Cancer Epidemiol 35(4):345–352PubMedCrossRefGoogle Scholar
  21. 21.
    Kipnis V, Freedman LS (2008) Impact of exposure measurement error in nutritional epidemiology. J Natl Cancer Inst 100(23):1658–1659PubMedCrossRefGoogle Scholar
  22. 22.
    Haskell WL, Lee IM, Pate RR et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116(9):1081–1093PubMedCrossRefGoogle Scholar
  23. 23.
    WHO (2011) Global strategy on diet, physical activity, and health. http://www.who.int/dietphysicalactivity/en/Google Scholar
  24. 24.
    Kushi LH, Byers T, Doyle C et al (2006) American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 56(5):254–281PubMedCrossRefGoogle Scholar
  25. 25.
    Steindorf K, Schmidt ME, Wiskemann J (2011) Körperliche Aktivität nach der Krebsdiagnose. Forum 26:38–41CrossRefGoogle Scholar
  26. 26.
    Speck RM, Courneya KS, Masse LC et al (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4(2):87–100PubMedCrossRefGoogle Scholar
  27. 27.
    Barbaric M, Brooks E, Moore L, Cheifetz O (2010) Effects of physical activity on cancer survival: a systematic review. Physiother Can 62(1):25–34PubMedCrossRefGoogle Scholar
  28. 28.
    Ibrahim EM, Al-Homaidh A (2011) Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol 28(3):753–765PubMedCrossRefGoogle Scholar
  29. 29.
    Irwin ML, McTiernan A, Manson JE et al (2011) Physical activity and survival in postmenopausal women with breast cancer: results from the women’s health initiative. Cancer Prev Res (Phila) 4(4):522–529CrossRefGoogle Scholar
  30. 30.
    Haydon AM, MacInnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55(1):62–67PubMedCrossRefGoogle Scholar
  31. 31.
    Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24(22):3527–3534PubMedCrossRefGoogle Scholar
  32. 32.
    Meyerhardt JA, Heseltine D, Niedzwiecki D et al (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24(22):3535–3541PubMedCrossRefGoogle Scholar
  33. 33.
    Meyerhardt JA, Giovannucci EL, Ogino S et al (2009) Physical activity and male colorectal cancer survival. Arch Intern Med 169(22):2102–2108PubMedCrossRefGoogle Scholar
  34. 34.
    Ainsworth BE, Haskell WL, Leon AS et al (1993) Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 25(1):71–80PubMedCrossRefGoogle Scholar
  35. 35.
    Ainsworth BE, Haskell WL, Whitt MC et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498–S504PubMedCrossRefGoogle Scholar
  36. 36.
    Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM (2011) Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol 29(6):726–732PubMedCrossRefGoogle Scholar
  37. 37.
    Richman EL, Kenfield SA, Stampfer MJ et al (2011) Physical activity after diagnosis and risk of prostate cancer progression: data from the cancer of the prostate strategic urologic research endeavor. Cancer Res 71(11):3889–3895PubMedCrossRefGoogle Scholar
  38. 38.
    Schmitz KH, Courneya KS, Matthews C et al (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426PubMedCrossRefGoogle Scholar
  39. 39.
    Keogh JW, Macleod RD (2011) Body composition, physical fitness, functional performance, quality of life, and fatigue benefits of exercise for prostate cancer patients: a systematic review. J Pain Symptom Manage [Epub ahead of print]Google Scholar
  40. 40.
    San Juan AF, Wolin K, Lucia A (2011) Physical activity and pediatric cancer survivorship. Recent Results Cancer Res 186:319–347Google Scholar
  41. 41.
    Lowe SS (2011) Physical activity and palliative cancer care. Recent Results Cancer Res 186:349–365PubMedCrossRefGoogle Scholar
  42. 42.
    Schmitz KH, Ahmed RL, Troxel A et al (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361(7):664–673PubMedCrossRefGoogle Scholar
  43. 43.
    Baumann F, Dimeo F, Graf C et al für die Kommission „Krebs und Sport“ der Deutschen Krebsgesellschaft (2009) Teil I: Richtlinien für die Anwendung von Sport und körperlicher Aktivität in der Prävention, supportiven Therapie und Rehabilitation neoplastischer Erkrankungen. Forum 23:14–17Google Scholar
  44. 44.
    Baumann F, Dimeo F, Graf C et al für die Kommission „Krebs und Sport“ der Deutschen Krebsgesellschaft (2009). Teil II: Richtlinien für die Anwendung von Sport und körperlicher Aktivität in der Prävention, supportiven Therapie und Rehabilitation neoplastischer Erkrankungen. Forum 24:9–12Google Scholar
  45. 45.
    Hayes SC, Spence RR, Galvao DA, Newton RU (2009) Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. J Sci Med Sport 12(4):428–434PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2011

Authors and Affiliations

  1. 1.AG Bewegung und Krebs, Umweltepidemiologie (C030)Deutsches Krebsforschungszentrum(DKFZ)HeidelbergDeutschland
  2. 2.Abteilung für Präventive OnkologieDeutsches Krebsforschungszentrum (DKFZ) und Nationales Centrum für Tumorerkrankungen (NCT)HeidelbergDeutschland

Personalised recommendations