The primary purpose of this narrative review was to evaluate the current literature and to provide further insight into the role physical inactivity plays in the development of chronic disease and premature death. We confirm that there is irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases (e.g., cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis) and premature death. We also reveal that the current Health Canada physical activity guidelines are sufficient to elicit health benefits, especially in previously sedentary people. There appears to be a linear relation between physical activity and health status, such that a further increase in physical activity and fitness will lead to additional improvements in health status.

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Health benefits of physical activity: the evidence

Background Sipuleucel-T, an autologous active cellular immunotherapy, has shown evidence of efficacy in reducing the risk of death among men with metastatic castration-resistant prostate cancer. Methods In this double-blind, placebo-controlled, multicenter phase 3 trial, we randomly assigned 512 patients in a 2:1 ratio to receive either sipuleucel-T (341 patients) or placebo (171 patients) administered intravenously every 2 weeks, for a total of three infusions. The primary end point was overall survival, analyzed by means of a stratified Cox regression model adjusted for baseline levels of serum prostate-specific antigen (PSA) and lactate dehydrogenase. Results In the sipuleucel-T group, there was a relative reduction of 22% in the risk of death as compared with the placebo group (hazard ratio, 0.78; 95% confidence interval [CI], 0.61 to 0.98; P = 0.03). This reduction represented a 4.1-month improvement in median survival (25.8 months in the sipuleucel-T group vs. 21.7 months in the placebo group). The 36-month survival probability was 31.7% in the sipuleucel-T group versus 23.0% in the placebo group. The treatment effect was also observed with the use of an unadjusted Cox model and a log-rank test (hazard ratio, 0.77; 95% CI, 0.61 to 0.97; P = 0.02) and after adjustment for use of docetaxel after the study therapy (hazard ratio, 0.78; 95% CI, 0.62 to 0.98; P = 0.03). The time to objective disease progression was similar in the two study groups. Immune responses to the immunizing antigen were observed in patients who received sipuleucel-T. Adverse events that were more frequently reported in the sipuleucel-T group than in the placebo group included chills, fever, and headache. Conclusions The use of sipuleucel-T prolonged overall survival among men with metastatic castration-resistant prostate cancer. No effect on the time to disease progression was observed. (Funded by Dendreon; ClinicalTrials.gov number, NCT00065442.)

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Sipuleucel-T immunotherapy for castration-resistant prostate cancer.

to physical functioning and quality of life are sufficient for the recommendation that cancer survivors follow the 2008 Physical Activity Guidelines for Americans, with specific exercise programming adaptations based on disease and treatment-related adverse effects. The advice to ‘‘avoid inactivity,’’ even in cancer patients with existing disease or undergoing difficult treatments, is likely helpful.

/pdf/american-college-of-sports-medicine-roundtable-on-exercise-3udagm54jn.pdf

American College of Sports Medicine roundtable on exercise guidelines for cancer survivors.

American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors: Corrigendum

Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.

https://www.unitypoint.org/desmoines/filesimages/Cancer%20Education/Oncology%20Nursing%20Conference/2015/2014%20NCCN%20Clin%20Pract%20Guidelines%20Male%20Sex%20Dysf.pdf

Clinical practice guidelines in oncology

Purpose: Androgen deprivation therapy is a common treatment in men with prostate cancer that may cause fatigue, functional decline, increased body fatness, and loss of lean body tissue These physical changes can negatively affect health-related quality of life Resistance exercise may help to counter some of these side effects by reducing fatigue, elevating mood, building muscle mass, and reducing body fat Methods: In a two-site study, 155 men with prostate cancer who were scheduled to receive androgen deprivation therapy for at least 3 months after recruitment were randomly assigned to an intervention group that participated in a resistance exercise program three times per week for 12 weeks (82 men) or to a waiting list control group (73 men) The primary outcomes were fatigue and disease-specific quality of life as assessed by self-reported questionnaires after 12 weeks Secondary outcomes were muscular fitness and body composition Results: Men assigned to resistance exercise had less interference fr

Resistance Exercise in Men Receiving Androgen Deprivation Therapy for Prostate Cancer

Effect of supervised exercise on aerobic capacity in cancer survivors: Adherence and workload predict variance in effect

A comparative study of the operation of the purine nucleotide cycle and of the activity of adenylosuccinase in extracts of muscle from the two strains of dystrophic mouse shows that the cycle is defective in both cases in the conversion of adenylosuccinate to AMP. However, adenylosuccinase activity is only slightly reduced in the standard conditions for its direct assay.

Purine nucleotide cycle enzymes in dystrophic and normal mouse muscle

Purpose: Androgen deprivation therapy is a common treatment in men with prostate cancer that may cause fatigue, functional decline, increased body fatness, and loss of lean body tissue. These physical changes can negatively affect health-related quality of life. Resistance exercise may help to counter some of these side effects by reducing fatigue, elevating mood, building muscle mass, and reducing body fat. Methods: In a two-site study, 155 men with prostate cancer who were scheduled to receive androgen deprivation therapy for at least 3 months after recruitment were randomly assigned to an intervention group that participated in a resistance exercise program three times per week for 12 weeks (82 men) or to a waiting list control group (73 men). The primary outcomes were fatigue and disease-specific quality of life as assessed by self-reported questionnaires after 12 weeks. Secondary outcomes were muscular fitness and body composition. Results: Men assigned to resistance exercise had less interference from fatigue on activities of daily living (P .002) and higher quality of life (P .001) than men in the control group. Men in the intervention group demonstrated higher levels of upper body (P .009) and lower body (P < .001) muscular fitness than men in the control group. The 12-week resistance exercise intervention did not improve body composition as measured by changes in body weight, body mass index, waist circumference, or subcutaneous skinfolds. Conclusion: Resistance exercise reduces fatigue and improves quality of life and muscular fitness in men with prostate cancer receiving androgen deprivation therapy. This form of exercise can be an important component of supportive care for these patients. J Clin Oncol 21:1653-1659. © 2003 by American Society of Clinical Oncology.

Resistance E xercise i n M en R eceiving A ndrogen D eprivation Therapy f or P rostate C ancer

Halsklierdissectie (operatief verwijderen van de lymfeklieren in de hals) wordt vaak uitgevoerd in samenhang met chirurgische resectie van de plaats van de primaire tumor bij kanker van hoofd of hals. Een ernstige complicatie bij halsklierdissectie is het verlies van functie van de m. trapezius als gevolg van niet-permanente beschadiging van of resectie (gedeeltelijke verwijdering) van de n. accessorius. Mettertijd kan de resulterende schouderdisfunctie verergeren tot een chronische toestand met bewegingsbeperking van het glenohumerale gewricht en aanzienlijke deformiteit van het schoudercomplex. Patienten met ernstige klachten kunnen zijn aangewezen op langdurig gebruik van verdovende middelen.Hoewel er in de literatuur al meer dan twintig jaar gunstige resultaten van fysiotherapie zijn vermeld, bestaat er maar weinig onderzoek op dit gebied en blijft onzeker wat de meest effectieve therapeutisch interventies zijn. Wij presenteren drie casussen die de heilzame rol van progressieve weerstandstraining (pwt) illustreren bij de vermindering van schouderpijn en -disfunctie bij hoofdpatienten met hoofd-halskanker, met beschadiging van de n. accessorius.

Matthew B. Parliament

Papers

Resistance Exercise in Men Receiving Androgen Deprivation Therapy for Prostate Cancer

Effect of supervised exercise on aerobic capacity in cancer survivors: Adherence and workload predict variance in effect

Purine nucleotide cycle enzymes in dystrophic and normal mouse muscle

Resistance E xercise i n M en R eceiving A ndrogen D eprivation Therapy f or P rostate C ancer

Weerstandsoefeningen voor schouderpijn na halsklierdissectie: drie casussen