Kanser Tedavisinde Bazı Biyokimyasal Parametreler Üzerine Fiziksel Aktivitenin Rolü

Yıl 2024, , 10 - 24, 31.03.2024

Egemen Dere

https://doi.org/10.59312/ebshealth.1363593

Öz

Kanser ciddi bir halk sağlığı sorunu oluşturmaktadır. Son araştırmalar, kanser hastalarının hem tedavi sırasında hem de sonrasında yaşam kalitesini artırmada egzersizin önemli rolünün ve tedavi sonuçları üzerindeki potansiyel olumlu etkisinin altını çiziyor. Bu makale, güncel verilerden yararlanarak, kanser bağlamında fiziksel aktivitenin önemini değerlendirmektedir.
Kanser tedavisi farklı yöntem ve stratejileri içeren uzun vadeli bir süreçtir. Bir tedavi planı hazırlamak hastanın yaşı, genel sağlık durumu, spesifik kanser türü ve evrelemesi gibi faktörlere bağlıdır. Kanser tedavisinin ana yöntemleri arasında kemoterapi, radyoterapi, immünoterapi, cerrahi prosedürler, hedefe yönelik tedaviler, hormon tedavisi ve kök hücre nakli yer alır. Bu yöntemlerden bir veya birkaçı ile tedavi edilen hastalarda ortaya çıkan yan etkileri azaltmanın yollarından biri aerobik ve direnç egzersizleri yapmaktır.
Araştırmalar kanser tedavisinde fiziksel aktivitenin artan önemini vurgulamaktadır. Bu dönem artan duygusal stres ile karakterizedir. Düzenli egzersizin kanıtlanmış faydaları vardır. Egzersiz, endorfin salınımını uyarır, depresyonu, kaygıyı azaltır ve daha iyi uyku kalitesini artırır. Ayrıca yorgunluk, kas kaybı, kilo alımı ve kemik yoğunluğunun azalması gibi yan etkilerin hafifletilmesine de hizmet eder. Ayrıca düzenli egzersiz bağışıklık sisteminin güçlendirilmesine, enfeksiyonlara karşı direncin artmasına katkıda bulunur. Özellikle, bir araştırma meme kanseri olan kadınların egzersizi yaşamlarına dahil ettiklerinde kanserin tekrarlama riskinin azaldığını vurgulamaktadır.
Kanser tedavisinde egzersiz, enzim aktiviteleri üzerinde önemli bir etkiye sahiptir ve potansiyel olarak metabolik süreçlerde değişikliklere yol açmaktadır. Enzim aktiviteleri metabolizma üzerindeki etkilerine bağlı olarak artabilir veya azalabilir. Özellikle egzersizin antioksidan enzimlerin aktivitesini arttırırken aynı zamanda oksidatif stresi azalttığı gösterilmiştir. Oksidatif stresin kanser hücrelerinin büyümesini ve yayılmasını kolaylaştırdığı bilindiğinden, kanser tedavisi düşünüldüğünde bu etki özel bir öneme sahiptir.
Sonuçta, kanser tedavisi sırasında ve sonrasında egzersiz yapmanın öneminin giderek daha fazla anlaşıldığı söylenebilir. Ancak her hastanın kanseri kendine özel olduğu için yapılacak fiziksel aktivitelerin bireysel olarak planlanması ve uzmanlar tarafından takip edilmesi gerekmektedir.

Anahtar Kelimeler

Aerobik egzersiz, kanser tedavisi, fiziksel aktivite

Etik Beyan

YOK

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

YOK

The Role of Physical Activity on Some Biochemical Parameters in Cancer Treatment

Öz

Cancer poses a serious public health problem. Recent studies underscore the crucial role of exercise in enhancing the quality of life for cancer patients, both during and after treatment, and its potential positive impact on treatment outcomes. This article assesses the importance of physical activity in the context of cancer, drawing on current data.
Cancer treatment is a long-term process that includes different methods and strategies. Crafting a treatment plan hinges on factors such as the patient's age, overall health, specific cancer type, and its staging. The main methods of cancer treatment include chemotherapy, radiotherapy, immunotherapy, surgical procedures, targeted therapies, hormone therapy and stem cell transplantation. One of the ways to reduce the side effects that occur in patients treated with one or more of these methods is to do aerobic and resistance exercises.
Research emphasizes the increasing importance of physical activity in cancer treatment. This period is characterized by increased emotional stress. Regular exercise has proven benefits. Exercise stimulates the release of endorphins, reduces depression, anxiety and promotes better sleep quality. Furthermore, it serves to alleviate side effects such as fatigue, muscle loss, weight gain, and diminished bone density. Additionally, regular exercise contributes to fortifying the immune system, enhancing resistance against infections. Notably, a research highlights that women with breast cancer exhibit a reduced risk of cancer recurrence when they incorporate exercise into their lives
Exercise in cancer treatment exerts a significant influence on enzyme activities, potentially leading to alterations in metabolic processes. Enzyme activities may either rise or fall based on their impact on metabolism. Notably, exercise has been shown to boost the activity of antioxidant enzymes while simultaneously diminishing oxidative stress. This effect holds particular importance when considering cancer treatment, as oxidative stress is known to facilitate the growth and dissemination of cancer cells
In conclusion, it can be said that the importance of exercising during and after cancer treatment is increasingly understood. However, since each patient's cancer is unique, physical activities need to be individually tailored and monitored by experts.

Anahtar Kelimeler

Aerobic exercise, cancer treatment, physical activity

Proje Numarası

YOK

Kaynakça

• Abdulrasool, M. D., Joda, E. O. and Alawady, A. A. (2020). The effect of psycho-physiological sports proposed in terms of the hormone endorphins serotonin and their relative results on mental fitness in the aged, Annals of Tropical Medicine & Public Health, 23(S13B), SP231369. doi:org/10.36295/ASRO.2020.231369
• AL-Mhanna, S. B., Ghazali, W. S. W., Mohamed, M., Rabaan, A. A., Santali, E. Y., Alestad J. H…Afolabi, H. A. (2022). Effectiveness of physical activity on immunity markers and quality of life in cancer patient: a systematic review. PeerJ, 10:e13664 doi:org/10.7717/peerj.13664
• Avancini, A., Sartori, G., Gkountakos, A., Casali M., Trestini I., Tregnago D…Pilotto, S. (2020). Physical activity and exercise in lung cancer care: will promises be fulfilled? Oncologist, 25(3), e55e569, doi:org/10.1634/theoncologist.2019-0463
• Baran, E. (2021). Ünilateral meme kanseri tedavisi ile ilişkili üst ekstremite lenfödeminde kompleks boşaltıcı fizyoterapinin duyusal parametreler üzerine etkisinin incelenmesi. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Fizik Tedavi ve Rehabilitasyon Programı Doktora Tezi.
• Basha, M. A., Aboelnour, N. H., Alsharidah, A. S. and Kamel F. H. (2022). Effect of exercise mode on physical function and quality of life in breast cancer–related lymphedema: a randomized trial. Supportive Care in Cancer, 30(3), 2101-2110. Doi:org/10.1007/s00520-021-06559-1
• Bessa, A., Bosco, C., Mehrotra, S., Rowland, M., Zhang, H., Russell…Hemelrijck, M. V. (2021). Is there a role for physical activity interventions in the treatment pathway of bladder cancer? A scoping review of the literature. BMJ Open Sport & Exercise Medicine, 7:e000951, doi:org/10.1136/bmjsem-2020-000951
• Boice, A. and Bouchier-Hayesa, L. (2020). Targeting apoptotic caspases in cancer. BBA - Molecular Cell Research 1867, 118688, doi:org/10.1016/j.bbamcr.2020.118688
• Bozkurt, F. (2021) Kadın futbolcularda ppar-alpha geni polimorfizinin incelenmesi. Ondokuz Mayıs Üniversitesi Lisansüstü Eğitim Enstitüsü Beden Eğitim ve Spor Anabilim Dalı Yüksek Lisans Tezi, Proje kodu: PYO.YDS.1904.19.001.
• Brown, J. C., Ma, C., Shi, Q., Niedzwiecki, D., Zemla, T., Couture, F…Meyerhardt, J. A. (2023). Association between physical activity and the time course of cancer recurrence in stage III colon cancer. British Journal of Sports Medicine, 1-8, doi:org/10.1136/bjsports-2022-106445
• Capozzi, L. C., Daun, J. T., Ester, M., Mosca, S., Langelier, D., Francis, G. J…Culos-Reed, S. N. (2021). Physical activity for individuals living with advanced cancer: evidence and recommendations. Seminars in Oncology Nursing, 37(4), 151170 doi:org/10.1016/j.soncn.2021.151170
• Chang, J. S., Kim, T. H. and Kong, I. D. (2020). Exercise intervention lowers aberrant serum WISP-1 levels with insulin resistance in breast cancer survivors: A randomized controlled trial. Scientific. Reports, 10, 10898, doi:org/10.1038/s41598-020-67794-w
• Chen, F. T., Hopman, R. J., Huang, C. J., Chu, C. H., Hillman, C. H., Hung, T. M. and Chang Y. K. (2020). The effect of exercise training on brain structure and function in older adults: A systematic review based on evidence from randomized control trials. Journal of Clinical. Medicine, 9 (4), 914 doi:org/10.3390/jcm9040914
• Chen, J., Zhou, R., Feng, Y. and Cheng, L. (2022). Molecular mechanisms of exercise contributing to tissue regeneration. Signal Transduction Targeted Therapy, 7, 383 doi:org/10.1038/s41392-022-01233-2
• Cormie, P., Zopf, E. M., Zhang, X., Kathryn, H. and Schmitz, K. H. (2017). The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiology Reviews, 39, 71-92, doi:org/10.1093/epirev/mxx007
• Cutone, A., Rosa, L., Ianiro, G., Lepanto, M. S., di Patti, M. C. B., Valenti, P. and Musci, G. (2020). Lactoferrin’s anti-cancer properties: Safety, selectivity, and wide range of action. Biomolecules, 10, 456, doi:org/10.3390/biom10030456
• Da Silveira, M. P., Fagundes, K. K. S., Bizuti, M. R., Starck, É., Rossi, R. C. and e Silva D. T. R. (2021). Physical exercise as a tool to help the immune system against COVID-19: An integrative review of the current literature Clinical and Experimental Medicine, 21, 15–28
• Davis, A. R., Goodenough, C. G., Westerlind, K. C., Strange, R., Deaver, J. W., Ryan…Fluckey, J. D. (2022). Myokines derived from contracting skeletal muscle suppress anabolism in MCF7 breast cancer cells by inhibiting mTOR. Frontiers Physiology. 13,1033585, doi:org/10.3389/fphyt.2022.1033585
• De Nys, L., Anderson, K., Ofosu, E. F., Ryde, G. C., Connelly, J. and Whittaker, A. C., (2022). The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis Psychoneuroendocrinology, 143, 105843, doi:org/10.1016/j.psyneuen.2022.105843
• De Roon, M., May, A. M., McTiernan, A., Scholten, R. J. P. M., Peeters, P. H. M., Friedenreich, C. M. and Monninkhof, E. M. (2018). Effect of exercise and/or reduced calorie dietary interventions on breast cancerrelated endogenous sex hormones in healthy postmenopausal women. Breast Cancer Research, 20, 81, doi:org/10.1186/s13058-018-1009-8
• Deb, A. A., Okechukwu, C. E., Emara, S. and Abbas, S. A. (2019). Physical activity and prostate cancer: A systematic review. Urology & Nephrology Open Access Journal, 7(5), 117-129.
• Dethlefsen, C., Hansen, L. S., Lillelund, C., Andersen, C., Gehl, J., Christensen J. F…Hojman, P. (2017). Exercise-Induced catecholamines activate the hippo tumor suppressor pathway to reduce risks of breast cancer development. Cancer Research, 77, 4894–4904, doi:org/10.1158/0008-5472.CAN-16-3125
• Docherty, S., Harley, R., McAuley, J. J., Crowe, L. A. N., Pedret, C., Kirwan ,P. D…Millar, N. L. (2022). The effect of exercise on cytokines: implications for musculoskeletal health: a narrative review. BMC Sports Science, Medicine and Rehabilitation, 14(5).
• Emery, A., Moore, S., James, E. Turner, J. E. and Campbell, J. P. (2022). Reframing how physical activity reduces the incidence of clinically-diagnosed cancers: appraising exercise-induced immuno-modulation as an integral mechanism. Frontiers in Oncology, 12, 788113, doi:org/10.3389/fonc.2022.788113
• Esmailiyan, M., Nobari, H., Kargarfard, M., Amerizadeh, A., Esfarjani, F., Vaseghi…Ardigo, L. P. (2022). Effect of 12-week aerobic exercise training on chemokine ligands and their relative receptors in balb/c mice with breast cancer. International Journal of Sport Studies for Health, 5(2), e134187, doi:org/10.5812/intjssh-134187.
• Faris, W. I. A., Ashem, H. N., El-Ghany, M., S., El-D. and Othman E. M. (2022). Leptin and ghrelin response to aerobic exercises in post-colectomy patients. International Journal of Recent Advances in Multidisciplinary Research, 09(08), 7911-7916, www.ijramr.com
• Goldschmidt, S., Schmidt, M. E. and Steindorf K. (2023). Long‑term effects of exercise interventions on physical activity in breast cancer patients: a systematic review and meta‑analysis of randomized controlled trials. Supportive Care in Cancer 31, 130, doi:org/10.1007/s00520-022-07485-6
• Hayes, S. C., Steele, M. L., Spence, R. R., Gordon, L., Battistutta, D., Bashford...Eakin, E. (2018). Exercise following breast cancer: Exploratory survival analyses of two randomised, controlled trials. Breast Cancer Research Treatment, 167, 505–514, doi:org/10.1007/s10549-017-4541-9
• Haupt, S., Niedrist, T., Sourij, H., Schwarzinger, S. and Moser, O. (2022). The impact of exercise on telomere length, dna methylation and metabolic footprints. Cells, 11, 153, doi:org/10.3390/cells11010153
• Hauth, F., De-Colle, C., Weidner, N., Heinrich, V., Zips D. and Gani, C. (2021). Quality of life and fatigue before and after radiotherapy in breast cancer patients. Strahlenther Onkology, 197(4), 281-7, doi:org/ 10.1007/s00066-020-01700-1
• Hilfiker, R., Meichtry, A., Eicher, M., Balfe, L. N., Knols, R. H., Verra, M. L. and Taeymans, J. (2018). Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: A systematic review incorporating an indirectcomparisons meta-analysis. British journal of sports medicine, 52(10), 651–658, doi:10.1136/bjsports-2016-096422
• Huneidi, S. A., Wright, N. C., Atkinson, A., Bhatia, S. and Singh, P. (2018). Factors associated with physical inactivity in adult breast cancer survivors-A population‐based study. Cancer Medicine, 7(12), 6331-6339, doi:10.1002/cam4.1847
• Iwase, T., Wang, X., Shrimanker, T. V., Kolonin, M. G. and Ueno, N. T. (2021). Body composition and breast cancer risk and treatment: Mechanisms and impact. Breast Cancer Research Treatment, 186, 273-283, doi:org/10.1007/s10549-020-06092-5
• Kim, J., Lee, J., Oh, J. H., Chang, H. J., Sohn, D. K., Shin, A. and Kim, J. (2020). Plasma inflammatory biomarkers and modifiable lifestyle factors associated with colorectal cancer risk. Clinical Nutrition, 39(9), 2778–2785, doi:org/10.1016/j.clnu.2019.12.005
• Lee, J. H. and Jun, H. S. (2019). Role of myokines in regulating skeletal muscle mass and function. Frontiers Physiology, 10(42) 1-9, doi:org/10.3389/fphys.2019.00042
• Lee, M. K. and Oh, J. (2021). Patient-reported outcomes of regular aerobic exercise in gastric cancer. Cancers, 13, 2080. doi:org/10.3390/cancers13092080.
• Lee, S. and Margolin, K. (2011). Cytokines in cancer immunotherapy, Cancers (Basel), 3(4), 3856–3893. Doi:org/10.3390/cancers3043856
• Ligibel, J. A., Bohlke, K., May, A., M., Clinton, S. K., Demark-Wahnefried, W., Gilchrist, S...Alfano, C. M. (2022). Exercise, diet, and weight management during cancer treatment: ASCO Guideline Journal of Clinical Oncology, 40(22), 2491-2507, Doi:org/10.1200/JCO.22.00687
• Marques, A., Marconcin, P., Werneck, A. O., Ferrari, G., Gouveia, E. R., Kliegel, M… Ihle, A. (2021). Bidirectional association between physical activity and dopamine across adulthood—A Systematic Review. cBrain Science, 11(7), 829, doi:org/10.3390/brainsci11070829
• Metcalfe, R. S., Kemp, R., Heffernan, S. M., Churm, R., Chen, Y. C., Ruffino, J. S…Orange, S. T. (2021). Anticarcinogenic effects of exercise-conditioned human serum: evidence, relevance and opportunities. European Journal of Applied Physiology, 121, 2107-2124, doi:org/10.1007/s00421-021-04680-x
• Misiag, W., Piszczyk, A., Szymanska-Chabowska, A. and Chabowski, M. (2022). Physical Activity and Cancer care-a review. Cancers, 14, 4154, doi:org/10.3390/cancers14174154
• Moon, H.S. and Mantzoros, C. S. (2014). Regulation of cell proliferation and malignant potential by irisin in endometrial, colon, thyroid and esophageal cancer cell lines. Metabolism, 63(2), 188-193, doi:org/10.1016/j.metabol.2013.10.005.
• Morishita, S., Hamaue, Y., Fukushima, T., Tanaka, T., Fu J. B. and Nakano, J. (2020). Effect of exercise on mortality and recurrence in patients with cancer: A Systematic Review and Meta-Analysis Integrative Cancer Therapies, 19, 1-10, doi:org/10.1177/1534735420917462
• Nazik, E., Öztunç, G. and Şahin, B. (2014). Effects of progressive relaxation training on sleep quality and pain in patients with breast cancer undergoing chemotherapy. Anatolian Journal of Nursing and Health Sciences, 17(3), 171-178.
• Nuri, R., Moghaddasi, M. and Izadpanah, A. (2016). Effect of aerobic exercise on leptin and ghrelin in patients with colorectal cancer. Journal of Cancer Research and Therapeutics, 12(1), 169-174, doi:org/10.4103/0973-1482.155982
• Onerup, A. (2021). The role of physical activity for recovery after surgical procedures. Department of Surgery Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg, ISBN 978-91-8009-159-6 (PDF), http://hdl.handle.net/2077/67125
• Oruç, Z. and Kaplan, M. A., (2019). Effect of exercise on colorectal cancer prevention and treatment, World Journal Gastrointest Oncology, 11(5), 348-366, doi:org/10.4251/wjgo.v11.i5.348
• Pahlavani, H. A. and Veisi, A. (2018). The effect of aerobic and anaerobic training with melatonin consumption on the expression of apoptotic genes BAX and BCL2 myocardial in rats after ischemic reperfusion. Journal of Human Sport and Exercise, 13(2), 454–66, doi:org/10.14198/jhse.2018.13.Proc2.29.
• Perego, S., Sansoni, V., Ziemann, E. and Lombardi, G. (2021). Another weapon against cancer and metastasis: physical-activity-dependent effects on adiposity and adipokines. International Journal of Molcular Sciences, 22, 2005. doi:org/10.3390/ijms22042005
• Permadi, A. (2019). The benefits of aerobic training for improving quality of life: A Critical Review of Study, WMJ, 4(2), 57-60, doi:org/10.22225/wmj.4.2.1016.57-60
• Piraux, E., Caty, G., Nana, F. A. and Reychler, G. (2020). Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: A narrative review, 8, doi:org/10.1177/2050312120922657
• Pollán, M., Casla‑Barrio, S., Alfaro, J., Esteban, C., Segui‑Palmer, M.A., Lucia, A. and Martín, M. (2020). Exercise and cancer: a position statement from the Spanish Society of Medical Oncology. Clinical and Translational Oncology, 22, 1710-1729, doi:org/10.1007/s12094-020-02312-y
• Rasmussen, G. H. F., Kristiansen, M., Arroyo-Morales, M., Voigt, M. and Madeleine, P. (2020). Absolute and relative reliability of pain sensitivity and functional outcomes of the affected shoulder among women with pain after breast cancer treatment. Plos one, 15(6), e0234118 doi:10.1371/journal.pone.0234118
• Robsahm, T. E., Hestvik, U. E., Veierod, M. B., Fagerlie, A., Nystad, V., Engebretsen, L. and Tretli, S. (2010). Cancer risk in Norwegian world class athletes, Cancer Causes & Control, 21(10), 1711-1719, doi:org/10.1007/s10552-010-9600-z
• Roscoe, C. M. P., Pringle, A., Chandler, C., Faghy, M. A. and Barratt, B. (2022). The role of physical activity in cancer recovery: an exercise practitioner’s perspective. International Journal of Environmental Research Public Health, 19, 3600, doi:org/10.3390/ijerph19063600
• Schink, K., Herrmann, H. J., Schwappacher, R., Meyer, J., Orlemann, T., Waldmann, E... Zopf, Y. (2018). Effects of whole-body electromyostimulation combined with individualized nutritional support on body composition in patients with advanced cancer: a controlled pilot trial. BMC Cancer, 18, 886 doi:org/10.1186/s12885-018-4790-y
• Schwappacher, R., Dieterich, W., Reljic, D., Pilarsky, C., Mukhopadhyay, D., Chang, D. K…Zopf , Y. (2021). Muscle-Derived Cytokines Reduce Growth, Viability and Migratory Activity of Pancreatic Cancer Cells Cancers (Basel), 29;13(15), 3820, doi:org/10.3390/cancers13153820
• Severinsen, M. C. K. and Pedersen, B. K. (2020). Muscle-Organ crosstalk: The emerging roles of myokines. Bioogy Medicine, Endocrine Reviews. 41(4), 594-609, doi:org/10.1210/endrev/bnaa016
• Shao, W., Zhang, H., Qi H. and Zhang, Y. (2022). The effects of exercise on body composition of prostate cancer patients receiving androgen deprivation therapy: An update systematic review and meta-analysis. PLoS One, 17(2), doi:org/10.1371/journal.pone.0263918
• Sundari, L. P. R. and Arsani, N. L. K. A. (2022). Regular physical exercise increase of growth hormone (gh) and insulin-like growth factor-1 (igf-1) activity in elderly improve the aging process and quality of life: A mini review. Biomedical & Pharmacology Journal, 15(2), 883-890, doi:org/10.13005/bpj/2422
• Swain, C. T. V., Ann, E., Drummond, A. E., Boing, L., Milne, R. L., Dallas, R…Lynch, B. M. (2022). Linking physical activity to breast cancer via sex hormones, part 1: the effect of physical activity on sex steroid hormones. Cancer Epidemiol Biomarkers Prevention, 31(1), 16-27, doi:org/10.1158/1055-9965.EPI-21-0437.
• Teixeira, G. R., Mendes, L. O., Veras, A. S. C., Thorpe, H. H. A., Fávaro, W. J., Chuffa, L. G. A... Martinez F.E. (2020). Physical resistance training-induced changes in lipids metabolism pathways and apoptosis in prostate. Lipids in Health and Disease, 19, 14, doi:org/10.1186/s12944-020-1195-0
• Thomsen, S. N., Lahart, I. M., Thomsen, L. M., Fridh, M. K., Larsen, A., Mau-Sørensen, M… Simonsen C., (2023). Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials. EClinicalMedicine, 6(59), 101937. doi:org/10.1016/j.eclinm.2023.101937. Torregrosa, C., Chorin, F., Beltran, E. E. M., Neuzillet, C. and Cardot-Ruffino, V. (2022). Physical activity as the best supportive care in cancer: The clinician’s and the researcher’s perspectives. Cancers, 14(21), 5402. doi:org/10.3390/cancers14215402.
• Wiestad, T. H., Raastad, T., Nordin, K., Igelström, H., Henriksson, A., Demmelmaier, I. and Berntsen, S. (2020). The Phys-Can observational study: adjuvant chemotherapy is associated with a reduction whereas physical activity level before start of treatment is associated with maintenance of maximal oxygen uptake in patients with cancer. BMC Sports Science, 12(53), doi:org/10.1186/s13102-020-00205-9
• Wang, Q. and Zhou W. (2021). Roles and molecular mechanisms of physical exercise in cancer prevention and treatment. Journal of Sport and Health Science, 10(2), 201-210, doi:org/10.1016/j.jshs.2020.07.008.
• Yang, H., Yang, Z., Pan, H. and Zhou, Q. (2021). Effects of physical activity on sleep problems in breast cancer survivors: a meta-analysis. Supportive Care in Cancer, 29(24), 1-10, doi:org/10.1007/s00520-020-05914-y
• Yang, Y-P., Pan, S-J., Qui, S-L. and Tung, T-H. (2022). Effects of physical exercise on the quality-of-life of patients with haematological malignancies and thrombocytopenia: A systematic review and meta-analysis. World Journal of Clinial Cases, 10(10), doi:org/10.12998/wjcc.v10.i10.3143.
• Yousaf, R. and Marwat, M. K. (2022). Effect of moderate level aerobic training on maximum oxygen consumption and cardiovascular fitness of non-athlete students GESR VII, (1) 15, doi:org/10.31703/gesr.2022(VII-I).15
• Zerhouni, M. and Piskounova, E. (2022). Running to outcompete metastasis. Cancer Research, 82 (22), 4124– 4125, doi:org/10.1158/0008-5472.CAN-22-2898
• Zhao, H., Cheng, R., Song, G., Teng, J., Shen, S., Fu, X…Liu C. (2022). The effect of resistance training on the rehabilitation of elderly patients with sarcopenia: A Meta-Analysis. International Journal of Environmental Research and Public Health, 19, 15491, doi:org/10.3390/ijerph192315491
• Zheng, A. S., Zhang, L., Yang, J., Xiaomeng, Yin, X., Zhang, T… Ma, X. (2022). Physical activity prevents tumor metastasis through modulation of immune function. Frontiers in Pharmacology. 13, 1034129. doi:org/10.3389/fphar.2022.1034129
• Zhou, Y., Jia, N., Ding, M. and Yuan K. (2022). Effects of exercise on inflammatory factors and IGF system in breast cancer survivors: a meta‑analysis. BMC Women’s Health, 22, 507, doi:org/10.1186/s12905-022-02058-5
• Zhu, C., Ma, H., He, A., Li, Y., He, C. and Xia, Y. (2022). Exercise in cancer prevention and anticancer therapy: Efficacy, molecular mechanisms and clinical information. Cancer Letters, 544, 215814 doi:org/10.1016/j.canlet.2022.215814