Jessica M. Brown

Cancer Type Does Not Affect Exercise-Mediated Improvements in Cardiorespiratory Function and Fatigue

Purpose. Despite mounting evidence indicating that exercise training has a positive effect on cancer recovery, the influence of cancer type on the response to exercise training remains uncharacterized. Therefore, the adaptations to exercise training were compared between groups composed of 7 different forms of cancer. Methods. A total of 319 cancer survivors completed fatigue inventories and participated in assessments of cardiorespiratory function, which encompassed aerobic capacity (VO2peak), pulmonary function (forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1]), and resting blood pressure and heart rate. Participants were divided into 7 groups based on cancer type, including breast cancer (BC, n = 170), prostate cancer and other male urogenital neoplasia (PC, n = 38), hematological malignancies (HM, n = 34), colorectal cancer (CC, n = 25), gynecological cancers (GC, n = 20), glandular and epithelial neoplasms (GEN, n = 20), and lung cancer (LC, n = 12). All participants completed an individualized, multimodal exercise intervention consisting of cardiorespiratory, flexibility, balance, and muscular strength training 3 days per week for 3 months. Following the intervention, all subjects were reassessed. Generalized Estimating Equations with exchangeable working correlation structure was used to model each response; the group by time interaction effect represented the effect of cancer type on exercise-associated improvements. Results. No significant (P > .05) group by time interaction effects were observed between different types of cancer for any parameter. Pre- to postexercise contrasts revealed significant improvements in VO2peak in BC, PC, HM, and GEN at the Bonferroni adjusted significance level (.00714). Heart rate was significantly lowered in the BC and CC groups. Mean fatigue indices decreased by at least 17% in all groups, but these changes were only significant in the BC, HM, CC, and GC groups. Systolic blood pressure decreased significantly in BC and GC, and diastolic blood pressure decreased significantly only in the BC group while pulmonary function remained unchanged in all cancer types. Conclusion. Although trends toward improved cardiorespiratory and fatigue parameters only reached significance in some groups, there were no significant differences between cancer types. This suggests that cardiorespiratory and fatigue improvements following rehabilitative exercise are not dependent on cancer type. Further research investigating alternative physiological parameters are needed to confirm the relationship between cancer type and exercise-mediated rehabilitation.

Cancer Rehabilitation: Impact of Physical Activity on Initial Clinical Assessments

ABSTRACT Background: Preconditioning and prehabilitation have been reported to ameliorate a host of health- and cancer-related issues, yet few studies have examined implications of past physical ac...

The University of Northern Colorado Cancer Rehabilitation Institute Treadmill Protocol Accurately Measures VO2 peak in Cancer Survivors

Lichen planus (LP) is a chronic mucocutaneous disease, characterised by an inflammatory immune response with sub-epithelial infiltration of T lymphocytes causing basal epithelial cell damage. Secukinumab is a monoclonal antibody that blocks IL-17A; which is the primary cytokine of Th17 cells involved in the aetiology of inflammatory skin diseases such as psoriasis. Secukinumab has been linked to induction of oral LP, but never directly to cutaneous LP. We report the first case of drug-induced cutaneous LP in the setting of secukinumab for treatment of chronic plaque psoriasis. A 56-year-old man with chronic plaque psoriasis presented with a 2-month history of violaceous and pruritic, thickened plaques on his bilateral lower limbs and buttocks in the setting of secukinumab use for psoriasis. Histological analysis showed a band-like lymphocyte inflammatory infiltrate just beneath the epithelium and was consistent with cutaneous LP. He was treated with topical betamethasone dipropionate cream with moderate effect. Initial laboratory tests including hepatitis and inflammatory screens were within normal limits. We hypothesise that this causal association may be due to a microbial trigger, activating a T-cell mediated immunologic response in CD8+ T-cells and dendritic cells, causing activation of type I interferons and an inflammatory skin response consistent with LP. Clinicians should monitor patients for mucosal and cutaneous LP when using secukinumab or other biologic modulators of IL-17 for extended periods with psoriasis.