ECSS Paris 2023: CP-MH12
INTRODUCTION: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related deaths, with about 10% of cases linked to non-tobacco-related factors. There is still a need to determine whether indicators of sarcopenia—such as grip strength, appendicular lean mass index, and walking speed—can act as early predictors of lung cancer in non-smokers. METHODS: This study is a prospective cohort analysis utilizing data from the UK Biobank, focusing on participants aged 40 to 69 years. The primary outcome assessed was lung cancer in non-smokers. Indicators of sarcopenia evaluated included relative grip strength (RGS), appendicular lean mass (ALM) index, and walking speed. Grip strength was measured using a Jamar J00105 hydraulic hand dynamometer and normalized to body weight, resulting in the RGS. Appendicular lean mass was determined through bioelectrical impedance analysis and adjusted for height squared to calculate the ALM index. Walking speed was self-reported by the participants. RESULTS: In this study, we evaluated 164,337 non-smokers without lung cancer and 586 non-smokers with lung cancer. Individuals with lung cancer demonstrated significantly lower grip strength (mean relative grip strength: lung cancer-free group 0.41 [SD 0.13] vs. lung cancer group 0.38 [SD 0.13], P < 0.001) and a reduced appendicular lean mass index (lung cancer-free group 8.14 [SD 1.34] vs. lung cancer group 8.00 [SD 1.23], P = 0.009). Additionally, the incidence of slow walking speed was higher in the lung cancer group at 11.1%, compared to 5.8% in the lung cancer-free group. CONCLUSION: Non-smokers with lung cancer show significant impairments in muscular strength and physical performance compared to those without lung cancer. Specifically, they have lower grip strength and appendicular lean mass index, as well as a higher prevalence of slow walking speed. These findings suggest a potential association between sarcopenic indicators and lung cancer, underscoring the need for further research to explore the mechanisms involved and the implications for early detection and intervention strategies to enhance physical function and quality of life in this population.
Read CV Lai Chih JunECSS Paris 2023: CP-MH12
INTRODUCTION: Patients with cancer often experience fatigue and sleep disturbances due to the disease and treatment side effects. Physical exercise may help to alleviate this impairment, even if few data are available concerning the relationship with physical fitness components. This study examines the associations between fatigue, sleep quality, and physical performance in patients with cancer. METHODS: The physical and patient-reported data, along with the clinical and demographic variables, were collected by a dedicated exercise professional. The parameters included in the analysis were: Body Mass Index (BMI), and the waist-to-hip (W/H) ratio; functional capacity, assessed using the Six-Minute Walk Test (6MWT); upper limb strength, with the handgrip strength test (HSGT); and flexibility of the upper and lower limbs, assessed with the back scratch (BST) and chair sit-and-reach tests (CSRT), respectively. Data on sleep quality and fatigue were also collected using the Pittsburgh Sleep Quality Index (PSQI) and the Brief Fatigue Inventory (BFI) questionnaires, respectively. Descriptive analysis, absolute frequencies, and Pearsons correlations were used for data analysis. RESULTS: A total of 84 patients (mean age 59 years, 61% female) were included in the study. Regarding the disease type, 28% of patients had breast, 20% pancreatic, and 15% colorectal cancers. Overall, 40% presented an advanced stage of disease, 85% were receiving chemotherapy and 45% radiotherapy. Forty-five percent of patients reported poor sleep quality, while 9% experienced a clinically significant level of fatigue. Patients reached the following mean values in the physical fitness parameters: 523.8 m (± 91,4) for 6MWT, 60.8 kg (± 20.2) for HSGT (right plus left hand), -8.9 cm (± 23.8) for CRST and -12.2 cm (± 21.6) for BST. A moderate and significant correlation was found between fatigue levels and 6MWT (rs = -0.416; p < 0.001), as well as a mild but significant correlation for upper limb strength and fatigue (rs = -0.247; p < 0.028). Finally, high levels in upper limb strength were correlated with lower impairments in sleep quality (rs = -0.222; p = 0.048). CONCLUSION: Sleep quality and fatigue can significantly impair the quality of life in patients with cancer. Our study identified correlations between certain physical fitness parameters, lower fatigue levels, and improved sleep quality. Additional enrollments are currently underway to further clarify these associations.
Read CV Christian CiurnelliECSS Paris 2023: CP-MH12
INTRODUCTION: Survival rates for children, adolescents, and young adults with cancer have increased over the years due to improved care and personalized treatment. Treatment may cause short- and long-term toxicity limiting their ability to participate in exercise programs and sports. Survivors engage in less physical activity, leading to reduced exercise tolerance. An important tool for assessing the reduced exercise tolerance is cardiopulmonary exercise test (CPET). The CPET provides key indicators such as VO₂ peak and cardiopulmonary efficiency that can be a predictive index of morbidity and mortality [1]. Despite the increased use of CPET in pediatric oncology units, what occurs during the first year of follow-up remains partially unknown. Our aim is to evaluate exercise tolerance in a cohort of survivors of solid pediatric cancers within one-year post-treatment and identify possible indicators of cardiopulmonary fitness shortly after ending cancer therapy. METHODS: CPET was performed on a cycle ergometer at the pediatric oncology unit using an incremental workload protocol until exhaustion. At the beginning of the test, participants were asked whether they had participated in any exercise programs during their treatment. The predicted peak VO₂ was calculated using the gender-, age-, and weight-adjusted Hansen/Wasserman equations. RESULTS: We tested 17 patients (7 females; median age 15.01 years; range 13-20 years) at median 8.90 months post-treatment. The averaged of VO₂ peak value was 30.63 ± 10.22 ml/min/kg (range: 14.10–52.20) for males and 28.28 ± 10.08 ml/min/kg (range: 19.20–46.30) for females. These values were reduced of 54% and 34%, respectively, comparing to the predicted values of healthy peers [2]. Analysis of cardiovascular efficiency, measured by slope of the relationship between heart rate (HR) and VO₂ , revealed significant differences depending on physical activity levels during treatment. Survivors who engaged in moderate-to-vigorous tailored exercise programs during treatment had statistically significant greater efficiency (Y = 2.886*X + 67.68) compared to those who did not train (Y = 3.952*X + 66.03) (p=0.009). CONCLUSION: These data highlight the importance of starting supervised precision-based exercise programs early in the disease trajectory. Additionally, we suggest that exercise should be continued soon after treatment to enhance recovery and improve long-term fitness outcomes. CPET has been shown to be an effective tool for assessing the fitness status of survivors, providing valuable insight into their exercise tolerance and guiding personalized training programs. 1.Myers J et all. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002 Mar 14;346(11):793-801. 2.Blanks Z et all. Dynamics of gas exchange and heart rate signal entropy in standard cardiopulmonary exercise testing during critical periods of growth and development. Physiol Rep. 2024 Sep;12(17):e70034.
Read CV William ZardoECSS Paris 2023: CP-MH12