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Review
. 2022 Dec 10;14(24):6078.
doi: 10.3390/cancers14246078.

Exercise and Bone Health in Cancer: Enemy or Ally?

Alice Avancini  1   2 , Giulia Benato  2 , Anita Borsati  2 , Luca Oliviero  2 , Lorenzo Belluomini  2 , Marco Sposito  1 , Daniela Tregnago  1 , Ilaria Trestini  3 , Jessica Insolda  1 , Francesca Zacchi  1 , Elena Fiorio  1 , Federico Schena  2 , Michele Milella  1 , Sara Pilotto  1
Affiliations
Review

Exercise and Bone Health in Cancer: Enemy or Ally?

Alice Avancini et al. Cancers (Basel). .

Abstract

Bone health is often threatened in cancer patients. Bone metastasis and osteoporosis frequently occur in patients with cancer and may lead to different skeletal-related events, which may negatively affect patients' quality of life and are associated with high mortality risk. Physical exercise has been recognized as a potential adjunctive strategy in the cancer setting to improve physical function as well as treatment-related side effects. Nevertheless, exercise is often not recommended to patients with bone health impairments due to safety concerns. In the current review, we aimed, through a comprehensive review of the evidence, to explore the impact of exercise in terms of safety profile, bone outcomes, and the effects on other outcomes in patients with cancer affected by bone metastasis or at high risk of losing bone. Additionally, we explored the potential mechanisms by which exercise may act on bone, particularly the impact of mechanical load on bone remodeling. Finally, considerations about exercise prescription and programming in these populations are also discussed.

Keywords: bone loss; bone metastases; bone remodeling; cancer disease; exercise.

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Conflict of interest statement

The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. M.M. reports personal fees from Pfizer, EUSA Pharma, and Astra Zeneca, outside the submitted manuscript. S.P. received honoraria or speakers’ fees from Astra-Zeneca, Eli-Lilly, BMS, Boehringer Ingelheim, MSD, and Roche, outside the submitted manuscript. All remaining authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The effect of mechanical load induced by exercise on bone.
See this image and copyright information in PMC

References

    1. Coleman R.E., Croucher P.I., Padhani A.R., Clézardin P., Chow E., Fallon M., Guise T., Colangeli S., Capanna R., Costa L. Bone metastases. Nat. Rev. Dis. Prim. 2020;6:83. doi: 10.1038/s41572-020-00216-3. - DOI - PubMed
    1. Virk M.S., Lieberman J.R. Tumor metastasis to bone. Arthritis Res. Ther. 2007;9((Suppl. S1)):S5. doi: 10.1186/ar2169. - DOI - PMC - PubMed
    1. Hong S., Youk T., Lee S.J., Kim K.M., Vajdic C.M. Bone metastasis and skeletal-related events in patients with solid cancer: A Korean nationwide health insurance database study. PLoS ONE. 2020;15:e0234927. doi: 10.1371/journal.pone.0234927. - DOI - PMC - PubMed
    1. Miyashita H., Cruz C., Smith C. Risk factors of skeletal-related events in patients with bone metastasis from non-small cell lung cancer undergoing treatment with zoledronate—A post hoc analysis of a randomized clinical trial. Support. Care Cancer. 2021;29:1629–1633. doi: 10.1007/s00520-020-05665-w. - DOI - PubMed
    1. Coleman R., Hadji P., Body J.-J., Santini D., Chow E., Terpos E., Oudard S., Bruland Ø., Flamen P., Kurth A., et al. Bone health in cancer: ESMO Clinical Practice Guidelines. Ann. Oncol. 2020;31:1650–1663. doi: 10.1016/j.annonc.2020.07.019. - DOI - PubMed

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