Advanced Exercise Prescription for Cancer Patients and its Application in Germany
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REVIEW ARTICLE
Advanced Exercise Prescription for Cancer Patients and its Application in Germany Moritz Schumann1 · Nils Freitag1 · Wilhelm Bloch1 Received: 30 April 2020 / Accepted: 1 August 2020 © The Author(s) 2020
Abstract The scientific interest of exercise medicine for the treatment of cancer is ever expanding. Recently published and updated guidelines for exercise training in cancer patients by the American College of Sports Medicine (ACSM), the Clinical Oncology Society of Australia (COSA) or the Exercise and Sports Science Australia (ESSA) are leading the way towards an individualized approach for exercise prescription. These guidelines provide physicians and therapists with a comprehensive and detailed overview about the beneficial effects of exercise training and, more so, summarize the evidence on potential dose– response mechanisms, including pathways of exercise-induced stimuli to counteract tumour microenvironmental pathologies. However, the most optimal types and doses of exercise training across the cancer disease and treatment continuum are yet to be determined. Therefore, the purpose of this narrative review was to illustrate the current implications but also limitations of exercise training during the different stages of cancer therapy, as well as to discuss necessary future directions. As a second purpose, special attention will be given to the current role of exercise in the treatment of cancer in Germany. Keywords Exercise medicine · Clinical exercise science · Exercise guidelines · Exercise therapy · Exercise oncology
Introduction The scientific interest of exercise as medicine continues to grow rapidly. After the American College of Sports Medicine (ACSM) and the American Medical Association (AMA) launched their ground-breaking initiative of “Exercise is Medicine” in 2007 [82], the scientific publications focusing on exercise as medicine listed in PubMed have almost tripled. However, the history of exercise prescription dates back to ancient times and many of the recent developments are actually not novel but much rather are rediscovered after periods of exercise science research with a focus on athletic performance [93]. * Moritz Schumann m.schumann@dshs‑koeln.de Nils Freitag n.freitag@dshs‑koeln.de Wilhelm Bloch w.bloch@dshs‑koeln.de 1
Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
While initially the term exercise is medicine was understood as a means to improve population health and wellbeing by raising awareness of health care providers to focus on physical activity as a vital sign, nowadays it is much rather considered as a crucial part for the therapy of numerous chronic diseases [73]. In fact, current studies provide evidence for exercise to complimentarily support primary therapy of more than 26 chronic diseases, such as psychiatric, neurological, metabolic, cardiovascular, pulmonary, musculoskeletal, and oncological diseases [7
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