Table 3.
Effects of exercise training on blood-based biomarkers from clinical studies.
| Tumor type (study) | N | Design/cohort/setting | Biological mechanisms |
|---|---|---|---|
| Breast adenocarcinoma (Fairey et al., 2003) | 53 | RCT. Postmenopausal breast cancer patients randomized to a supervised 15-week aerobic training intervention or sedentary control | Exercise was associated with decreases in IGF-1 (10.9%, p = 0.045) and IGF-1:IGFBP-3 M ratio (18.2%, p = 0.017) and increase in IGFBP-3 (p = 0.021). No significant effect on fasting insulin, glucose, or insulin resistance |
| (Irwin et al., 2005) | 710 | Observational. Stage 0–IIIA breast cancer survivors; Health, Eating, Activity, and Lifestyle Study | Exercise was associated with significantly lower C-peptide (p = 0.001) and leptin levels (p = 0.001) and higher IGF-1 (p = 0.0037). There was a trend toward increased IGFBP-3 levels (p = 0.055) |
| (Fairey et al., 2005a,b) | 53 | RCT of exercise training in postmenopausal survivors of stage I–IIIB breast cancer who had completed surgery, RT, and/or chemo with or without tamoxifen or arimidex; Rehabilitation Exercise for Health after Breast Cancer Trial | Exercise was associated with a trend toward decreased C-reactive protein levels (p = 0.066) |
| (Fairey et al., 2005a,b) | 53 | RCT of exercise training in postmenopausal survivors of stage I–IIIB breast cancer after surgery, RT, and/or chemo with or without tamoxifen or arimidex; Rehabilitation Exercise for Health after Breast Cancer Trial | Exercise was associated with increases in natural killer cell cytotoxic activity (p = 0.035) and unstimulated mononuclear cell function (p = 0.007). No significant differences were observed in blood mononuclear cell production of pro-inflammatory (IL-1, TNF-α, IL-6) and anti-inflammatory cytokines (IL-4, IL-10, transforming growth factor-1) |
| (Schmitz et al., 2005) | 85 | RCT. Posttreated breast cancer patients 4–36 months after adjuvant therapy. | Six months of weight training significantly decreased IGF-II (p = 0.02) and IGFBP-3 levels (p = 0.03). There were no significant changes in glucose, insulin, IGF-I, IGFBP-1, and IGFBP-2 |
| (Irwin et al., 2006) | 474 | Observational. Stage 0–IIIA breast cancer survivors; Health, Eating, Activity, and Lifestyle Study | Exercise was associated with a significant decrease in mammographic dense area (p = 0.046) and percent density (p = 0.026) in postmenopausal women with BMI ≥ 30 kg/m2. Exercise was associated with a significant increase in percent density in premenopausal women with BMI < 30 kg/m2 (p = 0.037) |
| (Irwin et al., 2007) | 522 | Observational. Stage 0–IIIA breast cancer survivors; Health, Eating, Activity, and Lifestyle Study | Exercise was associated with a significant decrease in mammographic dense area in postmenopausal women with BMI ≥ 30 kg/m2 (p = 0.036). Exercise was associated with an increase in dense area in women with BMI < 25 kg/m2, but this difference was not statistically significant |
| (Payne et al., 2008) | 20 | RCT. Postmenopausal breast cancer patients receiving hormonal therapy | No significant differences were observed between groups with respect to cortisol or IL-6 levels. Serotonin levels (p = 0.009) were significantly affected by exercise |
| (Ligibel et al., 2008) | 101 | RCT. Sedentary, overweight early stage breast cancer patients to home-based aerobic and resistance training program or sedentary control for 16 weeks | Exercise was associated with a 28% reduction in fasting insulin (p = 0.03) and a nonsignificant improvement in insulin sensitivity (p = 0.09) |
| (Pierce et al., 2009) | 741 | Observational. Stage 0–IIIA breast cancer survivors; Health, Eating, Activity, and Lifestyle Study | Exercise was associated with significantly lower concentrations of C-reactive protein (p = 0.005) and non-significant decreases in serum amyloid A concentrations (p = 0.06) |
| (Evans et al., 2009) | 14 | Pre-post. Posttreated breast cancer patients within 6 months of completion of all major cancer therapy and healthy controls matched for age and physical activity level; Get REAL & HEEL Breast Cancer Program | Breast cancer patients had significantly lower post-exercise blood lactate levels following high-intensity exercise (70% of VO2max, p < 0.0005). There was no significant difference between patients and sedentary controls at low (40%) and moderate (60%) intensity |
| (Irwin et al., 2009) | 75 | RCT. Sedentary postmenopausal breast cancer survivors diagnosed 1–10 years prior with stage 0–IIIA breast cancer after adjuvant treatment at least 6 months before enrollment | Exercise was associated with a decrease in insulin (p = 0.089), IGF-I (p = 0.026), and IGFBP-3 (p = 0.0006) levels |
| (George et al., 2010) | 746 | Observational. Stage 0–IIIA breast cancer survivors; Health, Eating, Activity, and Lifestyle Study | Physical activity offset the negative effects of poor diet quality on C-reactive protein levels (p = 0.03) in breast cancer survivors |
| (Tosti et al., 2011) | 14 | Pre-post. Stage I–III invasive breast cancer within 6 months of completion of all major cancer treatments and no evidence of metastatic disease, matched to healthy controls | Patients with breast cancer had significantly lower blood lactate response to exercise (p ≤ 0.05) across a variety of intensities. There was a trend toward more elevated glucose responses in women with cancer before and after exercise (p < 0.08) |
| (Janelsins et al., 2011) | 21 | RCT. Sedentary patients with stage 0–IIIb breast cancer after primary treatment 1–30 months prior to enrollment | Insulin levels did not rise in exercising patients compared to an increase in sedentary controls that received psychosocial therapy (significance not reported). IGF-1 decreased more in exercising patients than controls and IGFBP-3 increased in the exercising group (compared with a decrease in the control group), but neither of these changes was significant |
| (Zheng et al., 2011) | 75 | Pre-post/observational. Physically inactive postmenopausal women diagnosed with stage 0–IIIA breast cancer after completion of adjuvant treatment at least 6 months prior to enrollment. | Exercise was associated with a significant reduction in methylation of the L3MBTL1 tumor suppressor gene (p = 2.9 × 10−5) |
| Colon/colorectal adenocarcinoma (Allgayer et al., 2004) | 23 | RCT. Stage II or III colorectal cancer patients at least 4 weeks after completion of primary therapy (surgery and radiation and/or chemotherapy) | Short-term (2 weeks) of moderate intensity exercise was associated with decreased IL-1 receptor agonist response to LPS (p < 0.05) and a more pro-inflammatory state (decreased LPS antagonist/IL-1β, TNF-α, and IL-6 cytokine ratio; p < 0.05 for IL-6, all others non-significant) |
| (Allgayer et al., 2008) | 48 | RCT. Colorectal cancer patients after completion of primary therapy (surgery and radiation and/or chemotherapy) | Short-term (2 weeks) of moderate intensity exercise significantly decreased urinary 8-oxo-dG excretion levels (p = 0.02). High intensity exercise resulted in a non-significant increase in 8-oxo-dG levels (p = 0.18) |
| Prostate adenocarcinoma (Segal et al., 2003) | 155 | RCT. Men with a confirmed prostate cancer diagnosis scheduled to receive at least 3 months of androgen deprivation therapy after enrollment | Exercise did not significantly affect testosterone or PSA levels |
| (Segal et al., 2009) | 121 | RCT. Men with a confirmed prostate cancer diagnosis scheduled to receive radiation therapy with or without androgen deprivation therapy after enrollment | Neither resistance nor aerobic exercise significantly affected hemoglobin, testosterone, or PSA levels |
| (Galvao et al., 2010) | 57 | RCT. Men with confirmed prostate cancer at least 2 months of androgen deprivation therapy and were expected to undergo at least 6 more months of ADT with no evidence of disease | Exercise was associated with a significant decrease in C-reactive protein (p = 0.008). No significant differences were observed in testosterone, PSA, cholesterol, triglyceride, insulin, glucose, or homocysteine levels |
| Gastric adenocarcinoma (Na et al., 2000) | 35 | RCT. Stomach cancer patients after surgery | Exercise was associated with a significant sequential change in function in vitro of natural killer cells isolated from stomach cancer patients (p < 0.05) |
| (Yuasa et al., 2009) | 106 | Observational. Patients with primary gastric carcinoma | There was an association between physical activity and decreased methylation of CACNA2D3 (commonly methylated, poor prognostic factor in gastric cancer) (p = 0.03) |
| Lung adenocarcinoma (Jones et al., 2011,2012b) | 16 | Pre-post. Stage I–IIIB non-small cell lung cancer | Exercise was associated with an increase in urinary F2-isoprostanes (markers of oxidative stress) (p = 0.08) |
Abbreviations: RCT, randomized controlled trial; 8-oxo-dG-8-Oxo-2′-deoxyguanosine; BMI, body mass index; IGF, insulin-like growth factor; IGFBP, insulin-like growth factor binding protein-3; RT, radiation therapy; LPS, lipopolysaccharide; PSA, prostate-specific antigen.