Exercise May Reduce Risk of Colorectal Cancer in Patients With Lynch Syndrome

Participating in exercises, such as regular and intense aerobic exercise, can reduce the chance of being diagnosed with colorectal cancer in patients with Lynch syndrome (LS). This can be caused by improving the immune system, allowing it to detect harmful cells easily and quickly, according to the University of Texas MD Anderson Cancer Center.

Lynch syndrome carriers who participated in high-intensity exercise noticed a decrease in the inflammatory marker prostaglandin E2 (PGE2) within the colon and blood. Two other immune cells, natural killer (NK) and CD8+ T cells, also saw an increase within the colon’s immune response.

“It was mind-blowing to me that exercise induced such strong and durable change,” wrote study lead Dr. Eduardo Vilar-Sanchez, professor of Clinical Cancer Prevention, GI Medical Oncology at the University of Texas MD Anderson Cancer Center, in the study. “We found that high-intensity training not only enhances how the body could fight cancer at its earliest stages, but it also gives many other health benefits.”

The study, consisting of 21 patients with Lynch syndrome, aged 18 to 50, were studied over a 12-month period, with eleven patients assigned to the exercise group and the other 10 to typical care.

Both groups were asked to complete a questionnaire and underwent a gastrointestinal endoscopy (GI). Exercise testing was prominent within the next visit and 30 days prior to the endoscopy. Every patient underwent a 1-year endoscopy and cardiopulmonary exercise testing (CPET) during the fourth visit, within 30 days after the endoscopy.

Patients in the exercise group had a median score of 164 minutes of exercise a week, while the standard care group had about 14 minutes a week.

“We do high interval intensity training, which is a very specific type of exercise intervention, but there are other types of exercise intervention. We do cycling classes in 45 minutes. And again, we wanted to do it in that way. When somebody asked the question that you just asked, we could provide an exercise prescription that is an attach to a specific biological effect. And then at least being able to say, ‘Okay, if you're a Lynch syndrome carrier, you want to modulate your cancer risk by generating immune activation,’ this type of intervention has proven to be able to do that, rather than giving a generic recommendation,” Vilar-Sanchez told CURE® in a recent interview.

Gene expressions also differed within patients in both groups. The exercise group detected 13 genes that became more active, compared with the standard care group, in which 33 genes became less active. Researchers had also concluded within the study that as oxygen increases, the immune system regulates, which became linked to exercise.

“In this study, at the end, what we are showing is that exercise is generating any view of the activation of immune cells that are resident within our gut. And we believe that is a way that our own systems and our own immune systema have to tackle cancer to prevent cancer,” explained Vilar-Sanchez.

Future clinical trials are put in place to examine the efficiency of exercise and other ways that the immune system can lower reductions within cancer risk.

“I think the future for the next trial is randomized intervention and looking into actual outcomes,” Vilar-Sanchez noted, “like looking into (questions such as) ‘Have we prevented the number of cancers?’ or ‘Have we modulated the presence of polyps, which are the premalignant lesions that proceed to the development of colon cancer?’”

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