Zusammenfassung
Hintergrund
In der Presse finden sich Aussagen wie „Sport ist wichtiger als ein Krebsmedikament“ und ein wachsendes Angebot an Sportangeboten wird von Tumorpatienten regelmäßig wahrgenommen. Welchen therapeutischen Wert hat Sport für Patienten, was macht ein solches Sportangebot aus, wie häufig und intensiv sollte Sport getrieben werden? Fragen, die sich Ärzte, Therapeuten und Patienten gleichermaßen stellen.
Ziel
Im Sinne der drei klassischen Präventionsebenen (primär, sekundär und tertiär) soll das Potenzial von Sport in der Prävention von Krebs betrachtet werden: Kann Sport das Risiko, an Krebs zu erkranken, verändern? Kann Sport zu der Früherkennung von Krebs beitragen? Hilft Sport Tumorpatienten bei der Bewältigung ihrer Erkrankung?
Material und Methoden
Diese Arbeit basiert auf einer selektiven Literaturrecherche in der Datenbank PubMed zum Thema „Sport, Bewegung und körperlicher Aktivität“ sowie „Krebs“. Zudem wurden Daten des eigenen Patientenkollektivs ausgewertet.
Ergebnisse und Diskussion
Epidemiologische Studien zeigen eine wirksame Reduzierung von molekularen Faktoren wie hohe Insulin- und IGF-Spiegel sowie eine hohe Insulinresistenz durch Sport, die gleichsam hohe Risikofaktoren für zahlreiche Tumorerkrankungen sind. Andere Faktoren wie Interleukin-6 (IL-6) gelten ebenfalls als Mediatoren der Erkrankung, sind aber auch Teil von physiologischen Anpassungsreaktionen auf Training im Sport, sodass ihre Rolle im Sinne einer präventiven Kausalkette kritisch hinterfragt werden darf. Die Ausübung von Sport oder auch negative Begleiterscheinungen wie die zunehmende Einnahme leistungssteigernder Substanzen kann das Krebsrisiko auch erhöhen. Im Sinne sekundärer Prävention können Sport und sportwissenschaftliche Methoden einen Beitrag leisten, um in der Frühphase der Krebserkrankung drohende Begleiterscheinungen der Erkrankung wie Kachexie aufzudecken. Für die Gestaltung von Trainingsprogrammen für Tumorpatienten werden konkrete Empfehlungen gegeben.
Abstract
Background
In the press there are statements, such as “sport more important than a cancer medicine” and tumor patients regularly participate in a growing number of sports. What is the therapeutic value of sport for patients, what is the impact of such a sport offer and how often and intensively should sport be practiced? Questions that are asked by doctors, therapists and patients.
Objectives
The potential of sport in the prevention of cancer should be considered in the sense of the three classical prevention levels (primary, secondary and tertiary): can practicing sport change the risk of developing cancer? Can sport contribute to the early detection of cancer? Does sport help tumor patients with their disease?
Material and methods
This article is based on a selective literature search of the PubMed database for the topics “sports, exercise and physical activity” and “cancer”. In addition, data from the own patient population were evaluated.
Results and conclusion
Epidemiological studies show an effective reduction of molecular factors, such as high insulin and insulin-like growth factor (IGF) levels as well as high insulin resistance through sport, which are high risk factors for numerous tumor diseases. Other factors, such as interleukin 6 (IL-6) are also mediators of the disease but are part of physiological adaptation responses to training in sport so that their role in the sense of a preventive causal chain can be critically questioned. The practice of sport and also negative side effects, such as increased intake of performance enhancing substances may also increase the risk of cancer. In the sense of secondary prevention, sports and sports scientific methods can contribute to uncovering threatening side effects of the disease, such as cachexia in the early stages of cancer. Concrete recommendations are given for the design of training programs for tumor patients.
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H. Krakowski-Roosen gibt an, dass kein Interessenkonflikt besteht.
Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.
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Krakowski-Roosen, H. Sport und Krebsprävention. Onkologe 23, 438–445 (2017). https://doi.org/10.1007/s00761-017-0202-1
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DOI: https://doi.org/10.1007/s00761-017-0202-1