16 november 2022: lees ook eens dit artikel: https://kanker-actueel.nl/cardiorespiratoire-fitness-crf-heeft-grote-invloed-op-risico-voor-mannen-op-ontwikkelen-van-darmkanker-en-longkanker-en-beinvloed-ook-sterk-de-overlevingstijd-als-mannen-eenmaal-kanker-hebben.html

16 november 2022: Bron: Clinical Lymphoma Myeloma and Leukemia Available online 22 October 2022.

Patiënten met ook gevorderd stadium van botkanker - multiple Myeloma (ook bekend als ziekte van Kahler) hebben toch baat bij lichaamsbeweging en bewegingsoefeningen / sport hoewel oncologen het lastig vinden om patiënten met botkanker lichamelijke oefeningen te laten doen omdat er de angst is voor botbreuken enz. Dat blijkt uit een reviewstudie van 7 gerandomiseerde studies bij totaal 563 deelnemende patiënten. Alleen is niet duidelijk welke lichaamsbewegingen goed zijn te geven bij patiënten met Multiple Myeloma en lijkt individueel bepaald.

Abstract van de reviewstudie staat verderop in dit artikel. 

Een recente gerandomiseerde studie bij totaal 60 patiënten met Multiple Myeloma (mediane leeftijd 65 jaar; 78 procent man), van wie 78 procent lytische laesies = botbeschadigingen vertoonde en 13 procent andere skeletcomplicaties onderzocht het effect van 12 weken lichaamsoefeningen specifiek gericht per patiënt / persoon.

Patiënten in de studiegroep ervoeren een toename van de gezondheidsgerelateerde kwaliteit van leven (P = 0,03), die werd aangestuurd door verbeterde symptomen van de ziekte multiple myeloma zelf (P = 0,07), minder botpijn (P = 0,03) en betere cardiorespiratoire fitheid (P = 0,001) , vergeleken met patiënten uit de controlegroep. Er waren geen verschillen tussen de groepen in algemene pijn, vermoeidheid of neuromusculaire kracht.

"De bevindingen ondersteunen de opname van lichaamsbeweging als onderdeel van de standaardzorg om de kwaliteit van leven en gezondheid van mensen met botkanker - multiple myeloma te verbeteren", schrijven de auteurs van deze studie: 

Abstract

People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.

Hier het abstract van de reviewstudie:
Review Article

Safety, feasibility, and efficacy of exercise interventions for people with multiple myeloma: a systematic review

https://doi.org/10.1016/j.clml.2022.10.003Get rights and content

Abstract

Background

Bone lesions and other disease- and treatment-related side effects commonly experienced by people with multiple myeloma (MM) may impede their ability to exercise. This systematic review evaluated the safety, feasibility, and efficacy of exercise program participation on the physiological and/or psychological health of people with MM.

Methods

Literature searches were conducted through five electronic databases and appraised using the Delphi list of criteria. Controlled trials that assessed the safety and feasibility of an exercise intervention and its effects on disease- or treatment-related symptoms in people with MM were included.

Results

Seven studies of varying quality involving 563 participants were included. All studies concluded that exercise was safe, reporting zero serious and four adverse events attributable to exercise testing or training. Attendance ranged from 58 to 96%, however no study reported adherence to the exercise prescription. Compared to a control group, exercise did not appear to affect fatigue, depression, anxiety, body composition, quality of life, or sleep. Isolated studies identified between-group differences favoring exercise in lower limb strength (+8.4kg, 95%CI 0.5, 16.3, p=0.04), peak oxygen uptake (+1.2ml/kg/min, 95%CI 0.3, 3.7, p=0.02), physical activity (+6.5MET-hours/week, p<0.001), stem cell collection attempts (1.1±0.2 versus 1.5±0.9, p<0.01), and red blood cell (1.8±2.2 versus 2.4±2.6, p<0.05) and platelet transfusions (2.3±1.6 versus 3.5±3.4, p<0.05) during transplantation.

Conclusion

Exercise interventions appear safe and well attended by people with MM. The lack of improvements in disease- and treatment-related symptoms requires further exploration to determine whether exercise is a sufficient stimulus to elicit benefits in this unique population.


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CRediT authorship contribution statement

Jennifer L Nicol: Conceptualization, Methodology, Formal analysis, Investigation, Data curation, Writing – original draft, Visualization. Jamie E Chong: Investigation, Writing – review & editing. Zoe K McQuilten: Writing – review & editing. Peter Mollee: Writing – review & editing. Michelle M Hill: Conceptualization, Writing – review & editing, Supervision. Tina L Skinner: Conceptualization, Writing – review & editing, Validation, Supervision.

Declaration of Competing Interest

The authors declare that they have no conflicts of interest.

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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