Exercise During Cancer Treatment, Body Composition and Inflammation

This part focuses on exercise before and during treatment. A systematic review found that exercise did not interfere with chemotherapy and may help patients reach the 85% relative dose intensity threshold below which prognosis worsens. In one trial, relative dose intensity was 84% in controls versus 90% with resistance and 87% with aerobic training. Single bouts increase tumor blood flow and perfusion and reduce hypoxia, which may improve drug delivery, and preclinical models show smaller, less aggressive tumors. Francesco explains why skeletal muscle index predicts survival better than BMI: muscle and adipose tissue are endocrine organs that release insulin, IGF-1, adipokines, TNF-alpha and IL-6. Resistance training with protein supplementation builds lean mass, and high-volume aerobic work with caloric restriction reduces fat mass. Exercise lowers insulin, IGF-1, CRP and pro-inflammatory markers and raises IL-10, though effects faded six weeks after a program ended. He recommends 10 to 15 reps, 3 or more sets, 3 to 5 days a week for muscle, and 20 to 30 minutes of aerobic work 5 days a week for fat loss.