Turkiye Klinikleri Journal of Health Sciences

.: REVIEW
Kanserde Kaşeksi Patofizyolojisi ve Egzersizin Etkisi: Geleneksel Derleme
Cancer Cachexia Pathophysiology and Effect of Exercise: Traditional Review
Ezgi ERGİNa, Didem KARADİBAKb
aDokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, Fizyoterapi ve Rehabilitasyon Bölümü, İzmir, Türkiye
bDokuz Eylül Üniversitesi Fizik Tedavi ve Rehabilitasyon Fakültesi, Kardiyopulmoner Rehabilitasyon Bölümü, İzmir, Türkiye
Turkiye Klinikleri J Health Sci. 2023;8(3):536-44
doi: 10.5336/healthsci.2023-96712
Article Language: TR
Full Text
ÖZET
 Kanser kaşeksisi (KK); beslenme desteğiyle düzelmeyen, ilerleyici fonksiyonel bozulma, iskelet kas kütlesi kaybı ile karakterize çok faktörlü bir sendromdur ve ileri evre kanser hastalarında oldukça yüksek oranlarda görülmektedir. Prekaşeksi, kaşeksi ve refrakter kaşeksi olarak 3 evresi bulunmaktadır. Sistemik inflamasyon, tümör hücrelerinden proinflamatuar sitokin üretimiyle tetiklenmektedir. Sitokin üretiminin organlara yayılma etkisi akut faz yanıtı, katabolik-anabolik uyarı değişimleri, artmış enerji harcaması, azalmış enerji alımı, anoreksiya, insülin direnci, oksidatif stres artışı, mitokodriyal disfonksiyon, yağ dokusunda ve kasta kayıplara yol açmaktadır. KK'de çok faktörlü patofizyoloji nedeniyle kapsamlı değerlendirme yapılmalıdır. Değerlendirme, uygun tedavi planının belirlenmesinde oldukça önemlidir. Net bir tedavi planı bulunmamasına rağmen egzersizin etkili olabileceği belirtilmiştir. Yapılan hayvan çalışmalarında, aerobik egzersizin oksidatif kapasitede artma, tümör hacminde ve inflamasyonda azalma ve kas atrofisini önlemeyi sağladığı bulunmuştur. Dirençli egzersizin KK'li bireylerde güvenli ve uygulanabilir olduğu, hareketlilik, kas kuvveti ve yağsız vücut kütlesinde anlamlı artış sağladığı görülmüştür. Hayvan çalışmalarında dirençli egzersizin; inflamasyon ve hiperlipidemide azalma, kilo alımı ve protein sentezinde artma sağladığı bildirilmiştir. Yapılan hayvan çalışmalarında, aerobik ve direçli kombine egzersizin; protein katabolizması ve oksidatif streste azalma, kas kaybını önleme ve kas kütlesinde artma sağladığı belirtilmiştir. Egzersiz, umut verici ve farmakolojik olmayan bir yaklaşımdır ve KK'li bireylerde egzersizin etkilerinin incelendiği çalışmalara ihtiyaç vardır. Bu çalışmada, KK'nin patofizyolojisi, kullanılan değerlendirme yöntemleri ve egzersizin patofizyoloji üzerine etkilerinin derlenmesi amaçlamıştır.

Anahtar Kelimeler: Kanser; kaşeksi; patofizyoloji; egzersiz; egzersiz tedavisi
ABSTRACT
 Cancer cachexia (CC) is characterized by progressive functional deterioration and loss of skeletal muscle mass, which doesn't improve with nutritional support, and is seen at very high rates in advanced cancer patients. It has stages as precachexia, cachexia and refractory cachexia. Systemic inflammation is triggered by proinflammatory cytokines production from tumor cells. The effect of cytokine production spreading to organs causes acute phase response, catabolicanabolic stimulus changes, increased energy expenditure, decreased energy intake, anorexia, insulin resistance, increased oxidative stress, mitochodrial dysfunction, loss of muscle and adipose tissue. Because of the multifactorial pathophysiology in CC, comprehensive evaluation should be performed. Evaluation is significant in determining the appropriate treatment plan. Although there isn't clear treatment plan, exercise can be effective. Animal studies reported that aerobic exercise increases oxidative capacity, reduces tumor volume and inflammation and prevents muscle atrophy. Resistance exercise has been reported to be feasible and safe in individuals with CC, provides significant improvements in mobility, muscle strength and lean body mass. Animal studies, reported that resistance exercise reduces inflammation and hyperlipidemia, increases weight and protein synthesis. Animal studies, stated that aerobic and resistance combined exercise is effective in reducing protein catabolism and oxidative stress, preventing muscle loss and improving muscle mass. Exercise is a promising non-pharmacological approach and exercise studies are needed for CC in adults. This study aimed to review the pathophysiology, evaluation methods and the effects of exercise on the pathophysiology.

Keywords: Cancer; cachexia; pathophysiology; exercise; exercise therapy
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"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com