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A reason to hit the gym?

SandiaBuddy's picture
SandiaBuddy
Posts: 1103
Joined: Apr 2017

A new study shows that loss of muscle mass is significantly related to mortality in stage I to III colorectal cancer.  (see also, weight loss and mortality, https://csn.cancer.org/node/311659 )

https://onlinelibrary.wiley.com/doi/full/10.1002/jcsm.12305

In this large population‐based cohort study, we demonstrated that longitudinal declines in muscle mass and radiodensity are a risk factor for all‐cause and CRC‐specific mortality in patients with stage I–III CRC. The observed associations were independent of recurrent disease and changes in body mass and other body composition parameters including visceral and subcutaneous adipose tissue. Extrapolated from the abdomen to the whole body, moderate and large deteriorations in muscle mass are consistent with losses of 1.8 ± 0.6 and 4.4 ± 1.9 kg of skeletal muscle, respectively.22

Among 215 patients receiving first‐line chemotherapy for metastatic CRC, a >5% deterioration in muscle mass over 4 months was associated with a 2.1‐fold higher risk of mortality.9 A ≥9% deterioration over 3 months was associated with a four‐fold increase in the risk of mortality in a cohort of 67 patients receiving first‐line and second‐line chemotherapy for metastatic CRC.8 In our study, over 14 months we observed small overall changes in muscle mass (+0.1 ± 5.7%) and muscle radiodensity (−0.7 ± 10.1%). This is in contrast to patients with stage metastatic CRC, such that over 14 months it is estimated that patients lose, on average, 28.5% and 17.3% in muscle mass and muscle radiodensity, respectively.8 In a cohort of 1803 healthy older adults, each ≈4% decline in thigh muscle mass over 4 years was associated with a 20% increase in the risk of death, independent of weight loss and changes in adiposity.28

At the time of diagnosis, 30−60% of patients with CRC may have a low muscle mass or low muscle radiodensity.829 Low muscle mass and low muscle radiodensity at diagnosis are risk factors for mortality.829 Our analyses demonstrated that, independent of muscle mass or radiodensity at diagnosis, muscle wasting within the first 9−27 months after diagnosis was a risk factor for mortality. In subgroup interaction analyses, the prognostic importance of muscle wasting did not vary by baseline muscle mass or radiodensity. This suggests that muscle wasting may be deleterious among all patients, regardless of their body composition at diagnosis. The identified associations were independent of weight loss, suggesting that monitoring changes in body mass may be insufficient to promptly identify occult muscle wasting. CT images of the chest and abdomen is recommended every 6−12 months in patients with stage II and III CRC for the surveillance of recurrent disease.30 If our findings are replicated, it may provide empirical support to the viewpoint that quantifying body composition in routinely collected CT images will add value to patient care.18 Additional research is necessary to replicate the effect modification of cancer site on the relationship between change in muscle mass and risk of all‐cause mortality.

The observation that muscle wasting is associated with mortality may serve as a framework to test the hypothesis that interventions which prevent or retard muscle wasting may offer clinical benefit in this population. In this framework, the measurement of muscle mass and radiodensity may serve as therapeutic targets (i.e. biomarkers) to guide early‐phase intervention development. Muscle wasting is characterized by inflammation and oxidative stress, which activate the ubiquitin‐proteasome system and apoptosis‐inducing proteins, and suppress insulin‐like growth factors.3132 Pharmacotherapy development for muscle wasting has just begun to emerge.33 Participation in physical activity after diagnosis of stage I–III CRC is associated with a 40% relative reduction in the risk of mortality.34 Physical activity, particularly resistance exercise, is efficacious for preserving or improving muscle mass in adults35 and may be synergized when prescribed with nutritional supplementation.36 However, the efficacy of resistance exercise and nutritional supplementation in patients with stage I–III CRC has not yet been established.

 

Annabelle41415's picture
Annabelle41415
Posts: 6550
Joined: Feb 2009

Totally agree.  Even during treatment exercise was important to me, however most of mine was done with brisk walking and trying to walk as much as possible.  No weight lifting because of the abdomen surgery but walking was a daily thing.  Also, my Fitbit was a big help for me to determine how much walking was done in a day.  There were some days that exercise was impossible.  You do what you can.

Kim

darcher's picture
darcher
Posts: 268
Joined: Jun 2017

  One gets weaker from this illness and getting exercise in is important after all.  It's strange in that my weight is nearly what it was before but my strength is crap.  I don't look 'weaker' in a mirror but then again I don't have a before picture to look at.  I probably am just don't see it or don't want to see it, lol.  I guess I need to head out and start taking those walks again along with push ups and other things.  At least this povides evidence that it improves our susrvial odds.

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I suspect that lower muscle mass is a mortality risk factor for older people in general. Cancer treatment is long and takes a toll on the body and lack of muscle mass can make you more accident prone. What I did at the gym today:

Leg extensions 12/90
Hip adduction 15/135
Hip abduction 20/110
Abdominal 15/120 12/125 10/130
Triceps press 13/85
Arm curl 11/50
Overhead press 15/75
Chest press 11/95
Fly 12/70
Rear delts 3/70 10/50
Rotary torso 12/90
Rows 8/90

I would love to go back to the bodyweight machines but I have to worry about the chest port and the illeostomy. One of my favorite exercises is pullups and those could place a lot of strain in both areas. Same with dips, planks and many other things that I took for granted.

My fitness center manager told me that she trans people in my office that can't do a squat; they would fall over because they don't have the muscle strength. I was a bit surprised at this but I'm a gym rat when I have the time and opportunity.

The nice thing about doing weights on a regular basis is that you have an objective measure as to where you are. I used to do the abs machine at 250 pounds but I'm doing about half that these days. I'd rather not damage anything than try to get back to where I was. But I want a decent measure of strength because it's useful in everyday life and helps prevent injuries. I think that strength training can be done in many forms. Yoga is great because it works balance muscles that aren't worked with weight machines or common free-weight exercises.

The important thing is to start doing something regularly.

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