Cancer as a Model of Accelerated Physiological Aging and Mitigating Effect of Exercise Training (#9)
Advances in early detection and adjuvant therapy have led to dramatic improvements in longevity following a cancer diagnosis. As a result, there are approximately 13.7 million cancer survivors alive in the US, with this figure projected to increase to 18 million in 2022. Despite improvements in the five-year relative survival rates, cancer patients with early-stage disease remain at high-risk of cancer recurrence but also have sufficient longevity to also be at risk for late-effects of adjuvant therapy, particularly cardiovascular disease (CVD). CVD is the predominant cause of mortality. Moreover, certain select cancer populations are at higher risk of CVD compared to sex-age-matched individuals without a history of cancer. In recent work, our group found that early breast cancer patients reach a predicted cardiovascular fitness level for a particular age group (e.g., 40 years) approximately 20 – 30 years earlier than healthy women without a history of breast cancer. This emerging evidence suggests that cancer may represent a model of accelerated physiological aging. We contend that this accelerated aging phenotype is a consequence of the direct as well as the indirect (i.e., lifestyle perturbations) effects of anticancer therapy (i.e., anticancer therapy refers to any type of cancer treatment) that through maladaptations impair the reserve capacity of organs within the cardiovascular (i.e., pulmonary, cardiac, blood-vascular) - skeletal muscle system. To this end, structured exercise training may provide a powerful therapeutic strategy is attenuate and/or reverse the cancer-related aging phenotype since it improves the reserve capacity of all organs within the cardiovascular system leading to profound improvements in whole-body cardiovascular function.