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Abstract

The last decade has seen a significant rise in interest in using exercise as medicine. Epidemiologic evidence concludes that those who perform a higher level of physical activity have a reduced likelihood of developing a variety of cancers compared to those who engage in lower levels of physical activity (Brown et al. 2012; Campbell et al. 2019; Meyerhardt et al. 2006; Patel et al. 2019). Cormie et al. in their review had mentioned that regular physical exercise counteracts cancer development and progression and reduces treatment related side effects, such as depressions and fatigue (Cormie et al. 2017). An active lifestyle is associated with reduced breast cancer risk and improved survival in breast cancer patients (Bodai and Tuso 2015). Besides a reduction of chronic inflammation, physical exercise has been shown to regulate hormonal balance including catecholamine, prostaglandins, and cortisol (Keast et al. 1988) (Figure 1). Physical exercise has also been shown to mimic chemotherapy and has an additive effect (Ballard-Barbash et al. 2012; Betof et al. 2015). Although evidence for primary and tertiary prevention in randomized controlled trials is still lacking, preclinical research has shown that exercise has a direct effect on the immune function as shown for the first time in 1989 by Nieman and his team (Nieman et al. 1989). Despite these observational evidences, the underlying mechanisms associated between participation in physical activity, immune modulation and cancer risk reduction remains understudied.