Esophageal cancer, also known as cancer of the food pipe, gullet cancer, or oesophageal cancer, develops in the tube that connects the throat to the stomach. There are two main types of esophageal cancer: squamous cell carcinoma, where cancer begins in the mucosal inner layer of the esophagus, and adenocarcinoma, where cancer begins in the glandular cells that produce mucus and other fluids.
The American Cancer Society estimates the lifetime risk of esophageal cancer at 1 in 125 in men and 1 in 417 in women. Standard treatment regimens for esophageal cancer include chemotherapy and surgery. Many esophageal cancer patients receive neoadjuvant chemotherapy, given before surgery in an effort to shrink the tumor, increasing the likelihood of successful tumor resection.
There is growing evidence that exercise helps control tumor growth, but no studies examine a connection between exercise and esophageal cancer. Researchers from Guy’s and St Thomas National Health Service Foundation Trust in London investigated the impact of “prehab”, a moderate-intensity exercise program, including cardiovascular and strength training, undertaken while receiving neoadjuvant chemotherapy. The 21 patients in the intervention group exercised and received neoadjuvant chemotherapy before surgery, while the 19 patients in the control group received standard neoadjuvant chemotherapy prior to surgery. Patients gave blood samples throughout the intervention period for further analysis.
The study, published in The British Journal of Sports Medicine, revealed that patients in the exercise intervention group had higher tumor regression rates (75% regression in the Intervention group versus 36.8% regression in the Control group). The investigators also examined immunological markers in the study participants, and those in the Intervention demonstrated increased levels of T cells, the immune cells responsible for tumor cell killing.
The results of the study suggest an association between exercise and chemotherapy response in esophageal cancer, likely due, in part, to improved immune function. The authors acknowledge the small number of patients in the study limits the potential impact of the findings. Thus, a larger-scale, randomized study to confirm these findings is needed. In addition, a long-term observational period is necessary to investigate the impact of exercise on survival.