The importance of movement to be included in rehabilitation programs is emphasized at the Cardioncology congress in Naples. But misinformation leads men and women to lead too sedentary lives while it is established that a tailor-made program for the patient helps prevent relapses. The cardioncology decalogue is illustrated
"Eating little and following a correct diet, losing excess pounds in case of overweight or obesity and carrying out regular physical activity will not only reduce the risk of recurrence in the cancer patient, but will have an efficacy that will be added to that determined by drug therapies". Thus Nicola Maurea and Michelino de Laurentiis Co-Presidents of the National Congress of Cardioncology which takes place in Naples at the National Cancer Institute Pascale Foundation on January 30 and at the Hotel Excelsior from January 31 to February 1. In addition to Professors Maurea and de Laurentiis, respectively Director of the Complex Structure of Cardiology of Pascale and Director of the Department of Breast Oncology, the appointment is organized with the General Director Attilio Bianchi and the Scientific Director Gerardo Botti. Also this year the partnership with the most important Cancer Center in the world, the MD Anderson Cancer Center in Houston, University of Texas, is repeated.
The goal of cardioncology is to diagnose, prevent and treat any cardiovascular complications in patients who are following anticancer therapies; for this reason the therapeutic path must be established thanks to the comparison and continuous collaboration between oncologist and cardiologist, so as to prevent all possible forms of heart disease, from the mildest to the most important ones. But, to improve the efficacy of drug therapies, it is essential to provide regular physical activity for cardioncology patients. According to the data reported by the AIOM Foundation, in fact, 38% of people affected by cancer do not play sports, despite the benefits of it have been amply demonstrated: practicing regular physical activity helps fight cancer, counteract the side effects of anticancer therapies. and even prevent recurrence. "Furthermore - explains De Laurentiis - sport has many psychological benefits that have a positive impact on the whole organism and on the entire therapeutic and rehabilitation process. In fact, movement, being in the midst of others, creates in the patient the perception of newfound "normality" and sociability that remove anxiety and above all the risk of falling into depression, which can affect up to 40% of these patients, often "folded" on themselves and closed in their thoughts. Therefore, a stimulated and motivated patient becomes much more collaborative because with his feedback - which for us doctors are very important - he becomes of great help in the formulation of a "targeted" therapeutic path and in its constant monitoring. Consequently, thanks to such a proactive attitude, he unconsciously contributes to improving its effectiveness because he does not passively "undergo" it but becomes an active part of it. Add to this the fact that physical activity causes the increase of endorphins with a consequent general state of well-being; so all this "virtuous circle" that gradually involves the whole organism contributes to greatly improve the patient's quality of life ".
"But the data that emerges at the Congress, which is a recent scientific acquisition - Maurea says - is that intense exercise protects against the cardiotoxicity of anticancer drugs. In short, intense sport prevents heart failure and this is particularly true in women with breast cancer. So much so that the cardiac rehabilitation program underway at the MD Anderson Cancer Center was illustrated ”. But how much should you train and what type of training should be adopted? As Maurea says: "Aerobic training contributes to tissue oxygenation, which means purifying the body of toxins. Quick walks, moderate running, cycling and swimming are therefore very good. But an anaerobic workout is also needed that strengthens the muscles and strengthens the physical structure, preventing their decay. Obviously, it is essential to do all the necessary exams first, considering that since they are "special athletes", the program must be "personalized" for each patient. For this reason, all the steps must be taken under the constant and synergistic guidance of the cardiologist, oncologist, general practitioner and sports physician who will be able to insert sport in a way I would say obligatory within the therapeutic and rehabilitative path ".
De Laurentiis confirms that little is needed to "revolutionize" the patient's approach to his path: "With half an hour of moderate physical activity to be practiced every day, unimaginable benefits are obtained: for example, breast cancer mortality in women is reduced by 25% compared to sedentary ones. In this regard, we doctors should also be more persuasive towards our patients by pushing them more to play sports, because a “certified” encouragement from the specialist would not only break down the patient's hesitations but also the resistance of family members. In fact, in order to be "protective" towards their loved ones and being often poorly informed about the benefits of sport, they often unconsciously "work" in an opposite direction and not synergistic to the one we recommend: in fact, instead of encouraging them to move them to rest as much as possible. If we add to this that only 39% of patients report having had a suggestion to play a sport from their doctor, we can reasonably say that if this percentage increased, even the total number of patients most "projected" towards physical activity would increase considerably with all the benefits we have been able to analyze so far ".
"Nutrition also plays a fundamental role - concludes Maurea - because it helps to counteract the side effects of high-impact treatments on the cardiovascular system, such as chemotherapy and biological treatments. For an effective anticancer diet it is enough to follow a few rules: it is necessary to limit or abolish red meat, sugars and sweets. Dairy products should be consumed without exaggerating, they should not be eliminated completely. Also because all foods must provide the right amount of necessary nutrients in terms of carbohydrates, proteins, vitamins, fats and mineral salts. If we unbalance a diet we risk making it deficient ”.
Il Decalogue Cardioncological:
- Control body weight by avoiding it increases under the effect of therapies or reducing it in case of overweight / obesity: remaining of your own weight is fundamental to lower the risk of cardiovascular diseases and reduce the risk of recurrence.
- Adopt an active lifestyle by getting used to using your body whenever possible, moving for example on foot or by bicycle and avoiding elevators and escalators whenever possible.
- Practices physical / sport activity regularly 2-3 times a week: it is a "cure" that counteracts the side effects of therapies and significantly reduces both the cardiovascular risk and the risk of recurrence of the tumor.
- Reduce or abolish cigarette smoke
- Reduce or abolish alcohol consumption
- Check cholesterol and triglycerides, the values can change during cancer therapies; to reduce them to diet, physical activity and any lipid-lowering drugs.
- Check your blood pressure and, in case of hypertension, take appropriate drug therapy under medical supervision.
- Choose a balanced diet, rich in vegetables, limiting or abolishing red meat and sugars and sweets, but without any other particular restrictions. Extreme diets, such as the vegan diet, are more difficult to maintain balanced and there is no clear demonstration of any benefits.
- Evaluate with your oncologist the opportunity to take calcium, vitamin D and antiosteporotic drugs to counteract the tendency to osteoporosis induced by the therapies practiced.
- Contact a cardio-oncology team for an optimal approach to integrated control of oncological and cardiac risks