Exercise can improve cancer-induced anemia


Many cancer patients suffer from anemia, leaving them tired, weak, and unable to perform physical activity. Medicines rarely relieve this type of anemia. Researchers at the University of Basel have now been able to show the causes of anemia and that physical exercise can improve this condition.

The two main symptoms of cancer are loss of muscle mass and reduced hemoglobin levels, leading to weight loss, fatigue, lethargy, and reduced physical performance. In addition, the two symptoms – atrophy and anemia – prompt many patients to make a doctor’s appointment, which in turn leads to the diagnosis of a tumor. Why cancer causes muscle atrophy and anemia is not yet understood, and treatment is currently difficult.

The fact that anemia leads to a decline in general health and can negatively affect the course of cancer treatment underscores the urgency of obtaining information on causes and potential remedies. In collaboration with the Department of Biomedicine at the University of Basel, the research group of Prof. Christoph Handschin at the Biozentrum has now been able to show in a mouse model that cancer not only triggers a systemic inflammatory reaction, but also massively modifies the manipulation of lipids and other metabolites in the body.

The fight of the body is unsuccessful

These changes lead to increased destruction of red blood cells linked to the tumor. The study published in Science Advances shows that exercise normalizes these metabolic abnormalities and thus reduces the anemia caused by cancer.

The body tries to counter the breakdown by increasing the production of red blood cells in the bone marrow and spleen – without success. However, the increased production of blood cells is insufficient to prevent anemia associated with tumors. “We have now been able to clarify how cancer causes the breakdown of red blood cells,” explains Christoph Handschin. “Cancer massively alters the metabolism of lipids and other compounds. This alters not only red blood cells but also macrophages, causing a sharp increase in the destruction of red blood cells by macrophages.” Macrophages are a type of white blood cell and are part of the immune system.

Exercise normalizes metabolism and relieves anemia

The research group attempted to normalize the metabolism by pharmacological means. However, none of the drugs could significantly improve the anemia. In contrast, the metabolism was so regulated by exercise that the anemia also decreased. Even the abnormal increase in red blood cell production could be reduced to a lower level.

The training restored the tumor-induced metabolic remodeling and inflammation sufficiently to reduce the excessive formation and destruction of blood cells. “

Professor Christoph Handschin

This study provides new information on the development of tumor associated anemia. The results suggest that exercise is a useful therapy for cancer patients, to counteract anemia and associated fatigue and lethargy and in turn improve their overall well-being and quality of life. This also leads to better tolerance of radio- and chemotherapy, as has been established previously.


Journal reference:

Hammarström, S., et al. (2021) Remodeling of metabolism and inflammation through exercise improves anemia associated with tumors. Scientists progress. doi.org/10.1126/sciadv.abi4852.


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