Exercise under hypoxic condition as a potential therapeutic paradigm for digestive system cancers: A narrative review

Abstract

Cancer, like other chronic pathologies, is associated with the presence of hypoxic regions due to the uncontrolled cell growth. Under this pathological hypoxic condition, various molecular signalling pathways are activated to ensure cell survival, such as those that govern angiogenesis, erythropoiesis, among others. These molecular processes are very similar to the physiological response caused by exposure to altitude, the use of artificial hypoxia devices (systemic simulated hypoxia) or the delivery of vascular occlusion to the extremities (also called local hypoxia by the blood flow restriction technique). “Tumor hypoxia” has gained further clinical importance due to its crucial role in both tumor progression and resistance to treatment. However, the ability to manipulate this pathway through physical exercise and systemic hypoxia-mediated signalling pathways could offer an important range of therapeutic opportunities that should be further investigated. This review is focused on the role of systemic hypoxia combined with exercise as a potential therapeutic proposal in digestive system neoplasms. We conclude that there is evidence that exercise performed under hypoxic conditions can improve digestive system cancers modulating prognosis and quality of life, which could be considered as a potential new intervention in digestive oncological population.