- People with cancer undergoing chemotherapy experience similar physical effects — including loss of body mass, loss of bone density, and radiation — as astronauts in space.
- While astronauts have comprehensive exercise programs to act as a countermeasure, people with cancer are typically advised to rest.
- Researchers are working on applying targeted, NASA-style workout programs to cancer therapy.
Spaceflight is tough on the human body.
For decades, scientists and researchers have developed countermeasures to help astronauts deal with the effects of living in orbit.
These effects include, but aren’t limited to, decreased muscle mass and bone density, along with the effects of cosmic radiation.
At first blush, an astronaut on the International Space Station might not appear to have much in common with a person with cancer here on Earth.
However, new research spells out numerous ways in which these two groups can be compared — and offers promise that techniques used in space could be used to help people undergoing cancer therapy.
The scientific study was published today in the scientific journal Cell.
“It’s very interesting research,” Naduparambil Jacob, PhD, a cancer researcher with The Ohio State University Comprehensive Cancer Center, told Healthline. “The overall data concept is solid, even if there are still unknowns.”
“We knew anecdotally that the side effects of spaceflight and cancer therapy were similar, but it was surprising how widespread the parallels were,” explained Jessica Scott, PhD, BSc, an exercise physiology researcher at the Memorial Sloan Kettering Cancer Center’s Exercise Oncology Service in New York and lead researcher on the study.
“For example, astronauts experience something called ‘space fog,’ which is similar to what cancer patients call ‘chemo brain,’ and both astronauts and cancer patients may have decreases in bone, muscle, and heart size,” Scott told Healthline.
To counteract some of these effects, NASA astronauts have comprehensive, individualized exercise programs for before, during, and after a mission into space.
People with cancer who are undergoing chemotherapy, on the other hand, are generally advised to rest.
To explain this disparity, it helps to go back into NASA’s early days, says Scott.
“It was fascinating to go through the history of human spaceflight and development of systemic therapies in cancer,” she said. “Both fields were making incredible progress in the early 1960s, but NASA’s first human mission in 1961 was a resounding success, whereas the earliest forms of anticancer agents had limited efficacy.”
“Therefore, NASA could focus on preventing and treating the side effects of spaceflight, whereas oncologists, rightly so, continued to focus on improving efficacy of cancer therapies,” she said.
Scott says that while working as a senior scientist with NASA, she studied the side effects of spaceflight and developed exercise programs to keep astronauts healthy.
“At a conference, I was speaking with a colleague who worked in cancer about the side effects of spaceflight and how NASA used exercise as the key intervention for astronauts,” she said.
“We realized that there were a lot of similarities between the side effects of spaceflight and a cancer patient. However, in contrast to NASA’s countermeasures program, a similar program wasn’t available for cancer patients,” Scott explained.
Jacob says that a collaboration between Ohio State and NASA helps researchers assess the risk of radiation levels as NASA prepares for eventual long-term space missions.
“We collect samples at different timepoints, looking at animals exposed to space radiation,” he said. “We look at the effects on their cardiovascular systems and look at the biomarkers. The goal is whether you can predict the risk.”
As it turns out, the months an astronaut might spend in space are comparable to the months a person with cancer might undergo chemotherapy.
“Patients undergoing therapy can physiologically age 10 years in just 6 months,” Scott said. “These declines in cardiorespiratory fitness are remarkably comparable to those in astronauts before in-flight exercise was introduced.”
Noting that cancer is one of the few major chronic disease conditions where exercise isn’t an aspect of standard management, Scott says it’s worth examining whether this should be changed.
“We think that a cancer countermeasures program that incorporates exercise before, during, and after therapy to prevent and/or treat the side effects of therapy has the potential to dramatically improve cancer care for the roughly 1 million individuals that will be diagnosed with cancer in the United States this year,” she said.
“We have already started implementing elements of NASA’s countermeasures program in some of our clinical trials in cancer patients,” Scott said. “For example, we are using certain assessments that are identical to those used in astronauts.”
Simple exercise techniques, such as using a treadmill, could make a big difference for people with cancer, says Scott. To this end, she and her colleagues have started delivering treadmills to clients’ homes.
“We’re conducting supervised exercise sessions from our ‘mission control’ at Sloan Kettering in Manhattan with video conferencing, just as astronauts hundreds of miles above Earth have exercise prescriptions delivered,” Scott said.
While initial returns have been promising, Scott cautions that these are just the first steps, and more research and clinical trials will be necessary before this approach could be incorporated into regular standards of care for cancer therapy.
It’s also worth noting that everyone is physiologically different, meaning there isn’t one exercise program that will work for all people. Astronauts all have individual exercise programs tailored to their unique biomarkers.
“What we’ve found, both in astronauts and cancer patients, is that one size of exercise does not fit all,” Scott said.
“The goal of a countermeasures program is to test a more targeted approach to exercise — just like patients receive different types, doses, and schedules of chemotherapy — to optimize the safety, tolerability, and efficacy of exercise for patients with a history of cancer,” she said.