Cancer is a deadly disease with a high mortality rate. According to WHO in 2018 there were 18.1 million new cases of cancer with a mortality rate of 9.8 million. Meanwhile, Basic Health Research (Riskesdas) data in 2018 showed that the prevalence of non-communicable diseases had increased compared to data of Riskesdas 2013. The prevalence of cancer rose from 1.4% to 1.8%. Oral cancer is a head and neck cancer with the highest mortality rate among all types of malignancies. Globally, more than 550,000 cases were found with a death toll of 380,000 annually.
Currently, oral cancer attacks many age groups under 40 years compared to three decades ago, attacking men 3 times more than women, and the most common type is oral squamous cell cancer (96.7%). The risk factors for squamous cell cancer in the oral cavity include smoking, alcohol consumption, bacterial and viral infections, malnutrition, denture irritation and decreased endurance; and smoking is the highest risk factor. Cigarette consumption in Indonesia is ranked 3rd in the world, after China and India.
Cigarettes contain substances that can cause cells to mutate, benzopyrene. Benzopyrene can enter our bodies by the way we breathe, or enter through food or drink we consume. Foods that are burned or smoked, have the opportunity to turn healthy cells into mutated cells, which lead to cancer.
Currently, many efforts that have been made against cancer are curative measures, while prevention measures are still limited. In contrast to other studies that have tested drugs to treat cancer, this study seeks preventive measures in a physiological way, by utilizing exercise. Exercise has been known to have a positive impact on body health, such as preventing obesity, diabetes mellitus, heart disease and stroke, osteoporosis, reducing the risk of hypertension and others. Besides, exercise can also improve your mood. This study aims to prove that exercise, especially moderate intensity exercise, can prevent oral cancer, the parameter used is the expression of p53 mutant.
This study used mice as experimental animals. A total of 18 mice were randomly selected and then divided into 3 groups, negative control (A), positive control (B) and treatment (C) groups. The mice used were male, 8 weeks old, weighing 25-35 grams. Before starting the study, the mice were adapted to the new environment for 1 week, then the mice were divided into 3 groups. In groups A and B, mice were only in contact with water (swimming), 3 times a day, for 3 months. While in group C the mice were exercised, with an intensity of 70% maximum swimming ability, 3 times a day, for 3 months. Because group A was a negative control group, group A was only injected oleum olivarum, at a dose of 0.08 ml; whereas in groups B and C, 0.08 mg benzopyrene was injected / 0.04 ml oleum olivarum. In all groups, the injection was administered into the right maxillary buccal mucosa, starting at week 5, for 1 month.
In the beginning of 13th week, all mice were ether anesthesized, waited until passing out, then a lump in the buccal mucosa of the right maxilla was taken. Then the mice were killed and buried. p53 mutant expression can be known through immunohistochemical staining. Immunohistochemical preparations can then be viewed under a light microscope at 400x magnification. The data from the examination results were then analyzed using the Kruskal Wallis test, followed by the Mann-Whitney test.
The results of the analysis showed that there were significant differences between all groups, where the reduction in p53 mutant expression in the moderate intensity exercise group was higher than the other two groups. p53 mutant is a protein that reflects the presence of malignancy, due to a mutation in the p53 protein (wild p53). More than 50% malignancy, contains p53 mutant. Exercise can cause apoptosis of diseased cells, cells containing the mutant protein p53. The results of this research indicate that exercise can be used as a preventive measure to reduce the risk of cancer, particularly squamous cell carcinoma of the oral cavity. The exercise is moderate intensity exercise, with a dose of 50-70% of maximum working capacity, which is done regularly, 3 times per week, for at least 2 months.
Author: Dr. Anis Irmawati, drg., MKes
Details of this research can be viewed here: Anis Irmawati, Ari Tri Wanodyo Handayani, Noor Faizah Balqis, Meircurius Dwi Condro Surboyo (2020). The Decreased of p53 Mutant Expression on Squamous Cell Epithelial of Oral in Mus musculus by Moderate Intensity of Exercise. Malaysian Journal of Medicine and Health Sciences 16(Supp 4):2636-9346, July 2020
