A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer

Abstract

Exercise therapy is a common supportive strategy in curative cancer treatment with strong evidence regarding its positive effects on, for example, cancer-related fatigue, health- related quality of life, and physical function. In the field of advanced cancer patients, knowledge about exercise as a useful supportive strategy is missing. The aim of this systematic review was to evaluate the feasibility and safety of exercise interventions as well as its effects on lowering the symptom burden. We included randomized controlled trials and nonrandomized controlled trials with advanced cancer patients receiving any type of exercise intervention. After an extensive literature search (in accordance to PRIMSA guidelines) in PubMed, Cochrane Library, and SPORTDiscus, 14 studies including 940 participants with different cancer entities were eligible. The results indicated the safety of exercise. In total, 493 participants received exercise interventions, with nine adverse events and no severe adverse events. The median recruitment rate was 68.33%, and adherence to exercise intervention was 86%. Further research with a high-quality and larger sample size is needed to clarify the potential of exercise with advanced cancer patients. Different advanced cancer entities have distinguished symptoms, and future research should construct entities-specific trial populations to figure out the best supportive exercise interventions.

“I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study

“…Equally, exercise might prevent declines in skeletal muscle mass [ 20 ] and manage cancer symptoms, increase physical function, and improve overall QoL [ 21 , 22 ]. There is evidence that aerobic and resistance exercise training (typically delivered in a structured, supervised setting) is beneficial among people with advanced cancer [ 23 ], including older adults with advanced cancer undergoing treatment [ 24 ]. Preliminary evidence from a recent randomized controlled trial in 40 patients with pancreatic cancer and cachexia also found a three month, supervised resistance training intervention may improve muscle strength and lean body mass [ 25 ].…”

Breast Cancer Patients’ Experiences with Online Group-Based Physical Exercise in a COVID-19 Context: A Focus Group Study

“…One strategy to control the side effects of these treatments is the prescription of physical exercise [ 6 ]. Several studies have shown how physical exercise reduces the toxicity of treatment in patients with breast cancer, improving physiological and functional parameters as well as quality of life [ 7 , 8 , 9 ]. As supported by the International Agency for Research on Cancer (IARC), a physical exercise regimen can be routinely prescribed to women with breast cancer both during treatment and afterwards, although they must meet a series of characteristics [ 8 , 10 ].…”

Ein individualisiertes Bewegungsprogramm für kinderonkologische Patienten in palliativen Situationen mithilfe von Hausbesuchen

“…Eine enge Anbindung an das medizinische Behandlungsteam ist wichtig, um Kenntnisse über den aktuellen Gesundheitszustand der Patienten zu erlangen, unerwünschte Ereignisse zu vermeiden und ein sicheres Training zu ermöglichen. Am Universitätsklinikum Essen traten bisher keine unerwünschten Ereignisse in diesem Projekt auf, was im Einklang mit der Literatur über Bewegungsinterventionen in der pädiatrischen Onkologie 6 und bei erwachsenen Patienten mit fortgeschrittener Krebserkrankung 7 steht und zeigt, dass ein sicheres Training auch für diese besondere Patientengruppe möglich ist.…”