Physical activity and fitness in childhood cancer survivors: A scoping review

Abstract

Background: Estimates indicate that nearly 8% of the over 500,000 survivors of childhood cancer living in the United States are frail in their fourth and fifth decades of life, a phenotype typically seen in geriatric populations. Participation in regular physical activity to improve physical fitness in healthy and diseased populations reduces risk for frail health by increasing physiologic reserve. However, physical activity may not have the same effects on fitness in childhood cancer survivors as it does among their peers with no cancer history. Aims: This scoping review seeks to describe associations between physical activity, physical fitness, chronic disease, and mortality in childhood cancer survivors. Methods: Relevant literature was identified through a comprehensive search in the PubMed, Web of Science, CINAHL, and Cochrane databases. A narrative synthesis was performed on observational studies that had physical activity or physical fitness clearly defined and compared with chronic disease outcomes. Results: A total of 595 studies were screened, and results from 11 studies are presented. Childhood cancer survivors who participate in regular physical activity have improved markers of cardiovascular health, decreased risk of overt cardiovascular disease, and decreased risk of all-cause mortality compared to survivors who are not physically active. Childhood cancer survivors who are physically fit have increased neurocognition, and decreased risk of all-cause mortality compared to survivor's who are not fit. The differential effects of physical activity on fitness and health among childhood cancer survivors when compared to peers is potentially related to treatment exposures that damage cardiovascular tissue and impact regenerative potential. Conclusion:Research is needed to determine the optimal timing, frequency, intensity, and duration of physical activity necessary to optimize fitness in childhood cancer survivors.

Perceived barriers and facilitators to physical activity in childhood cancer survivors and their parents: A large‐scale interview study from the International PACCS Study

“…[14][15][16] PA is especially important for young cancer survivors, as PA can reduce their risk of late effects such as metabolic syndrome, cardiovascular disease, and premature death. [17][18][19][20][21] Regardless, most survivors are less active than siblings and age-matched healthy controls. [22][23][24] A recent study found that only 25% of childhood cancer survivors meet PA recommended guidelines (60 minutes a day).…”

“…Participating in physical activity (PA) in childhood is essential for attaining developmental milestones, improving physical fitness, and forming long‐lasting beneficial lifestyle behaviors 14–16 . PA is especially important for young cancer survivors, as PA can reduce their risk of late effects such as metabolic syndrome, cardiovascular disease, and premature death 17–21 . Regardless, most survivors are less active than siblings and age‐matched healthy controls 22–24 .…”

Risk factors for overweight and obesity after childhood acute lymphoblastic leukemia in North America and Switzerland: A comparison of two cohort studies

“…6,39 We recommend identifying survivors at risk for cardiovascular disease early and offering support with targeted interventions. 40,41 Physical activity has been shown as beneficial and safe during and after treatment, 42,43 yet currently well below recommended levels. [44][45][46][47] Some children need special support because of musculoskeletal or medical impairments.…”

The Impact of Exercise on Cardiotoxicity in Pediatric Cancer Survivors: A Scoping Review Protocol

“…A scoping review on the topic could provide important information about the breadth of evidence available, offer guidance for future exercise interventions designed to prevent cardiotoxicity in CACS, and identify where more research is necessary. While several reviews are available, none have explored the impact of exercise interventions on heart health in CACS (Huang & Ness, 2011;Upshaw, 2020;Varghese et al, 2021;Wogksch et al, 2021;Wurz, McLaughlin, Lategan, Ellis, & Culos-Reed, 2021).…”