Exercise, Quality of Life, and Physical Function in Patients with Cancer

MASCC members Paul Jacobsen (Moffitt Cancer Center and Research Institute, Tampa, Florida) and Irma Verdonck-de Leeuw (VU University Medical Center, Amsterdam, The Netherlands) were among the many collaborators on a large-scale meta-analysis (Buffart et al., 2017) designed to evaluate the effects of exercise on quality of life and physical function in adult cancer patients.1 The study also aimed to determine the extent to which demographic, clinical, exercise, and other intervention-related variables moderated the main effects. The analysis included 34 randomized controlled trials that involved more than 4,500 adult cancer patients and that evaluated the effects of exercise on quality of life and physical function. Exercise was found to significantly improve both quality of life and physical function. These effects were unaffected by differences in demographic, clinical, and exercise variables, such as age, sex, education level, marital status, BMI, cancer type, metastatic stage, and treatment. Also, exercise was equally effective during and following cancer treatment.

Of note is that the effects of supervised exercise interventions were twice as large as those associated with unsupervised exercise. This finding is consistent with a previous systematic review (Baumann et al., 2012) and may reflect the effects of several variables, such as attention of an exercise supervisor, access to better equipment, a more challenging exercise protocol, and/or better adherence to it. The authors note that the effect sizes were small, but the analysis offers sound empirical evidence to support making exercise a regular part of supportive cancer care. The report includes recommendations for further research on understudied and advanced cancer populations, on optimizing participation, and on other clinical outcomes, including survival.
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1A recent systematic review (Teleni et al., 2016) by MASCC members Laisa Teleni, Ray Chan, Alex Chan, Liz Isenring, Alexandra McCarthy, and others showed that exercise enhances health- and disease-specific quality of life in men with prostate cancer undergoing androgen-deprivation therapy.
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References

Buffart LM, Kalter J, Sweegers MG, Courneya KS, Newton RU, Aaronson NK et al. Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev. 2017 Jan;52:91-104. Epub Dec 5, 2016.

Baumann FT, Zopf EM, Bloch W. Clinical exercise interventions in prostate cancer patients: A systematic review of randomized controlled trials. Support Care Cancer 2012;20:221–33.

Teleni L, Chan RJ, Chan A, Isenring EA, Vela I, Inder WJ, McCarthy AL.Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials. Endocr Relat Cancer. 2016 Feb;23(2):101-12.