Exercise can counter the detrimental effects of cancer treatment – such as heart and nerve damage and brain fog – an overarching review of the existing pooled data analyses of the most recent research has suggested.
The conclusion appears in an article by Xue-Li Bai, who is based at the Department of Obstetrics and Gynaecology, Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, and a number of colleagues, all of whom are based in China.
The article was published today (30 April) online in the British Journal of Sports Medicine. Exercise also seems to boost psychological wellbeing and overall quality of life, lending weight to its routine inclusion in treatment protocols for the disease, say Xue-Li Bai and fellow researchers.
Several pooled data analyses of the available research have evaluated the impact of exercise on health outcomes in people with cancer, but significant gaps remain in our understanding, explain the researchers.
And to date, no comprehensive evaluation of the results of existing pooled data analyses on exercise and health outcomes in people with a broad range of cancers has been published, they add.
To plug this gap, with the aim of strengthening the evidence base and informing clinical care, the researchers carried out an umbrella review of the existing pooled data analyses of randomised controlled trial results, published between 2012 and July 2024.
The review included 485 associations from 80 articles, all of which were evaluated as being of moderate to high quality.
Exercises ranged from ‘mind-body’ types to HIIT and more
included Among these associations, the types of exercise of any length, intensity, and duration included mind-body (138, 28.5 per cent), such as Qigong, tai chi, and yoga; aerobic and resistance exercise (48, 10 per cent), high intensity interval training (HIIT) (18, 4 per cent); and other types (281, 59 per cent).
These associations were explored in people with cancers of the breast (244, 50 per cent), digestive system (20, 4 per cent), blood (13, 3 per cent), lung (47, 10 per cent), prostate (12, 2.5 per cent) plus others (149, 31 per cent).
In all, 260 (54 per cent) associations were statistically significant, and 81 (17 per cent) and 152 (31 per cent), respectively, were supported by high and moderate certainty evidence, according to GRADE criteria – used to assess the certainty of scientific evidence and the strength of recommendations in health care.
‘Incorporating mind–body exercises into the exercise guidelines for people with cancer may be a valuable consideration. Future high quality research is needed to explore additional outcomes …’ [Xue-Li Bai et al]
Exercise significantly reduced various side effects associated with cancer and its treatment compared with usual care or no exercise. For example, it lessened heart and peripheral nerve damage associated with chemotherapy, brain fog (cognitive impairment), and shortness of breath (dyspnoea).
It also changed body composition and key physiological indicators of health, such as insulin, insulin-like growth factor, and C-reactive protein in people with cancer. And it improved sleep quality, psychological wellbeing, the normal workings of the body, and social interaction, while boosting overall quality of life.
And there was evidence of high to moderate certainty that preoperative exercise reduced the risk of postoperative complications, pain, length of hospital stay, and risk of death.
Caveats and conclusions
The researchers acknowledge various limitations to their findings. The pooled data analyses included in the review differed considerably, including the number of studies on which they variously drew.
Participants with cancer able to exercise might also have been healthier, the researchers suggest. And side effects of treatment vary, depending on cancer type and how advanced the disease is, they point out.
But Xue-Li Bai and colleagues conclude: ‘Incorporating mind–body exercises into the exercise guidelines for people with cancer may be a valuable consideration.’
They add: ‘Future high quality research is needed to explore additional outcomes, clarify underlying mechanisms and refine exercise prescriptions tailored to cancer type, treatment timing, exercise modality and individual characteristics, ensuring more precise and clinically relevant interventions for diverse cancer populations.’
To access the full version of the article – titled Impact of exercise on health outcomes in people with cancer: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials Doi: 10.1136/bjsports-2024-109392 – see: https://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2024-109392
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