Researchers have found a link between muscular strength and good levels of physical fitness with a significantly lower risk of death from any cause among people with cancer.
An international team published the results of a pooled data analysis of the available evidence online in the British Journal of Sports Medicine today (22 January).
The paper’s first author is Francesco Bettariga, a physical therapist who graduated in Italy and gained further qualifications in the UK. He is based at the Exercise Medicine Research Institute at Edith Cowan University in Joondalup, Western Australia. One author in the 12-person team is currently based in the UK: Chris Bishop, who works at the Middlesex University-based London Sports Institute.
Dr Bettariga and his colleagues suggest that people with cancer who follow tailored exercises to their boost muscle strength and cardiorespiratory fitness may be helping to improve their chances of survival.
To inform potential options for extending survival in people diagnosed with cancer, Dr Bettariga and his colleagues set out to see if muscular strength and cardiorespiratory fitness might be associated with lower risks of death in these patients, and whether cancer type and stage might be influential.
They searched for relevant studies published in English up to August 2023 and included 42 in their pooled data analysis, involving nearly 47,000 patients (with an average age of 64) with various types and stages of cancer.
Low muscle strength, using handgrip strength, was classified as either less than 13 kg to less than 25 kg in women, and from less than around 20 kg to less than 40 kg in men.
Cardiorespiratory fitness was assessed using either cardiopulmonary exercise testing (CPET) or the six-minute walk test (MWT).
‘Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in cancer patients in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy’ [Francesco Bettariga et al]
Key findings and conclusions
The pooled data analysis of the study results showed that both muscular strength and cardiorespiratory fitness were significantly associated with the risk of death from any cause and specifically from cancer.
Compared with those with poor muscle strength and low levels of cardiorespiratory fitness, those at the other end of the spectrum were from 31 to 46 per cent less likely to die from any cause. And this risk fell by a further 11 per cent with each unit increase in muscular strength.
What’s more, this combination of strength and fitness was associated with an 8 per cent-46 per cent lower risk of death from any cause in patients with advanced cancer (stages 3 and 4), and a 19 per cent to 41 per cent lower risk of death from any cause among those with lung or digestive cancers.
And each unit increase in fitness level was associated with an 18 per cent lower risk of death from cancer itself.
Dr Bettariga and his colleagues state: ‘Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in cancer patients in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy.’
Fact file
In 2022 alone, 20 million people were diagnosed with cancer worldwide, and nearly 10 million died from their disease –trends that are projected to increase in the coming decades, note the researchers.
They add that despite notable advances in cancer prevention, diagnosis, and treatment, the side effects of treatment, including those on the heart and muscles, can take their toll on survival.
To access the full version of the paper – titled Association of muscle strength and cardiorespiratory fitness with all-cause and cancer-specific mortality in patients diagnosed with cancer: a systematic review with meta-analysis Doi: 10.1136/bjsports-2024-108671 – see: https://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2024-108671
Extract from information on a bio on Francesco Bettariga (available on the website of the Exercise Medicine Research Institute at Edith Cowan University)
- Francesco Bettariga is a PhD candidate at the Exercise Medicine Research Institute. Francesco has completed a Bachelor of Science in physiotherapy and exercise physiology at University of Brescia (Italy) and a Master of Science in strength and conditioning and exercise physiology at Middlesex University (London – UK).
- He worked as exercise physiologist in a private clinic with patients suffering from cancer, lipedema, lymphedema, cardiovascular diseases, metabolic conditions and musculoskeletal disorders. During his Master’s degree was responsible for implementing exercise programs in athletes. His current research focuses on exercise-induced myokines and their effects on cancer cells in breast cancer survivors.
- For more information, see: https://www.exercisemedicine.org.au/staff/profiles/francesco-bettariga