Skip to main content
Log in

Review and critique of the quality of exercise recommendations for cancer patients and survivors

  • Review Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

The benefit of exercise for cancer patients is starting to become recognized. The purposes of this paper were to review the literature to examine whether research findings are being converted into guidelines for patients and survivors and to examine the quality of evidence on which they were based. A computer search of major health databases was conducted for peer-reviewed literature and books on exercise and cancer, and an Internet search was conducted for cancer websites reporting any exercise guidelines/recommendations for cancer patients. Seven peer-reviewed articles, eight books and eight cancer websites were identified that suggested exercise guidelines for cancer patients and survivors. None of the published guidelines identified appeared to have been developed via a process that would allow them to be cited as evidence-based guidelines. Based on the studies to date, no direct cancer-specific evidence about the best type, frequency, duration or intensity of exercise is currently available in the peer-reviewed literature. It is currently not known what would be most beneficial for which cancers, at which stage of disease or treatment. Given the current interest in cancer and exercise, there is an urgent need for an evidence-based set of exercise guidelines to be developed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. ACSM: Position stand: exercise and type 2 diabetes 2004, http://www.acsm-msse.org/pt/pt-core/template-journal/msse/media/0700.pdf

  2. ACSM: Position stand: exercise and hypertension 2004, http://www.acsm-msse.org/pt/pt-core/template-journal/msse/media/0304.pdf

  3. Ahlberg K, Ekman T, Gaston-Johansson F, Mock V (2003) Assessment and management of cancer-related fatigue in adults. Lancet 362:640–651

    Article  PubMed  Google Scholar 

  4. Alberta Breast Cancer Program. Physical activity/exercise for women diagnosed with breast cancer. Accessed July 2004, http://www.albertabreast.com/hottopics/ht6.php

  5. American Cancer Society. Exercise to stay active. Accessed July 2004, http://www.cancer.org/docroot/MIT/MIT_2_1x_ExerciseToStayActive.asp?sitearea=MIT

  6. American College of Sports Medicine (1991) Guidelines for exercise testing and prescription. Lea & Febiger, USA

    Google Scholar 

  7. American College of Sports Medicine (2000) ACSM’s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, USA

    Google Scholar 

  8. American Institute for Cancer Research. For cancer survivors: exercise tips. Accessed July 2004, http://www.aicr.org/surviveexercise.html

  9. Australian Institute of Health and Welfare National Cancer Statistics Clearing House. Accessed July 2004, http://www.aihw.gov.au/cancer/ncsch/index.html

  10. Berman J, Fleegler F, Hanc J (2001) The FORCE program. Ballantine Books, New York

    Google Scholar 

  11. Blanchard C, Baker F, Denniston M, Courneya KS, Hann D, Gesme D, Reding D, Flynn T, Kennedy J (2003) Is absolute amount or change in exercise more associated with quality of life in adult cancer survivors? Prev Med 37:389–395

    Google Scholar 

  12. British Columbia Cancer Agency. Rehab exercises. Accessed July 2004, http://www.bccancer.bc.ca/PPI/TypesofCancer/Breast/RehabExercises/AdvancedExercises.htm

  13. Burnham T, Wilcox A (2002) Effects of exercise on physiological and psychological variables in cancer survivors. Med Sci Sports Exerc 34:1863–1867

    Google Scholar 

  14. Canadian Cancer Society. Exercise after breast cancer. Accessed July 2004, http://www.jco.org/cgi/content/abstract/23/4/899?etoc

  15. Cancer Research UK. Are there exercise guidelines for cancer patients? Accessed July 2004, http://www.cancerhelp.org.uk/help/default.asp?page=2639

  16. Carlson L, Angen M, Cullum J, Goodey E, Koopman J, Lamont L, MacRae J, Martin M et al (2004) High levels of untreated distress and fatigue in cancer patients. Br J Cancer 90:2297–2304

    Google Scholar 

  17. Courneya K (2003) Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 35:1846–1852

    PubMed  Google Scholar 

  18. Courneya K, Friedenreich C (1997) Relationship between exercise during treatment and current quality of life among survivors of breast cancer. J Psychosoc Oncol 15:35–57

    Google Scholar 

  19. Courneya K, Friedenreich C (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3:215–266

    CAS  PubMed  Google Scholar 

  20. Courneya K, Friedenreich C (1999) Physical exercise and quality of life following cancer diagnosis: a literature review. Annals Behav Med 21:171–179

    Google Scholar 

  21. Courneya K, Mackey J, Jones L (2000) Coping with cancer: can exercise help? Phys Sportsmed 28, online at http://www.physsportsmed.com/issues/2000/05_00/may00.htm

  22. Courneya K, Mackey J, McKenzie D (2002) Exercise for breast cancer survivors: research, evidence, and clinical guidelines. Phys Sportsmed 30:33–53

    Google Scholar 

  23. Courneya KS, Vallance JKH, McNeely ML, Karvinen KH, Peddle CJ, Mackey J (2004) Exercise issues in older cancer survivors. Crit Rev Oncol/Hematol 51:249–261

    Google Scholar 

  24. Curt G (2000) Cancer fatigue: diagnosis, treatment and economic impact. ONE 1:29–33

    Google Scholar 

  25. Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J (1997) Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood 90:3390–3394

    CAS  PubMed  Google Scholar 

  26. Drouin J, Pfalzer L (2001) Aerobic exercise guidelines for the person with cancer. Acute Care Perspec 10:18–24

    Google Scholar 

  27. Durak E, Lilly P (1998) The application of an exercise and wellness program for cancer patients: a preliminary outcomes report. J Strength Cond Res 12:3–6

    Google Scholar 

  28. Ebell M, Siwek J, Weiss B, Woolf S, Susman J, Ewigman B, Bowman M (2004) Strength of Recommendation Taxonomy (SORT): a patient-centred approach to grading evidence in the medical literature. J Fam Pract 53:111–120

    Google Scholar 

  29. Halverstadt A, Leonard A (2000) Essential exercises for breast cancer survivors. The Harvard Common Press, Boston

    Google Scholar 

  30. Hoffman M, Morrow G, Roscoe J, Hickok J, Mustian K, Wade J et al (2004) Cancer patients’ expectations of experiencing treatment-related side effects. Cancer 101:851–857

    Google Scholar 

  31. Holtzman J, Schmitz K, Babes G, Kane R, Duval S, Wilt T, MacDonald R, Rutks I (2004) Effectiveness of behavioral interventions to modify physical activity behaviors in general populations and cancer patients and survivors. Summary, Evidence Report/Technology Assessment No. 102. AQHR Publication No. 04-E027-1. Rockville, MD

  32. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun M (2003) Cancer statistics, 2003. Cancer J Clin 53:5–26

    PubMed  Google Scholar 

  33. Johnson J, Kelly A (1991) A multifaceted rehabilitation program for women with cancer. Oncol Nurs Forum 17:691–695

    Google Scholar 

  34. Kolden G, Strauman T, Ward A, Kuta J, Woods T, Schneider K et al (2002) A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psycho-oncol 11:447–456

    Google Scholar 

  35. Koopman C, Nouriani B, Erickson V, Anupindi R, Butler LD, Bachmann MH et al (2002) Sleep disturbances in women with metastatic breast cancer. Breast J 8:362–370

    Article  PubMed  Google Scholar 

  36. Lucia A, Earnest C, Perez M (2003) Cancer-related fatigue: can exercise physiology assist oncologists? Lancet Oncol 4:616–625

    Article  PubMed  Google Scholar 

  37. MacVicar M, Winningham M (1986) Promoting the functional capacity of cancer patients. Cancer Bull 38:235–239

    Google Scholar 

  38. MacVicar M, Winningham M, Nickel J (1989) Effects of aerobic interval training on cancer patients’ functional capacity. Nurs Res 38:348–351

    Google Scholar 

  39. Mazzeo R, Cavanagh P, Evans W, Fiatarone M, Hagberg J, McAuley E, Starzell J (1998) ACSM position stand: exercise and physical activity for older adults. Med Sci Sports Exerc 30:975–991

    PubMed  Google Scholar 

  40. Mock V (1996) The benefits of exercise in women with breast cancer. In: Dow K (ed) Contemporary issues in breast cancer. Jones and Bartlett Publishers, London

    Google Scholar 

  41. Mock V, Burke M, Sheehan P, Creaton E, Winningham M, McKenney-Tedder S, Schwager L, Liebman M (1994) A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum 21:899–907

    Google Scholar 

  42. Mock V, Dow K (1994) An exercise rehabilitation program for women in treatment for breast cancer. Oncol Nurs Forum 22:370

    Google Scholar 

  43. Mock V, Hassey Dow K, Meares C, Grimm P, Dienemann J, Haisfield-Wolfe M, Quitasol W et al (1997) Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 24:991–1000

    CAS  PubMed  Google Scholar 

  44. Mock V, Pickett M, Ropka M, Lin E, Stewart K, Rhodes V et al (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 9:119–127

    Article  CAS  PubMed  Google Scholar 

  45. Nebraska Medical Center. Physical exercise. Accessed July 2004, http://www.nebraskamed.com/cancer/physexrc.cfm

  46. North Eastern Health Board. Physical activity and cancer. Accessed July 2004. http://www.nehb.ie/nehb/services/healthpromotion/documents/physicalactivity7.pdf

  47. Oldervoll LM, Kaasa S, Hjermstad MJ, Lund JA, Loge JH (2004) Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients? Eur J Cancer 40:951–962

    Google Scholar 

  48. Passik S, Dugan W, McDonald M, Rosenfeld B, Theobald D, Edgerton S (1998) Oncologists recognition of depression in their patients with cancer. J Clin Oncol 16:1594–1600

    Google Scholar 

  49. Pinto B, Clark M, Maruyama N, Feder S (2003) Psychological and fitness changes associated with exercise participation among women with breast cancer. Psycho-oncol 12:118–126

    Google Scholar 

  50. Pinto B, Maruyama N (1999) Exercise in the rehabilitation of breast cancer survivors. Psycho-oncol 8:191–206

    Google Scholar 

  51. Pinto B, Trunzo J, Reiss P, Shui S (2002) Exercise participation after diagnosis of breast cancer: trends and effects on mood and quality of life. Psycho-oncol 11:389–400

    Google Scholar 

  52. Piper B (2003) Fatigue. In: Carrieri-Kohlman V, Lindsey A, West C (eds) Pathophysiological phenomena in nursing. SAUNDERS An imprint of Elsevier Science, USA, pp 209–234

    Google Scholar 

  53. Pollock M, Gaesser G, Butcher J, Despres J, Dishman RK, Franklin B, Garber C (1998) ACSM position stand: the recommended quality and quantity of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 30:975–991

    PubMed  Google Scholar 

  54. Raftopoulos H, O’Driscoll E (2003) Exercises for chemotherapy patients. Hatherleigh Press, New York

    Google Scholar 

  55. Savard J, Morin C (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19:895–908

    Google Scholar 

  56. Schneider C, Dennehy C, Carter S (2003) Exercise and cancer recovery. Human Kinetics, USA

    Google Scholar 

  57. Schwartz A (2003) Cancer. In: American College of Sports Medicine (ed) Exercise management for persons with chronic diseases and disabilities. Human Kinetics, USA

    Google Scholar 

  58. Schwartz A (2004) Physical activity after cancer diagnosis: psychosocial outcomes. Cancer Investig 22:82–92

    Google Scholar 

  59. Schwartz A, Mori M, Gao R, Nail L, King M (2001) Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med Sci Sports Exerc 33:718–723

    Google Scholar 

  60. SEER Cancer Statistics Cancer statistics review 1975–2001. National Cancer Institute, http://seer.cancer.gov/cgi-bin/csr/1975_2001/search.pl#results

  61. Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG et al (2003) Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 21:1653–1659

    Article  PubMed  Google Scholar 

  62. Segar M, Katch V, Roth R, Garcia A, Portner T, Glickman S, Haslanger S, Wilkins E (1998) The effect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors. Oncol Nurs Forum 25:107–113

    CAS  PubMed  Google Scholar 

  63. Selby G (1997) Cancer. In: ACSM (ed) Exercise management for persons with chronic diseases and disabilities. Human Kinetics, USA

    Google Scholar 

  64. Sellick S, Crooks D (1999) Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psycho-oncol 8:315–333

    Google Scholar 

  65. Skaer T, Robison L, Sclar D (2001) Diagnosis and treatment of depression in the cancer patient. Oncol Spectr 2:101–110

    Google Scholar 

  66. Smith S (1996) Physical exercise as an oncology nursing intervention to enhance quality of life. Oncol Nurs Forum 23:771–778

    Google Scholar 

  67. Tavio M, Milan I, Tirelli U (2002) Cancer-related fatigue (review). Int J Oncol 21:1093–1099

    Google Scholar 

  68. Winningham M (1983) Effects of a bicycle ergometry program on functional capacity and feelings of control in women with breast cancer. Dissertation, Ohio State University, Columbus

    Google Scholar 

  69. Winningham M (1991) Walking program for people with cancer. Cancer Nurs 14:270–276

    Google Scholar 

  70. Zabora J, Brintzenhofeszoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-oncol 10:19–28

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nancy Humpel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Humpel, N., Iverson, D.C. Review and critique of the quality of exercise recommendations for cancer patients and survivors. Support Care Cancer 13, 493–502 (2005). https://doi.org/10.1007/s00520-005-0811-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-005-0811-x

Keywords

Navigation