Exercise programs for patients with cancer improve physical functioning and quality of life

The Summary of: Fong DYT, et al (2012) Physical activity for cancer survivors: meta-analysis of randomized controlled trials. BMJ 344:e70 doi: 10.1136/bmj.e70. [Prepared by Nicholas Taylor, CAP Co-ordinator.] Objective: To review the evidence about whether physical activity exercise programs improve health indicators in adult patients after they have completed their main treatment related to cancer. Data sources: PubMed, CINAHL and Google Scholar were searched up to September, 2011. This search was supplemented by searching the Cochrane Library for systematic reviews and examining the reference lists of all selected studies. Study selection: Randomised controlled trials involving adult patients who had completed their main treatment for cancer but who might still be receiving hormonal therapy. The effect of an exercise program was assessed on physical functions, physiological parameters, psychosocial outcomes, and quality of life compared with sedentary or no-exercise control groups. Data extraction: Two reviewers independently extracted data and discrepancies were resolved by consensus. Risk of bias in selected studies was assessed using a checklist developed by the Scottish Inter-Collegiate Guidelines Network. Data synthesis: Of 1505 studies initially identified by the search and 387 studies identified from additional sources, 34 studies were included for review and meta-analysis. Most studies focused on patients with breast cancer (65%) and investigated aerobic exercise programs (86%), while a smaller number investigated resistance training interventions (14%). The median duration of the exercise programs was 13 weeks. Based on quantitative pooling of available data there were statistically significant improvement in insulin-like growth factor-I, muscle strength, fatigue, depression, and quality of life in favour of exercise for patients with breast cancer. Based on quantitative pooling of data from studies of different types of cancer, there were improvements in favour of exercise in body mass index, body weight, peak oxygen consumption, distance walked in 6 minutes, handgrip strength and quality of life. For example, there was a weighted mean difference of 29 m (95% CI 4 to 55) for the 6 minute walk distance in favour of exercise. Significant differences were not found on the remaining outcomes, including lean mass and flexibility. Conclusion: Exercise programs for patients who have completed their treatment for cancer result in positive effects in a range of health indicators including physical functioning and quality of life.