Physical activity for cancer survivors: meta-analysis of randomised controlled trials

Daniel Y T Fong, Judy W C Ho, Bryant P H Hui, Antoinette M Lee, Duncan J Macfarlane, Sharron S K Leung, Ester Cerin, Wynnie Y Y Chan, Ivy P F Leung, Sharon H S Lam, Aliki J Taylor, Kar-keung Cheng, Daniel Y T Fong, Judy W C Ho, Bryant P H Hui, Antoinette M Lee, Duncan J Macfarlane, Sharron S K Leung, Ester Cerin, Wynnie Y Y Chan, Ivy P F Leung, Sharon H S Lam, Aliki J Taylor, Kar-keung Cheng

Abstract

Objective: To systematically evaluate the effects of physical activity in adult patients after completion of main treatment related to cancer.

Design: Meta-analysis of randomised controlled trials with data extraction and quality assessment performed independently by two researchers.

Data sources: Pubmed, CINAHL, and Google Scholar from the earliest possible year to September 2011. References from meta-analyses and reviews.

Study selection: Randomised controlled trials that assessed the effects of physical activity in adults who had completed their main cancer treatment, except hormonal treatment.

Results: There were 34 randomised controlled trials, of which 22 (65%) focused on patients with breast cancer, and 48 outcomes in our meta-analysis. Twenty two studies assessed aerobic exercise, and four also included resistance or strength training. The median duration of physical activity was 13 weeks (range 3-60 weeks). Most control groups were considered sedentary or were assigned no exercise. Based on studies on patients with breast cancer, physical activity was associated with improvements in insulin-like growth factor-I, bench press, leg press, fatigue, depression, and quality of life. When we combined studies on different types of cancer, we found significant improvements in body mass index (BMI), body weight, peak oxygen consumption, peak power output, distance walked in six minutes, right handgrip strength, and quality of life. Sources of study heterogeneity included age, study quality, study size, and type and duration of physical activity. Publication bias did not alter our conclusions.

Conclusions: Physical activity has positive effects on physiology, body composition, physical functions, psychological outcomes, and quality of life in patients after treatment for breast cancer. When patients with cancer other than breast cancer were also included, physical activity was associated with reduced BMI and body weight, increased peak oxygen consumption and peak power output, and improved quality of life.

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4790041/bin/fond892448.f1_default.jpg
Fig 1 Selection process of eligible randomised controlled studies
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4790041/bin/fond892448.f2_default.jpg
Fig 2 Association between physical activity and insulin-like growth factor-I (ng/mL) in patients with breast cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4790041/bin/fond892448.f3_default.jpg
Fig 3 Association between physical activity and BMI, body weight, and waist:hip ratio in patients with cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4790041/bin/fond892448.f4_default.jpg
Fig 4 Association between physical activity and distance (m) walked in six minutes in patients with cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4790041/bin/fond892448.f5_default.jpg
Fig 5 Association between physical activity and fatigue and depression in patients with cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4790041/bin/fond892448.f6_default.jpg
Fig 6 Association between physical activity and markers of quality of life (measured by SF-36) in patients with cancer

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