Exercise therapy is an effective adjunctive strategy that improves cardiorespiratory fitness (CRF) among patients with adult-onset cancer, according to a study published in the Journal of Clinical Oncology.1

CRF decline — a commonly observed adverse event (AE) with locoregional or systemic anticancer therapies and their secondary effects — has been associated with increased symptom burden and morbidity among this patient population. Exercise therapy is thought to improve peak oxygen consumption (VO2peak) — a measure of CRF — and improve clinical outcomes, but findings from previous studies have been inconclusive.

For this study, researchers performed a systematic search and identified 48 randomized clinical studies representing 3632 patients with cancer that assessed the effect of exercise therapy on non-exercise control groups. Patients received aerobic (endurance) therapy, resistance therapy, or a combination of both for at least 3 weeks. The mean standard deviation patient age was 55±7.5 years, and 68% of patients were women.

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Results showed that patients assigned to exercise therapy had significant increases in CRF with plus-2.80 mL O2×kg−1×min−1 compared with patients in the control group with plus-0.2 mL O2×kg−1×min−1 (weighted mean differences, +2.13 mL O2×kg−1×min−1; 95% CI, 1.58-2.67; I2, 20.6; P < .001). Subgroup analyses revealed that treatment effect modifiers, such as exercise modality, schedule, length, supervision, intervention timing, and site of primary cancer did not significantly affect outcomes.

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Of the 30 trials that monitored adverse events (AE), a total of 44 cases were reported. AEs were primarily non-serious, and included dizziness, chest pain, and muscle-related pain. Serious AEs included hip fractures and myocardial infarction.

The authors concluded that the “findings support the recommendation of exercise therapy to augment, mitigate decline, and/or recover impaired VO2peak in patients with cancer.”


  1. Scott JM, Zabor EC, Schwitzer E, et al. Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: a systematic review and meta-analysis [published online June 12, 2018]. J Clin Oncol. doi: 10.1200/JCO.2017.77.5809