What Are the Benefits of Exercise for Cancer Patients? | Blog

While most individuals, including cancer patients, understand that exercise is good for overall health, several recent studies have highlighted just how much of an impact physical activity can have on survival and quality of life for patients with cancer.  

Associations between exercise and benefits to cancer patients have long been studied. A recent publication found that more than 3,000 papers have examined such associations, with many indicating that exercise can help improve anxiety, depression, fatigue, and physical functioning, among other factors. Studies have also shown that physical activity can help lower the recurrence of cancers, improve overall quality of life, and even increase survival, as outlined in the AACR Cancer Progress Report 2024.

But how much exercise should cancer survivors be doing? How soon should they start exercising following their diagnosis? What types of exercise can lead to various improvements in their quality of life? Recently published studies have explored these questions and provided further evidence into the benefits of physical activity for cancer patients.    

When Should Cancer Patients Start Exercising? 

Researchers at the National Cancer Center of the Republic of Korea conducted a population-based retrospective study of the impact of physical activity immediately after cancer diagnosis. They evaluated sufficient physical activity, defined as vigorous physical activity (e.g., running, aerobics, climbing) for 75 to 150 minutes per week or light/moderate physical activity (e.g., walking, doubles tennis, bike riding) for 150 to 300 minutes per week.  

The data, published in the AACR journal Cancer Epidemiology, Biomarkers & Prevention, found that of the 215,191 participants, those who maintained sufficient physical activity following their diagnosis had a lower risk of death from any cause compared with those who remained inactive. For men, the risk of all-cause mortality dropped between 18% to 23% across all cancer stages, while for women, the risk dropped between 13% to 19% but only when they were diagnosed at an early stage. The reduction in risk varied based on the cancer type, cancer stage, and level of physical activity. In terms of death specifically from cancer, the risk significantly reduced for men with gastric, colorectal, liver, and lung cancers, and for women with colorectal cancer.       

In another study, also published in Cancer Epidemiology, Biomarkers & Prevention, researchers from the National Institutes of Health and other institutions specifically looked at the benefit of post-diagnosis physical activity for patients with breast cancer. They wanted to understand the impact on those who meet the standard recommended guidelines of at least 150 minutes per week of aerobic exercise and at least two days per week of muscle-strengthening exercise.  

Based on data from 50,689 female breast cancer patients that they collected from 20 previously conducted studies, they found that compared with those who did no or minimal exercise, the unadjusted all-cause mortality dropped by 8% in those who followed the recommended guidelines. 

Can Exercise Reduce the Risk of Cancer Recurrence? 

Previous observational studies have found that exercise could help lower the risk of recurrence for patients with colorectal cancer, but researchers with the Canadian Cancer Trials Group tested this in a phase III clinical trial. From 2009 through 2024, the CO.21 Colon Health and Lifelong Exercise Change (CHALLENGE) trial enrolled 889 patients who had complete resection of stage 3 or high-risk stage 2 adenocarcinoma of the colon and completed adjuvant chemotherapy. Patients were randomly assigned to either receive education about the benefits of diet and exercise (444) or to receive that information while also participating in a supervised three-year exercise program (445).  

As part of the exercise program, patients attended mandatory, behavioral-support sessions designed to help each individual overcome any barriers that may prevent them from exercising, such as long-term side effects from treatment or finding a place and time to exercise.  

The goal was to help participants increase their recreational aerobic exercise from their own individual baselines by at least 10 metabolic equivalent task (MET)-hours per week in the first 12 weeks and then maintain that level or continue to increase it over the course of the rest of the program. Each participant could select the type of exercise they were most comfortable with. For example, brisk walking for an hour is equal to about 4 MET-hours while an hour of jogging is about 10 MET-hours.  

At a median follow-up of 7.9 years, exercise was found to reduce risk of recurrence, a new primary cancer developing, or death by 28%. Additionally, disease-free survival was significantly longer in the exercise group compared with the health-education group after both five years (80.3% vs. 73.9%) and eight years (90.3% vs. 83.2%), according to the results published in the New England Journal of Medicine.  

Can Exercise Help Improve Sexual Functioning for Cancer Survivors? 

Male prostate cancer survivors may experience side effects impacting their sexual function that may last for up to 15 years following treatment. In a study published in JAMA Network Open, researchers at Peter MacCallum Cancer Centre and other Australian institutions conducted a three-arm clinical trial to see if exercise and psychosexual education could improve erectile function. Participants were randomly assigned either to a six-month supervised resistance and aerobic exercise program, the same program plus psychosexual education and self-management intervention, or standard medical care.  

The exercise program included 20 to 30 minutes of cardiovascular exercises on a treadmill, cycling or rowing ergometer, or elliptical or cross trainer, three days per week. Participants were also asked to exercise on their own so they could reach 150 minutes of moderate-intensity aerobic exercise per week. The resistance training included six to eight exercises targeting both upper and lower body muscle groups with repetitions ranging from six to 12 and sets from one to four per exercise.  

Sexual function was assessed using the International Index of Erectile Function (IIEF), and after six months, the adjusted mean difference in IIEF scores increased by 5.1 points in the exercise group compared with 1 point in the standard-of-care group. The effects of exercise on sexual function were greater for those who had received radiotherapy (4.2-point increase) or androgen deprivation therapy (4.4-point increase) compared with prostatectomy (1.6-point increase). The addition of psychosexual education and self-management intervention did not show a significant benefit. 

In another study, exercise was also found to improve sexual functioning for women with metastatic breast cancer who experience symptoms following treatment that impact sex. Results of the PREFERABLE-EFFECT study, published in the International Journal of Cancer, revealed that compared with those who received usual care, patients who participated in an exercise program for six months reported an average 5.6-point increase on a questionnaire evaluating their sexual functioning. 

The exercise program included supervised one-hour exercise sessions twice a week that involved resistance, aerobics, and balance training. Women in the exercise arm also reported an average 7.1-point decrease in vaginal symptoms associated with their cancer or treatment compared with the standard-of-care arm. 

What Are the Quality of Life Benefits From Exercise? 

Researchers at Shengjing Hospital and other institutions in China recognized that studies about exercise in relation to cancer have found contradictory results. So, they performed an umbrella review, published in the British Journal of Sports Medicine, which ultimately examined 80 randomized controlled trials to evaluate the reliability of the associations found between some form of exercise and a resulting benefit for cancer patients. Out of 485 associations mentioned, they determined that 260 were statistically significant with moderate-level evidence and 81 were supported by high-certainty evidence.      

For example, yoga was among the exercises that had at least moderate-level evidence in helping women with breast cancer alleviate gastrointestinal symptoms caused by their treatment, reduce short-term sleep disturbances, improve short-term quality of life, enhance social well-being, and decrease depression when combined with exercise. The study also found that evidence supported qigong and tai chi in relieving anxiety in patients with various cancer types, high-intensity interval training in reducing cancer-related pain, and mind-body exercise in improving cognitive function in lung cancer patients. 

Looking at exercise in general, the study found physical activity helped to alleviate the symptoms of chemotherapy-induced peripheral neuropathy, improve dyspnea in people with advanced-stage cancer, reduce the risk of pulmonary complications following surgery in patients with non-small cell lung cancer, as well as boost the psychological well-being and overall quality of life of older patients with colorectal cancer. But those were just some of the many benefits found that should have cancer patients considering ways they can stay physically active.