Physical Activity Levels in People with Cancer Undergoing Chemotherapy: A Systematic Review

Rebecca Cesnik; Kellie Toohey; Nicole Freene; Brea Kunstler; Stuart Semple

doi:10.1016/j.soncn.2023.151435

Physical Activity Levels in People with Cancer Undergoing Chemotherapy: A Systematic Review

Semin Oncol Nurs. 2023 Aug;39(4):151435. doi: 10.1016/j.soncn.2023.151435. Epub 2023 Apr 30.

Authors

Rebecca Cesnik¹, Kellie Toohey², Nicole Freene³, Brea Kunstler⁴, Stuart Semple⁵

Affiliations

¹ PhD Candidate, ACT Health, ACT, Australia; Professor, Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Assistant Professor, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia.
² Professor, Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Assistant Professor, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia. Electronic address: kellie.toohey@canberra.edu.au.
³ Associate Professor, Physiotherapy, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Associate Professor, Health Research Institute, University of Canberra, Bruce, ACT, Australia.
⁴ Research Fellow, BehaviourWorks, Monash University, Victoria, Australia.
⁵ Professor, Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Associate Professor, Health Research Institute, University of Canberra, Bruce, ACT, Australia; Professor, Research Institute of Sport and Exercise, University of Canberra, Bruce, ACT, Australia.

PMID: 37127520
DOI: 10.1016/j.soncn.2023.151435

Abstract

Objectives: Physical activity (PA) has been shown to improve chemotherapy side effects, survival rates and treatment adherence in people with cancer. This review aimed to identify whether people undergoing chemotherapy in different exercise interventions meet PA guidelines during chemotherapy.

Data sources: Databases searched were CINAHL complete, PubMed, Cochrane Library, EMBASE, AMED, Joanna Briggs Institute, OVID MEDLINE, and Google Scholar. Eligibility and risk-of-bias were reviewed by two authors. PROSPERO registration: CRD42018093839.

Conclusion: Thirty-three studies were eligible (14 randomized controlled trials, six pre-post, and 13 cross-sectional studies), which included 2,722 people with cancer undergoing chemotherapy. Studies (n = 11/13) found PA interventions successfully increased or maintained PA participation levels, whereas PA declined without intervention. This review has identified that due to limited evidence it is not possible to determine the most appropriate intervention to improve PA for people undergoing chemotherapy. Despite the well-documented benefits of PA, most people undergoing chemotherapy do not achieve the PA guidelines. Clinicians should be aware that during treatment, participants may not meet PA guidelines even if they participate in an intervention. However, interventions may prevent PA levels from declining. Further research is required to determine the most effective approaches to increase PA levels while undergoing chemotherapy.

Implications for nursing practice: Nurses are well placed to have conversations with patients undergoing chemotherapy regarding PA levels. PA should be considered as part of a treatment regimen. Tailored advice must be provided aiming to improve health outcomes. Referral to an exercise professional is best practice to improve the uptake of PA.

Keywords: Behavior change; Cancer; Chemotherapy; Exercise; Physical activity.

Publication types

Systematic Review
Review

MeSH terms

Cross-Sectional Studies
Exercise
Humans
Neoplasms* / drug therapy