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Exercise Recommendations for Cancer-Related Fatigue, Cognitive Impairment, Sleep Problems, Depression, Pain, Anxiety, and Physical Dysfunction—A Review

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Published Online: Jun 25th 2012 Oncology & Hematology Review (US), 2012;8(2):81-8 DOI:
Authors: Karen M Mustian, Lisa K Sprod, Michelle Janelsins, Luke J Peppone, Supriya G Mohile
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Cancer and its treatments produce a myriad of burdensome side effects and significantly impair quality of life (QoL). Exercise reduces side effects and improves QoL for cancer patients during treatment and recovery. Exercise prior to, during, and after completion of cancer treatments provides numerous beneficial outcomes. It represents an effective therapeutic intervention for preparing patients to successfully complete treatments, for reducing acute, chronic, and late side effects, and for improving QoL during and after treatments. This overview of exercise oncology and side effect management summarizes existing evidence-based exercise guidelines for cancer patients and survivors.


Exercise, physical activity, cancer, side effects, quality of life, yoga, tai chi, aerobic exercise, resistance exercise, cancer-related fatigue, bone loss, muscle loss, mental health, cardiotoxicity


Over 1.6 million Americans will be diagnosed with cancer in 2012, adding to the approximately 12 million Americans already living with a diagnosis of cancer.1 The vast majority of these cancer patients are receiving or have completed treatment for their disease. The overall survival rate for all types of cancer has increased from less than 50 % in 1975 to over 68 % in 2012.1 Therefore, many Americans with a wide variety of cancers are living beyond the historical 5-year survival marker. The number of cancer survivors will continue to increase with continued improvements in screening and treatment. Despite these improvements, however, many cancer survivors suffer from the acute, chronic, and late side effects of treatment. Acute side effects are thosewhich develop during treatment and last a short time (days, weeks, or months); chronic side effects develop during treatment and persist for months to years, and late side effects arise months or even years after treatments are complete. All of these side effects negatively impact cancer patients and survivors during, immediately following, and long after treatments. Exercise is an effective therapeutic intervention for preparing patients to successfully complete treatments, managing acute, chronic, and late side effects and improving quality of life (QOL).

Side Effects Of Cancer Treatment
Treatments for cancer often include surgery, chemotherapy, radiation therapy, hormone therapy and/or a combination of these modalities. These treatments lead to a myriad of physical and psychological side effects which subsequently interfere with a cancer patient’s ability to complete treatments as prescribed, function independently, perform activities of daily living, and live with a high QOL. Side effects are especially burdensome in older adults who are at greatest risk for functional impairment after cancer treatment. Among the most onerous side effects stemming from cancer and its treatments are cancer-related fatigue (CRF), cognitive impairment, sleep problems, depression, pain, anxiety, and physical dysfunction including impaired muscular function, reduced cardiopulmonary function, and decreased bone mineral density.

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The authors have no conflicts of interest to declare.


Karen M Mustian, PhD, MPH, ACSM, FSBM, University of Rochester School of Medicine, James P Wilmot Cancer Center, Department of Radiation Oncology, PEAK Lab, 265 Crittenden Boulevard, Rochester, NY 14642, US. E:




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