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Cited by 2,988Cancer survivorship and careChildhood Cancer Survivors' Quality of LifePhysical Activity and Health

Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable

Open access
CAMPBELL, KRISTIN L., WINTERS-STONE, KERRI M., WISKEMANN, JOACHIM, MAY, ANNE M., SCHWARTZ, ANNA L., COURNEYA, KERRY S., ZUCKER, DAVID S., MATTHEWS, CHARLES E. +7 more·2019·Medicine & Science in Sports & Exercise
DOI 10.1249/mss.0000000000002116PMC PMC8576825
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Abstract

Purpose: The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone—a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue. Methods: A second Roundtable was convened in 2018 to advance exercise recommendations beyond public health guidelines and toward prescriptive programs specific to cancer type, treatments, and/or outcomes. Results: Overall findings retained the conclusions that exercise training and testing were generally safe for cancer survivors and that every survivor should “avoid inactivity.” Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. Implications for other outcomes, such as peripheral neuropathy and cognitive functioning, remain uncertain. Conclusions: The proposed recommendations should serve as a guide for the fitness and health care professional working with cancer survivors. More research is needed to fill remaining gaps in knowledge to better serve cancer survivors, as well as fitness and health care professionals, to improve clinical practice.

Integrity signals

Registry

Crossref · 10.1249/mss.0000000000002116

Cites

122 of 122 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 110 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    There may be a dose-response effect for depressive symptoms where higher volumes of aerobic exercise (90 min vs. up to 180 min/week) lead to better symptom reduction.

    “Based on results from high quality trials of aerobic training, there may be a dose-response effect where higher volumes of aerobic exercise (90 min vs. up to 180 min/week) leads to better symptom reduction.”
    Quote in the paperSubstantial claim
  • Findingnone given

    Resistance training alone does not seem effective for depressive symptoms in cancer survivors.

    “Based on sufficient evidence, resistance training alone does not seem to be effective for this outcome.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Moderate intensity combined aerobic plus resistance training 2-3 times per week may reduce cancer-related fatigue.

    “Moderate intensity combined aerobic plus resistance training sessions performed 2–3 times per week or twice weekly moderate intensity resistance training may also be effective(21, 24–26), and the latter particularly in prostate cancer(27).”
    Quote in the paperSubstantial claim0 of 4 sources checked
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  • Findingcitation

    Resistance training alone does not reduce anxiety in cancer survivors.

    “Based on sufficient evidence, it does not appear that resistance training alone reduces anxiety.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Twice weekly moderate intensity resistance training may reduce cancer-related fatigue, particularly in prostate cancer.

    “Moderate intensity combined aerobic plus resistance training sessions performed 2–3 times per week or twice weekly moderate intensity resistance training may also be effective(21, 24–26), and the latter particularly in prostate cancer(27).”
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  • May combine two claims. 36
  • Classified as probably not a substantial claim. 5
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingnone given

    Exercise training and testing is generally safe for cancer survivors.

    “Overall findings retained the conclusions that exercise training and testing was generally safe for cancer survivors and that every survivor should “avoid inactivity”.”
    • Also stated in: § INTRODUCTION · plain
      “exercise training was generally safe and well tolerated during and after cancer treatment and could elicit improvements in some health outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Moderate intensity aerobic training three times per week for at least 12 weeks or twice weekly combined aerobic plus resistance training for 6-12 weeks significantly reduces depressive symptoms in cancer survivors during and after treatment.

    “Moderate intensity aerobic training performed three times per week and for at least 12 weeks or twice weekly combined aerobic plus resistance training lasting 6–12 weeks can significantly reduce depressive symptoms in cancer survivors during and after treatment(18, 19).”
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  • May combine two claims.

    Findingreasoning

    There is insufficient evidence for a linear dose-response for cancer-related fatigue because going beyond 150 minutes per week of aerobic exercise does not appear to result in the greatest reductions in fatigue.

    “There is insufficient evidence for a linear dose response since going beyond 150 minutes per week of aerobic exercise does not appear to result in the greatest reductions in fatigue.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    In unsupervised interventions, physical function may improve with higher weekly energy expenditure (MET-hr/week) but not with weekly exercise duration (min/week).

    “Further, there is some evidence to suggest that if the intervention is unsupervised, physical function could improve with higher weekly energy expenditure (MET-hr/week) but not weekly exercise duration (min/week)(32).”
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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Improvements in HRQoL are more robust when the physical functioning domain is the primary outcome.

    “For example, improvements seems to be more robust if the physical functioning domain of HRQoL is the primary outcome and this will be covered separately.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In the few published studies, exercise appeared safe for chemotherapy-induced peripheral neuropathy, but the degree of improvement varied for this outcome and related outcomes such as mobility and balance.

    “In general, exercise appeared safe in the few published studies, however, the degree of improvement varied for this outcome, and other related outcomes, such as mobility and balance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Promising results for a protective effect of exercise on cardiotoxicity exist in animal models, and there is some novel evidence in humans for cardiac function, including left ventricular function and vascular endothelial function.

    “The effect of exercise to prevent or ameliorate cardiotoxicity is an emerging field of research and promising results for a protective effect of exercise in animal models and some novel evidence in humans for cardiac function(55), including measures of left ventricular function(55), and vascular endothelial function, measured as flow-mediated dilation(56).”
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    Findingown data

    The number of randomized controlled exercise trials in cancer survivors has increased by 281% since the 2010 publication, to over 2500 published RCTs.

    “since that landmark publication the number of randomized controlled exercise trials in cancer survivors has increased by 281% (PubMed Search completed March 2018) to over 2500 published randomized controlled trials.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    The majority of human studies on exercise and cognitive function in cancer have been conducted in breast cancer survivors, using self-reported measures, and report inconsistent results.

    “The majority of human studies, so far, have been conducted in breast cancer survivors, using self-reported measures of cognitive function, and report inconsistent results.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Two recent systematic reviews provided mixed evidence for overall sleep quality in cancer survivors, indicating either a positive effect of walking or no effect of exercise.

    “Two recent systematic reviews in cancer survivors(49, 50) provided mixed evidence for overall sleep quality, indicating either a positive effect of walking(49), or no effect of exercise(50).”
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    Findingreasoning

    Understanding the specific efficacy of exercise for a particular outcome is hampered because most research does not consider initial values, rarely examines moderators, and often draws conclusions from secondary outcomes.

    “understanding the specific efficacy of exercise for a particular outcome is hampered by the fact that the majority of research to date does not consider the training principle of initial values by limiting enrollment to individuals experiencing the specific outcome of interest (i.e., those with sleep issues or high level of fatigue), rarely examines potential moderators of the exercise response (i”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Promising results from animal studies are emerging for a protective effect of aerobic training on cancer treatment-related changes in cognitive function, but evidence in humans is limited.

    “While promising results from animal studies are emerging for a protective effect of aerobic training on cancer treatment related changes in cognitive function, to date, the evidence in humans is limited(58).”
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    Findingnone given

    The majority of available literature is in early stage breast and prostate cancers, limiting extrapolation to other cancer types or advanced cancers.

    “The majority of available literature is still in the most common cancers, namely early stage breast cancer and prostate cancers, which limits the ability to extrapolate to other cancer types or advanced cancers.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Randomized trials of aerobic exercise during adjuvant chemotherapy show preservation or improvement in cardiorespiratory fitness, especially in those with low initial values, while others report better improvement in those with higher initial values.

    “Randomized trials of aerobic exercise during adjuvant chemotherapy demonstrate a preservation of, or an improvement in, cardiorespiratory fitness, especially in those with low initial values(86), while others report better improvement in those with higher initial values(91).”
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  • May combine two claims.

    Findingcitation

    Research supports that cancer survivors can respond positively to exercise training by improving cardiorespiratory fitness, muscular strength and endurance, and body composition.

    “Research to date supports the potential of cancer survivors to respond positively to an exercise training stimulus by improving individual components of physical fitness, including cardiorespiratory fitness (i.e., VO2peak)(86), muscular strength and endurance(87, 88), body composition(89).”
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  • May combine two claims.

    Findingreasoning

    Literature on yoga is heterogeneous in type and prescription, making a definitive prescription difficult.

    “the literature is reflective of practices for many different types of yoga, including those that incorporate non-exercise features such as breathing or meditation and which use a wide variety of prescriptions (e.g., frequency, duration, with/without home practice), making it difficult to generate a definitive prescription.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The majority of available evidence on safety and efficacy of exercise during and following cancer treatment is from RCTs of supervised and/or home-based prescribed exercise, and trials in breast cancer survivors.

    “the majority of available evidence on the safety and efficacy of exercise during and following cancer treatment is derived from RCTs of supervised and/or home-based prescribed exercise, and trials in breast cancer survivors(17, 31, 32).”
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  • May combine two claims.

    Findingcitation

    A recent systematic review reported that yoga during and after cancer treatment improves quality of life and fatigue, with potential to improve sleep, depressive symptoms, anxiety/distress, and cognitive change needing confirmation.

    “In a recent systematic review of the role of yoga in symptoms management for cancer survivors, yoga both during and after cancer treatment was reported to improve quality of life and fatigue, while further research is needed to confirm the observed potential to improve sleep, depressive symptoms, anxiety/distress, and cancer-related cognitive change(78).”
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    Findingreasoning

    Individuals enrolled in studies commonly meet pre-specified eligibility criteria, are from academic or medical centers, and were willing to participate in research.

    “the individuals enrolled in studies commonly meet pre-specified eligibility criteria for age, comorbidities, physical ability, largely based out of academic and/or medical centers, and were willing to participate in research.”
    Quote in the paperSubstantial claim

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    Findingnone given

    The literature remains insufficient for detailing prescriptions by cancer type, timing, or treatment type, and prescriptions were rarely based on head-to-head comparisons of FITT components.

    “the literature remains insufficient for further detailing prescriptions according to cancer type, timing of treatment, and/or types of treatment, while exercise prescriptions were rarely based on studies that directly compared varying FITT components, such as a head-to-head trial of low versus high intensity training.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Men on ADT may not build lean mass in response to resistance training, but several trials report small statistically significant improvements in lean body mass after 12-36 weeks.

    “men on ADT may not be able to build lean mass in response to resistance training; however, several trials that have employed resistance training, or combined with aerobic training, have reported small, but statistically significant improvements in lean body mass after 12–36 weeks of training(96)”
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    Findingcitation

    Exercise is generally safe for cancer survivors, based on the 2010 Roundtable and the majority of studies since.

    “The overall conclusion from the 2010 Roundtable was that exercise is generally safe for cancer survivors(6) and this has not changed based on the majority of studies conducted since that time.”
    Quote in the paperSubstantial claim0 of 1 sources checked
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  • May combine two claims.

    Interpretationreasoning

    Specific doses of aerobic, combined aerobic plus resistance, and/or resistance training improve anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life in cancer survivors.

    “Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: The exercise prescriptions are assumed to generalize across cancer types unless otherwise specified.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Resistance plus impact training may not be appropriate for individuals with joint/orthopedic issues and/or stability problems, who may be better served by an exercise program aimed at reducing fall risk.

    “Furthermore, it may not be appropriate for individuals with joint/orthopedic issues and/or stability problems who may be better served by an exercise program aimed at reducing fall risk.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The 2010 ACSM Roundtable concluded that exercise training was generally safe and well tolerated during and after cancer treatment and could improve some health outcomes.

    “Drawing on studies mainly in breast and prostate cancer survivors, the key findings from this review were that exercise training was generally safe and well tolerated during and after cancer treatment and could elicit improvements in some health outcomes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] source

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  • May combine two claims.

    Premisecitation

    In 2010, there was sufficient evidence to conclude that exercise could improve physical fitness, physical functioning, quality of life, and cancer-related fatigue.

    “There was sufficient evidence to conclude that exercise could improve physical fitness, physical functioning, quality of life, and cancer-related fatigue.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] source

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  • May combine two claims.

    Interpretationreasoning

    Causes of cancer-treatment-associated falls are not fully characterized and may involve treatment toxicities beyond age-related risks.

    “Similarly, the causes of falls associated with cancer treatment have not been fully characterized and may be due to more than an acceleration of the risks associated with age-related falls (i.e., muscle weakness and poor balance), but may also be due to treatment-related toxicities such as hearing loss, ataxia, peripheral neuropathies and fatigue, creating a challenge to develop new exercise-based”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Determining the effects of exercise on treatment tolerance is challenging and may limit generalizability.

    “Consequently, determining the effects of exercise on “treatment tolerance” is a challenging goal and may make it difficult to achieve a high degree of generalizability.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Falls research in cancer survivors faces challenges including low incidence and the need for large samples and long follow-up.

    “There are several challenges to this type of research, including the relatively rare occurrence of falls and the large sample and time needed to observe a change in falls from an intervention.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Neuromuscular contributions explain up to 50% of variation in muscle strength in older adults, so resistance training in ADT or deconditioning may still improve muscle strength without muscle mass gains.

    “neuromuscular contributions explain up to 50% of variation in muscle strength in older adults, thus resistance training in the setting of ADT or deconditioning may still effectively improve muscle strength in the absence of gains in muscle mass(97).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [97] source

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  • May combine two claims.

    Interpretationnone given

    Supervised exercise programs appear more effective than strictly unsupervised or home-based programs, though the reason is unclear.

    “Exercise programs that were supervised appear to be more effective than strictly unsupervised or home-based programs, though it is unclear whether or not this is because a higher dose of exercise may be better achieved with supervised training or from other attributes of this setting (i.e., more attention, motivation, reinforcement, selection bias).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Surgery can result in temporary or more permanent reductions in joint range of motion and extensibility of muscle, tendon, fascia, and skin.

    “surgery can result in temporary or more permanent reductions in joint range of motion, and extensibility of muscle, tendon, fascia and skin.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Requiring a comprehensive physical fitness assessment before starting exercise may create an unnecessary barrier to starting activity.

    “requiring a comprehensive physical fitness assessment prior to starting exercise may create an unnecessary barrier to starting activity.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Interpretationnone given

    Based on current literature, an effective exercise prescription for health-related outcomes includes moderate intensity aerobic training at least 3 times per week, for at least 30 minutes, for at least 8-12 weeks.

    “Based on the current literature, an effective exercise prescription that most consistently addresses health-related outcomes experienced due to a cancer diagnosis and cancer treatment includes moderate intensity aerobic training at least 3 times per week, for at least 30 minutes, for at least 8–12 weeks.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Androgen deprivation therapy for prostate cancer results in an abrupt loss of lean body mass and a reduction in muscle strength and endurance.

    “androgen deprivation therapy (ADT), which is commonly used as treatment for prostate cancer, results in an abrupt loss of lean body mass accompanied by a reduction in muscle strength and endurance(94, 95).”
    Quote in the paperSubstantial claim0 of 2 sources checked
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  • May combine two claims.

    Premisecitation

    Obesity is a risk factor for multiple cancers including postmenopausal breast, renal cell, and endometrial cancer, so these survivors are more likely to be overweight or obese at diagnosis.

    “obesity is a risk factor for multiple cancers, including postmenopausal breast, renal cell and endometrial cancer, thus these survivors are more likely to be overweight or obese at the time of diagnosis(100).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • May combine two claims.

    Interpretationreasoning

    Exercise programs that only prescribe resistance training are efficacious for most health-related outcomes, though for some outcomes evidence is insufficient or suggests resistance training alone may not be enough (e.g., depressive symptoms).

    “Exercise programs that only prescribe resistance training are also efficacious at improving most health-related outcomes, though for some specific outcomes the evidence is either insufficient or suggestive that resistance training alone may not be enough (e.g., depressive symptoms).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    This often results in a sample that is healthier or has higher physical function and exercise motivation, which may not fully generalize to the broader cancer survivor population.

    “This often results in a sample that is healthier or with higher physical function and exercise motivation that may not fully generalize to the broader population of cancer survivors.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The impact of cancer treatment on exercise tolerance may depend on the pre-diagnosis health and functional capacity of the individual.

    “The impact of cancer treatment on exercise tolerance may further depend upon the pre-diagnosis health and functional capacity of the individual.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Aerobic exercise during adjuvant chemotherapy does not appear to stimulate greater red blood cell production, so improvements in cardiorespiratory fitness depend on other central and peripheral adaptations.

    “Aerobic exercise during adjuvant chemotherapy does not appear to stimulate greater production of red blood cells(92), so improvements in cardiorespiratory fitness are contingent on other central (i.e., cardiac function, plasma volume) and peripheral adaptations (i.e., improved vascularization and mitochondrial enzyme function)(93).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [92] source

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  • May combine two claims.

    Premisecitation

    Maintenance of body weight can be difficult during treatment for some cancers (advanced colon, lung, pancreatic) where weight and lean mass loss is common; weight gain is a common side effect of chemotherapy and anti-estrogen therapy for breast cancer or anti-androgen therapy for prostate cancer.

    “maintenance of body weight can be difficult during treatment for some cancers, where loss of weight and lean body mass is a common concern, such as advanced colon, lung cancer and pancreatic cancer(98); whereas weight gain can be a common side effect of chemotherapy and anti-estrogen therapy for breast cancer or anti-androgen therapy for prostate cancer(99).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [98] source

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    • cites [99] source

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41 of 41

  • The paper relies on this without support.

    The 2010 general exercise recommendations may be unachievable for cancer survivors with physical limitations, and benefits may come from less exercise.

    “As it was acknowledged that the general exercise recommendations put forward in 2010 may be unachievable for cancer survivors with physical limitations and that benefits may come from less exercise, a particular goal of the 2018 Roundtable was to develop more granular exercise prescriptions for distinct cancer-related health outcomes to better guide fitness and other healthcare professionals who”

  • The authors state this as an assumption.

    The exercise prescriptions are assumed to generalize across cancer types unless otherwise specified.

    “When interpreting and applying a prescription, the exercise professional should be mindful that the evidence is often disproportionately from trials in a single cancer type (i.e., breast), but the prescription is assumed to generalize across cancer types unless otherwise specified.”

  • The paper relies on this without support.

    Differences among cancer survivors by cancer type exist.

    “differences among cancer survivors by cancer type are known to exist (i.e., demographics, prognosis, treatments received and associated side effects)”

  • The paper relies on this without support.

    The treatment approach used varies by cancer type, stage, subtype, patient health, and other considerations.

    “The treatment approach used will differ by type of cancer, stage of disease, cancer subtype, patient health and many other considerations.”

  • The paper relies on this without support.

    Individuals diagnosed with cancer commonly have concerns that may limit prioritization of exercise in their lives.

    “individuals diagnosed with cancer commonly have many concerns, such as life expectancy, employment issues, and family matters, that may limit prioritization of exercise in their lives.”

  • The paper relies on this without support.

    Both cancer diagnosis and curative cancer treatments may affect the underlying safety of exercise training.

    “Both the diagnosis of cancer and curative cancer treatments may affect the underlying safety of exercise training.”

  • The authors state this as an assumption.

    In the absence of unique safety concerns, the efficacy of exercise on various outcomes would be similar for survivors with early stage cancers other than breast and prostate cancer.

    “it could be reasonably assumed that in the absence of any unique safety concerns for survivors of other types of cancer that the efficacy of exercise on various outcomes would be similar for survivors with early stage cancers other than breast and prostate cancer.”
7 of 7

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The basis for screening and intervention is the National Comprehensive Cancer Network guideline on fatigue.

    “The basis for screening and intervention is the National Comprehensive Cancer Network guideline on fatigue [38–42].”

    From The BrEasT cancer afTER-CARE (BETTER-CARE) programme to improve breast cancer follow-up: design and feasibility study results of a cluster-randomised complex intervention trial (2024) · cites this paper as [40]

    In “Implementing FITT Prescriptions in Practice” (page unavailable), the paper says that special considerations and modifications to exercise programs were adapted from NCCN guidelines. Its “Fatigue” section discusses exercise interventions, but our copy does not say that the NCCN fatigue guideline is the basis for both screening and intervention. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Scientific evidence supports the safety and effectiveness of physical activity for people with cancer, indicating health benefits such as reduced anxiety, reduced depressive symptoms, reduced fatigue, improved quality of life, and improved physical function.

    “Scientific evidence supports the safety and effectiveness of physical activity, indicating—for people with cancer experience—health benefits such as reduced anxiety, reduced depressive symptoms, reduced fatigue, improved quality of life, and improved physical function [40,41,42,43].”

    From The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic (2023) · cites this paper as [40]

  • The American College of Sports Medicine recently updated its exercise guidance for cancer prevention and for prevention and treatment of various cancer health-related outcomes such as fatigue, anxiety, depression, function, and quality of life.

    “Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health-related outcomes (eg, fatigue, anxiety, depression, function, and quality of life).”

    From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [10]

  • There is sufficient evidence to confirm the safety of resistance exercise training among patients with and at risk for breast cancer-related lymphedema.

    “There is also sufficient evidence to confirm the safety of resistance exercise training among patients with and at risk for breast cancer– related lymphedema.10”

    From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [10]

  • There is consistent evidence that supervised exercise is more effective but that there is still benefit to home-based exercise.

    “There is consistent evidence that supervised exercise is more effective but that there is still benefit to home-based exercise.10”

    From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [10]

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Authors
CAMPBELL, K. L., WINTERS-STONE, K. M., WISKEMANN, J., MAY, A. M., SCHWARTZ, A. L., COURNEYA, K. S., ZUCKER, D. S., MATTHEWS, C. E., LIGIBEL, J. A., GERBER, L. H., MORRIS, G. S., PATEL, A. V., HUE, T. F., PERNA, F. M., & SCHMITZ, K. H.
Affiliations
  • University of British Columbia (CA)
  • School of Nursing and Knight Cancer Institute, Oregon Health Sciences University, Portland, OR
  • Heidelberg University (DE)
  • Utrecht University (NL)
  • Northern Arizona University (US)
  • University of Alberta (CA)
  • Swedish Medical Center (US)
  • Division of Cancer Epidemiology and Genetics (US)
  • Harvard University (US)
  • Inova Health System (US)
  • Wingate University (US)
  • American Cancer Society (US)
  • University of California, San Francisco (US)
  • National Cancer Institute (US)
  • Penn State Cancer Institute (US)
ORCID
Venue
Medicine & Science in Sports & Exercise
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-11
Volume
51
Issue
11
Pages
2375-2390
ISSN
  • 0195-9131 (ISSN-L)
  • 1530-0315
DOI
10.1249/mss.0000000000002116
PMC
PMC8576825
OpenAlex
W2981263606
Semantic Scholar
476921561b2d12cddc4775c6092670414d9c97c5
Cited by
2,988
References
122
Citations by year
2026: 488 · 2025: 490 · 2024: 532 · 2023: 438 · 2022: 426 · 2021: 378 · 2020: 219 · 2019: 9 · 2014: 1
FWCI
106.99
Type
journal article
Language
en
Open access
Locations
  • Medicine & Science in Sports & Exercise (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • eScholarship (California Digital Library) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Funders
  • National Institutes of Health (Z99 CA999999)
  • National Cancer Institute (R01CA163474, R01CA222605)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
cancer survivors, exercise recommendations, exercise prescription, cancer-related fatigue, aerobic exercise, resistance training, physical function, quality of life, anxiety, depressive symptoms, exercise safety, cancer recurrence risk, all-cause mortality
MeSH terms
Cancer Survivors, Anxiety, Depression, Exercise Test, Exercise Therapy, Fatigue, Humans, Lymphedema, Physical Fitness, Quality of Life, Exercise, Exercise Tolerance, Evidence-Based Medicine

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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