Written by Mary Marschner
Spoon Feed
Adults with cancer should exercise to reduce symptoms of depression and anxiety and improve their quality-of-life scores.
Exercise when you have cancer
Patients with cancer have more anxiety, depression, and suicidality than the general population. Medications and cognitive behavioral therapy have been shown to improve symptoms, but for patients who are already receiving multiple medications and have a large treatment team, having a therapy option that restores a patient’s sense of control and reduces the above burdens is helpful.
This systematic review and meta-analysis evaluated the impact of exercise interventions on depression, anxiety, and health-related quality of life (HRQOL) in older adults with cancer. The study included 15 randomized clinical trials with a total of 1,366 participants. Exercise therapy was associated with significant reductions in depression (standardized mean difference, SMD -0.34; 95%CI -0.52 to -0.16) and anxiety (SMD -0.27; 95%CI -0.50 to -0.04), and improvements in HRQOL (SMD 0.28; 95%CI 0.12 to 0.44). These findings support incorporating exercise interventions into the care plans of older cancer patients to enhance mental health and quality-of-life.
This meta-analysis was limited by multiple confounding factors, but likely the most pressing one is that the majority of the studies it reviewed were done on prostate cancer. All cancer treatment is life-altering, but prostate cancer is very different from lung cancer or pancreatic cancer when it comes to invasive treatments, pain, nausea levels, and ability to perform daily activities, much less exercise.
How does this change my practice?
I’m on team exercise. However, while I appreciate that this study is looking at patients broadly diagnosed with cancer and finding a psychiatric and quality-of-life benefit of ongoing exercise, I think I’ll be recommending it with a commonsense approach. For my patients going through active cancer treatments, feeling severe fatigue and nausea and a noticeable decline in their ability to perform their daily activities, a reasonable approach is to tell them to exercise as they can, since it’s one thing they have some control over.
Source
Exercise Interventions for Depression, Anxiety, and Quality of Life in Older Adults With Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2025 Feb 3;8(2):e2457859. doi: 10.1001/jamanetworkopen.2024.57859. PMID: 39903465
