Review Effects of exercise training on cancer patients undergoing neoadjuvant treatment: A systematic review 2023 Malveiro et al

Abstract

Objectives
This systematic review aimed to analyze the effects of different exercise protocols on physical fitness (cardiorespiratory fitness, muscle strength, and body composition), quality of life, cancer-related fatigue, and sleep quality in patients with different types of cancer undergoing neoadjuvant treatment.

Design
Systematic review.

Method
A comprehensive search of existing literature was carried out using four electronic databases: PubMed, Scopus, Web of Science, and Cochrane Library (published until October 19, 2022). All databases were searched for randomized controlled trials, quasi-experimental investigations, and pre-post investigations assessing the effects of exercise in cancer patients during neoadjuvant treatment. Excluded articles included multicomponent interventions, such as exercise plus diet or behavioral therapy, and investigations performed during adjuvant treatment or survivorship. The methodological quality of each study was assessed using the Physiotherapy Evidence Database (PEDro) scale.

Results
Twenty-seven trials involving 999 cancer patients were included in this review. The interventions were conducted in cancer patients undergoing neoadjuvant treatment for rectal (n = 11), breast (n = 5), pancreatic (n = 4), esophageal (n = 3), gastro-esophageal (n = 2), and prostate (n = 1) cancers, and leukemia (n = 1). Among the investigations included, 14 utilized combined exercise protocols, 11 utilized aerobic exercise, and two utilized both aerobic and resistance training separately. Exercise interventions appeared to improve cardiorespiratory fitness, muscle strength, body composition, and quality of life, although many investigations lacked a between-group analysis.

Conclusion
Despite limited evidence, exercise interventions applied during neoadjuvant treatment demonstrate promising potential in enhancing cardiorespiratory fitness, muscle strength, body composition, and overall quality of life. However, a scarcity of evidence remains on the effects of exercise on cancer-related fatigue and sleep quality. Further research with high-quality randomized controlled trials is warranted.

Open access, https://www.sciencedirect.com/science/article/pii/S1440244023003821

 

Just quoting this bit again to emphasise it, "a scarcity of evidence remains on the effects of exercise on cancer-related fatigue".

 

Surely this is another area where the biggie is about longer-term follow-up not whether someone's fitness short-term changes? POtentially it is a good way to increase likelihood of long-term side effects from cancer treatment by having people 'pushing through' when undergoing something gruelling and then 4-5yrs on finding those who didn't might have recovered fitness more than those who pushed their body 'at the time'.

Given I'm assuming noone is surprised that people might end up with fatigue just from having gone through chemo (and it not being 'deconditioning' from having done less exercise) and its toll on the body, at the same time as whatever the cancer was doing to it, you'd think they'd be - as per they should have been with their CFS experiments - looking for potential harms as much as anything surely over the long-term?

What happened to the days where it was just common sense you could only push the body so far without it being a bad idea because you'll end up turning that bad illness into something even more long-term, like when people are told not to go to the gym or swimming when they have flu?