Table 2

Description of studies of exercise in patients with cancer

StudyDesignSampleExercise interventionOutcome variableResultsp Value
Adamsen et al25RCT with usual care controlsPatients with cancer (mixed) (randomised, n=269; completed programme, n=235) during chemotherapy, aged 18–65 years, WHO-PS 0–1Supervised exercise compromising high intensity cardiovascular and resistance training, relaxation, massage, 9 h/week for 6 weeksEORTC-QLQ
Leisure Time Physical Activity Questionnaire, 1RM, VO2 maximum
Significant reduce in fatigue* in intervention. No significant improvement in QoL**0.02*
Courneya et al26RCT with usual care controlsPostmenopausal breast cancer survivors (randomised, n=53; completed programme, n=52) aged 50–69Upright cycling 3 times a week, intensity of 70–75%, for 15 min at beginning, increased by 5 min/weekOverall QoL
Peak oxygen consumption
Significant increase in QoL* and peak oxygen consumption** in exercise group in comparison with control group0.001*
Courneya et al27RCT with usual care controlsColorectal cancer survivors (mixed)(randomised, n=102; completed programme, n=93 (QoL)/88 (fitness)Home-based, personalised exercise programme, 20–30 min, 3–5 times/week, intensity of 65–75%QoL (FACT-C)
No difference between exercise and control group in QoL*0.68*
Courneya et al28RCT with usual care controlsPatients with breast cancer (randomised, n=242; completed programme, n=194) during chemotherapy, aged ≥18 years, stage I-IIIA cancerAET: aerobic exercising 3 times/week, increasing from 60–80% of VO2 maximum from week 1–18, 15 min, increasing 5 min/week starting from week 3. RET: resistance exercising 3 times/week, for 18 weeks, intensity 60–70%.QoL
Peak oxygen consumption
Significant increase in peak oxygen consumption in AET* and RET** group in comparison with control group, as well as self- esteem in the AET† and RET†† group. No difference in QoL.0.006*
Courneya et al29RCT with usual care controlsLymphoma patients (randomised; n=122, completed programme, n=117), aged ≥18 years, during chemotherapyAerobic exercise 3 times/week for 12 weeks, 15 min increasing 5 min/week, intensity 60% with 5% increase every weekTOI-An
VO2 maximum
Significant increase in physical functioning*, overall QoL** and fatigue*** in AET group in comparison with control group0.012*
Dimeo et al30RCT with aerobic exercise vs relaxation trainingPatients with cancer (mixed)(randomised, n=72; completed programme, n=69), after surgery, aged 30–75 years, ECOG score 0–2Exercise: stationary bike 30 min 5 times/week intervals, intensity 80% for 3 weeks. Relaxation: 45 min 3 times/week for 3 weeksEORTC-QLQ
Physical performance
Global health
Significant increase in physical performance in exercise group, unchanged in relaxation group*. No difference for fatigue and global health between groups**0.01*
Goedendorp et al31RCT with BNI and CBT vs usual care controlsPatients with cancer (mixed)(randomised, n=240; completed programme, n=218) during therapy, aged 18–75 yearsBNI: walking/cycling 5 days/week for 3 months, 5 min and 5 min increasing/week
CBT: therapy for up to 10 1 h sessions for 6 months
Significant decrease in fatigue in CBT group in comparison with control*, no difference in BNI group in comparison with control**0.019*
Milne et al32RCT with IEG vs DEGBreast cancer survivors (randomised, n=58; completed programme, n=57), aged ≥18 years, with stage I-II cancerSupervised aerobic and resistance training, 3 times/week for 12 weeksQoL (FACT-B)
Fatigue (SCFS) SPAS-7
Significant increase in QoL in exercise groups in comparison with control group*<0.001*
Mutrie et al33RCT with usual care controlsPatients with breast cancer (randomised, n=203; completed programme, n=177) during therapy, stage 0-III cancerSupervised group exercise, 45 min for 12 weeksFACT-G
12 min-WT
Length of hospital stay
GP visits
Significant decrease in hospital nights* and GP visits** in exercise group in comparison with control group. No difference in FACT-G***0.044*
Andersen et al34RCT with usual care controlsPatients with cancer (mixed)(randomised, n=269; completed programme, n=213) during chemotherapy, aged 18–65 years, WHO-PS 0–1Four high and low intensity physical training sessions, 9 h/week for 6 weeksCRF
Significant reduce in fatigue in intervention group in comparison with control group*. No difference in FACT-G**0.002*
Cadmus et al35RCT with usual care controlsPatients with breast cancer (randomised, n=50, n=75; completed programme, n=45, n=67) during (IMPACT, aged 35–75 years) and after treatment (YES, aged 34–79 years), with stage 0-IIIA cancerExercise 30 min of moderate physical activity 5 days a week for 6 monthsHM
Exercise was not associated with improvement in QoL, but did improve social functioning*<0.05*
Streckmann et al36RCT with usual care controlsLymphoma patients (randomised, n=61; completed programme, n=56) during therapy, aged ≥18 years and KPS score ≥60Supervised exercise 2 times/week for 36 weeks, 1 h; aerobic, stability and strengthEORTC-QLQ
Activity level
Significant increase in QoL* in exercise group0.03*
Oldervoll et al37RCT with usual care controlsPatients with cancer (mixed) (randomised, n=231; completed programme, n=163) with metastases, KPS score ≥60Exercise 2 times/week for 8 weeks, 60 minFQSignificant improvement in physical performance tests in exercise group*, no difference in fatigue** between groups0.008*
Samuel et al38RCT with usual care controlsPatients with cancer (mixed)(randomised, n=48; completed programme, n=44) during chemoradiotherapy, aged ≥18 yearsExercise 5 days/week for 6 weeks, 20 min6MWD
Significant improvement in MCS of QoL in exercise group0.014
Henke et al39RCT with usual care controlsStage IIIA/IIIb/IV patients with lung cancer (randomised, n=46; completed programme, n=29, aged ≥18 years during chemotherapyEndurance training (6 min walk) and breathing techniques 5 days/week, strength training every other dayBarthel Index
Significant increase in Barthel Index* and physical functioning in exercise group in comparison with control group**0.003*
Monga et al40RCT with usual care controlsPatients with prostate cancer (randomised, n=21; completed programme, n=16), first cancer diagnosis, during radiotherapyAerobic exercise 3 times/week for 8 weeks, 50 minQoL (FACT-P)
Fatigue (PFS)
Significant increase in QoL* and fatigue in exercise group in comparison with control group**0.006*
  • The symbols (*, **, †, etc) connect the p values with the corresponding statements in the Results column.

  • 12 min-WT, 12 min walk test; 1RM, 1-repetition maximum; 6MWD, 6 min walk distance; BMI, body mass index; CES-D, Centers for Epidemiological Studies-Depression Scale; CRF, cancer-related fatigue; DOA, daily observed activity; EORTC-QLQ, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; FACT-An, Functional Assessment of Cancer Therapy-Anemia; FACT-B, Functional Assessment of Cancer Therapy-Breast; FACT-C, Functional Assessment of Cancer Therapy-Colorectal; FACT-G, Functional Assessment of Cancer Therapy-General; FACT-P, Functional Assessment of Cancer Therapy-Prostate; FQ, Fatigue Questionnaire; HM, happiness measure; MCS, Mental Component Score; MOS SF-36, Medical Outcomes Study Short Form; PAL, Physical Activity Log; PCS, Physical Component Score; PFS, Piper Fatigue Scale; PNP, peripheral neuropathy; QoL, quality of life; RCT, randomised controlled trial; RSES, Rosenberg Self-Esteem Scale; SCL-90, Symptom Checklist-90; SF-36, Health Survey Short Form-36; SPAS-7, Social Physique Anxiety Scale; STAI, State-Trait Anxiety Scale; TOI, Trial Outcome Index.