Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review (original) (raw)
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Journal of Functional Morphology and Kinesiology
In the European Union, five-year survival rates for childhood cancer patients are approaching 72-80%, which is a testament to better diagnostics and improved treatment. As a result, a large proportion of childhood cancer patients go on to live productive lives well past reproductive age. While this is encouraging, childhood cancer treatment is accompanied by multiple long-term adverse effects on physical and mental wellbeing. While there are several approaches to address mental health, reproductive integrity, secondary pathologies, and recurrence, in order to optimize quality of life in childhood cancer patients, exercise and nutrition should also be considered. It is clear that physical activity plays an important role in the prevention and reduction of long-term adverse side effects associated with cancer treatment in both children and adults. However, the current exercise guidelines for cancer survivors are based on adult data and accordingly are not appropriate for children. As children and adults are markedly different, including both the pathophysiology of cancer and exercise response, treatment plans incorporating exercise for children should be age-specific and individually tailored to both reduce the development of future comorbidities and enhance physical health. The purpose of this paper is to review the predominant cancer types and effects of cancer treatment in children, describe several special considerations, and propose a framework for assessment and exercise guidelines for this population.
Cancer treatment reviews, 2018
Physical capacity and quality of life (QoL) are typically impaired in children/adolescents with cancer. Our primary objective was to examine the effects of exercise training performed after diagnosis of any type of pediatric cancer on physical capacity-related endpoints, survival, disease relapse and adverse effects. (a) Search and selection criteria: Systematic review in Pubmed and Web of Science (until August 2018) of randomized controlled trials (RCTs) of exercise interventions in children with cancer during treatment or within one year after its end. (b) Data collection: Two authors independently identified studies meeting inclusion criteria, extracted data, and assessed risk of bias using standardized forms. When needed, we contacted authors to request clarifications or additional data. (c) Statistical Analysis: The pooled standardized mean differences (SMD) were calculated for those endpoints for which a minimum of three RCTs used the same assessment method. We also calculated...
Physical activity and childhood cancer
Pediatric Blood & Cancer, 2009
This review provides a survey of studies investigating physical activity and exercise interventions in patients during tumor treatment and survivors of childhood cancer. PubMed and Medline databases were searched using relevant terms. References of selected papers were tracked. A total of 28 studies could be identified. Seventeen studies investigated physical activity, 11 studies determined the effect of activity enhancing interventions during and after therapy. Even though most studies showed limitations and results were not consistent, considerably reduced physical activity is highly probable in patients during and after therapy. Studies on interventions provided promising results and revealed challenges to be faced.
Exercise and Childhood Cancer—A Historical Review
Cancers, 2021
Childhood cancer survivors are at risk of developing important adverse effects, many of which persist for years after the end of treatment. The implementation of interventions aiming at attenuating tumor/treatment-associated adverse effects is therefore a major issue in pediatric oncology, and there is growing evidence that physical exercise could help in this regard. The present review aims to summarize the main milestones achieved in pediatric exercise oncology. For this purpose, we conducted a systematic review of relevant studies written in English in the electronic database PubMed (from inception to 14 August 2021). This review traces the field of pediatric exercise oncology throughout recent history based on three fundamental pillars: (i) exercise during childhood cancer treatment; (ii) exercise during/after hematopoietic stem cell transplantation; and (iii) exercise after childhood cancer treatment. Accumulating evidence––although still preliminary in many cases––supports the...
Exercise medicine for child and adolescent cancer patients
Sports Health, 2019
Survival rates of children and adolescents with cancer have improved considerably in recent decades, with approximately 80% of child or adolescent patients surviving beyond 5 years, owing to improved treatment regimens and scientific advances. With many children continuing into adulthood, the total population of childhood cancer survivors is constantly growing, presenting health practitioners and cancer survivors with new challenges. Indeed, child and adolescent cancers are associated with a range of disease and treatment related adversities that can progressively lead to the development of chronic disease or other long-term health consequences into adulthood if unmanaged. Specifically, child and adolescent cancer patients (ie. at diagnosis and post-diagnosis, under observation and/or on active treatment) and survivors (ie. completed curative intent treatment and judged to be in remission or cured) experience a variety of burdensome toxicities and side-effects from primary therapies. The accumulation of these health consequences from cancer and its treatments, leads to drastic reductions in physical activity and exercise. Consequently, these children and adolescent individuals develop sedentary behaviours which impact significantly on the trajectory of their physical, mental and social development following curative treatment (for those able to be cured), and into adulthood. Further, child cancer survivors have a vastly reduced life expectancy than their healthy counterparts. As a result, strategies to safely and effectively reduce the burden of childhood cancer and treatment; increase quality of life; and extend survival have a high degree of clinical importance. Exercise is a highly promising potential countermeasure for child and adolescent cancer patients and survivors. Here, we review the effects of exercise on acute and long-term outcomes from cancer treatments.
Exercise as a Potential Intervention to Modulate Cancer Outcomes in Children and Adults?
Frontiers in Oncology, 2020
Exercise is recommended for the healthy population as it increases fitness and prevents diseases. Moreover, exercise is also applied as an adjunct therapy for patients with various chronic diseases including cancer. Childhood cancer is a rare, heterogeneous disease that differs from adult cancer. Improved therapeutic strategies have increased childhood cancer survival rates to above 80% in developed countries. Although this is higher than the average adult cancer survival rate of about 50%, therapy results often in substantial long-term side effects in childhood cancer survivors. Exercise in adult cancer patients has many beneficial effects and may slow down tumor progression and improve survival in some cancer types, suggesting that exercise may influence cancer cell behavior. In contrast to adults, there is not much data on general effects of exercise in children. Whilst it seems possible that exercise might delay cancer progression or improve survival in children as well, there is no reliable data yet to support this hypothesis. Depending on the type of cancer, animal studies of adult cancer types show that the exercise-induced increase of the catecholamines epinephrine and norepinephrine, have suppressive as well as promoting effects on cancer cells. The diverse effects of exercise in adult cancer patients require investigating whether these results can be achieved in children with cancer.
A Randomized Trial of Physical Activity in Children and Adolescents with Cancer
Cancers
Background: to evaluate the safety and efficacy of a physical activity program (PAP) in children and adolescents with cancer. Methods: children and adolescents with cancer were randomly assigned in a 1:1 ratio to the six-month PAP (intervention group) or to the control group. The first evaluation was performed at the end of the PAP (T0 + 6 mo). At T0 + 6 mo, both groups received the six-month PAP with a second evaluation at T0 + 12 mo. The primary outcome was the evolution of exercise capacity measured using the six-minute walk test (6 MWT) at T0 + 6 mo. Secondary outcomes included PAP safety and changes in other physical functions, self-esteem, and quality-of-life parameters. Results: The trial involved 80 children and adolescents (age range 5.0–18.4 years), of whom 41 were assigned to the interventional group and 39 to the control group. Underlying malignancies were leukemia (39%) and a broad range of solid tumors (61%). No adverse events occurred. At T0 + 6 mo, the evolution of t...
Advancing the Field of Pediatric Exercise Oncology: Research and Innovation Needs
Current Oncology, 2021
The field of pediatric exercise oncology explores the relationships between physical activity (PA), including exercise, and a range of outcomes among children and adolescents affected by cancer. Although PA is safe and beneficial for this population, several important gaps in knowledge and practice remain. In this article, we describe research and innovation needs that were developed with a team of international experts and relevant literature, a series of online surveys, and an in-person meeting. Addressing these needs will contribute valuable knowledge and practice outputs to advance this field, ultimately enabling a greater number of children and adolescents affected by cancer to realize the benefits of moving more.
JMIR Research Protocols, 2022
Background Survivors of childhood cancer represent a growing population with a long life expectancy but high risks of treatment-induced morbidity and premature mortality. Regular physical activity (PA) may improve their long-term health; however, high-quality empirical knowledge is sparse. Objective The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study comprises 4 work packages (WPs) aiming for the objective determination of PA and self-reported health behavior, fatigue, and quality of life (WP 1); physical fitness determination (WP 2); the evaluation of barriers to and facilitators of PA (WP 1 and 3); and the feasibility testing of an intervention to increase PA and physical fitness (WP 4). Methods The PACCS study will use a mixed methods design, combining patient-reported outcome measures and objective clinical and physiological assessments with qualitative data gathering methods. A total of 500 survivors of childhood cancer aged 9 to 18 years with ≥1 year ...