Exercise participation among cancer survivors has been shown to improve quality of life and physical functioning, yet only 10%-30% of survivors meet physical activity guidelines. In prostate cancer, aerobic exercise after prostate cancer diagnosis may reduce the risk of prostate cancer recurrence or death by up to 60 percent.
Sedentary behavior increased during the pandemic, but “stay at home” restrictions have also provided an opportunity to examine home-based exercise programs, according to a new paper by PCF-funded researcher Christina Dieli-Conwright, PhD, MPH of the Dana Farber Cancer Institute, and colleagues. The team reviewed 12 studies of exercise interventions in people with cancer that were all home-based and adapted for pandemic restrictions. The approaches broadly included:
- Self-directed, unsupervised: recommendation to adhere to exercise guidelines or to complete a daily exercise program with accompanying resources (e.g., video)
- Self-directed, with regular guidance: online videos, smart watches, and printed materials supplemented with regular phone calls or messages to patients
- Virtually supervised interventions: one-on-one or group exercise sessions over videoconferencing
Although this review did not aim to determine which approach was most effective, it did yield some preliminary information about home-based exercise programs in cancer survivors and identified challenges and areas for further research. For example, in the virtually supervised programs, adherence was quite high, ranging from 84%-94%. In two trials in breast and prostate cancer, attendance and retention were actually higher in the virtual sessions held during the pandemic, compared with in-person supervision prior to COVID-19.
The researchers concluded that virtually-supervised interventions may be feasible, safe, and have the potential to improve outcomes in cancer survivors such as fatigue and anxiety. More research is needed to understand their impact on important health outcomes such as physical function and survivorship.
In carrying out future studies, patient safety is paramount. Participants need training on proper use of equipment to maximize effectiveness and minimize the risk of injury. People undergoing cancer treatment may have different symptoms day-to-day, as well as other health conditions that may affect their ability to exercise. While home-based exercise avoids barriers (e.g., travel time, potential exposure to germs), it presents other challenges (e.g., lack of suitable space at home, technology access). Researchers will need to address these and other open questions as they develop high-quality exercise programs to support healthy cancer survivorship.
If you’ve found an exercise routine that works for you—Keep it up! Aiming to get started with exercise? See Dr. Dieli-Conwright’s suggestions here and ask your care team for more ideas. If you like the idea of exercise in a group setting but are hesitant to go to a crowded gym, look for outdoor options over the summer.