Oldervoll, L. M., Kaasa, S., Hjermstad, M. J., Lund, J. A., & Loge, J. H. (2004). Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients? European Journal of Cancer (Oxford, England: 1990), 40, 951–962.

DOI Link

Search Strategy

Databases searched were PubMed, PsycINFO, CANCERLIT, and Cochrane Library through May 2003.

Literature Evaluated

Twelve randomized trials were included. Nonrandomized trials, pilot studies, and studies in which exercise was combined with other therapies, such as cognitive therapy or diet, were excluded.  Outcomes were fatigue, health-related quality of life, physical exercise capacity (maximal oxygen consumption), and other physical performance measures.  Treatment evaluated aerobic exercise training (10 studies) and resistance exercise (two studies).

Sample Characteristics

  • Sample sizes ranged from 21 to 155 patients.
  • Nine studies included breast cancer patients, most of whom were stages I or II. The remaining studies included samples with mixed diagnoses, prostate cancer, and acute leukemia.
  • In 10 of 12 studies, the intervention was conducted when patients were undergoing radiation therapy and/or chemotherapy treatment; two trials implemented exercise after the treatment was finished.
  • Eleven of 12 studies were performed in patients receiving treatment with curative intent, and one study included a mix of patients receiving treatment with either curative or palliative intent.


Three studies reported a significant reduction in fatigue. One study observed a significant reduction in fatigue, although this did not reach statistical significance. In another study, no statistical analyses were performed to examine between-group differences.


The reviewed studies indicated promising effects on both physiological and psychological outcomes. However, the reviewed studies differed widely in the length of the exercise program, its intensity, content, and frequency, and the timing of the interventions in relation to the patient’s disease and treatment.


  • In many of the studies reporting data on quality of life, too many outcomes were listed (range 2–12), and only four of the trials defined which variables were the primary endpoints.
  • Randomized clinical studies are few, small in scope, and focus mainly on patients with breast cancer.
  • Complete knowledge about the type of physical exercise most beneficial for patients at different stages of disease is lacking.

Nursing Implications

Future exercise intervention studies should also identify fewer and more specific endpoints.

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