Speck, R.M., Courneya, K.S., Mâsse, L.C., Duval, S., & Schmitz, K.H. (2010). An update of controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Journal of Cancer Survivorship, 4, 87–100. 

DOI Link


STUDY PURPOSE: To evaluate the extent to which physical activity during and after treatment is appropriate and effective for health outcomes across the cancer control continuum (provides update from 2005 article)
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

KEYWORDS: Exercise, physical activity, cancer, randomized controlled trial, randomized controlled clinical trial, intervention studies, clinical trial, motor activity, and physical activity
INCLUSION CRITERIA: English language, adults diagnosed with cancer, interventions to increase physical activity not by a physical therapist, and included a comparison group
EXCLUSION CRITERIA: Delivery of intervention by physical therapist or lack of comparison group

Literature Evaluated

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Studies were critiqued for 10 internal validity characteristics. If five of 10 were met, the study was considered high-quality. Studies also were critiqued using the Physical Exercise Across the Cancer Experience framework. Weighted means effect sizes (WMES) and 95% confidence intervals were calculated.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 102 (However, data from 82 studies were abstracted, WMES were calculated from 66 high quality studies, and a systematic level of evidence criteria was applied to evaluate 60 outcomes.)
  • TOTAL PATIENTS INCLUDED IN REVIEW = 41 (control), 42 (intervention)
  • KEY SAMPLE CHARACTERISTICS: 40% during treatment, 60% after treatment, 83% breast cancer, 90% randomized controlled trials, 80% aerobic (either alone or combined with another modality), 76% did not adequately describe their sample, and 57% described the intervention

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care


The majority of studies demonstrated a positive effect on upper and lower body strength and self-esteem with physical activity during treatment. The majority of studies also demonstrated a positive effect on aerobic fitness, lower body flexibility, lean body mass, quality of life, trial outcome index, breast cancer subscale, vigor and vitality, fatigue, immune parameters, pain, symptoms, and side effects post-treatment. Twenty-nine of 36 studies reporting on aerobic exercises reported no side effects from physical activity. Significant WMES were found post-treatment for fatigue (-0.54, p = 0.003).


In general, physical activity is well-tolerated during and after cancer treatment. More studies are needed on specific kinds of exercise and the structure of delivery. Physical activity studies with fatigue as an outcome have increased from five to 14 since 2005 for post-treatment interventions with 93% of studies showing positive results and 50% of them being statistically significant.


  • Most of the studies involved patients with breast cancer.
  • Considerations for the difficulty of making recommendations based on variations in dose response, cancer diagnosis, and stage of treatment during the intervention were acknowledged.

Nursing Implications

Patients can be educated that physical activity after a cancer diagnosis can be safe with modifications as necessary.

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