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Cancer – Helps restore wellbeing


During Treatment

Meta-analysis demonstrated slight improvement in depression in all cancers, however no clear effect on depression was seen in a systematic review on breast cancer.[4, 10]

2 RCTs and a systematic review have demonstrated no clear change in anxiety levels in studies for all cancer types and breast cancer respectively.[4, 11]

Improved sleep quality was demonstrated from meta-analysis involving walking interventions.[12]

No improvement in quality of life was demonstrated in meta-analysis and systematic reviews for breast or prostate cancer, however for head and neck cancers there was control or improvement.[4, 6, 8]

Quality of evidence

Grade B – Moderate quality. Heterogenous studies with different interventions.

Strength of recommendation

Grade 2 – weak recommendation. Varied due to different outcomes.


Depression has been shown to have slight improvement. No change was seen in anxiety. Only walking interventions have been looked at for sleep quality and there is a lack of clear evidence for quality of life

Post Treatment

Meta-analyses reported an improved quality of life for cancer of all types, and a further meta-analyses showed a small increase in quality of life. [4, 5] No change in quality of life was seen in meta-analysis in lung cancer after resection and colorectal cancer survivors.[3, 6] Slight reductions in depression were demonstrated in a meta-analysis.[7]

Quality of evidence

Grade B – Moderate quality – Quality of life has been grouped together and not divided into different aspects. Quality of life evidence does not exist for post-surgical resection patients in lung cancer, and patients post treatment for colorectal cancer.

Strength of recommendation

Grade 2 – Weak recommendation. Overall patients would expect an improvement in quality of life with benefits outweighing risks.

  1. Cramp, F. and J. Byron-Daniel, Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev, 2012. 11: p. CD006145.
  2. Brown, J.C., et al., Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev, 2011. 20(1): p. 123-33.
  3. Cramer, H., et al., A systematic review and meta-analysis of exercise interventions for colorectal cancer patients. Eur J Cancer Care (Engl), 2014. 23(1): p. 3-14.
  4. Fong, D.Y., et al., Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ, 2012. 344: p. e70.
  5. Mishra, S.I., et al., Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev, 2012(8): p. CD007566.
  6. Cavalheri, V., et al., Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database Syst Rev, 2013(7): p. CD009955.
  7. Craft, L.L., et al., Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev, 2012. 21(1): p. 3-19.
  8. Dennett, A.M., et al., Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression. J Physiother, 2016. 62(2): p. 68-82.
  9. Chan, R.J., et al., Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer. Eur J Cancer, 2015. 51(4): p. 437-50.
  10. Focht, B.C., et al., Resistance exercise interventions during and following cancer treatment: a systematic review. J Support Oncol, 2013. 11(2): p. 45-60.