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Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116.

Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable.

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Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, CANADA.
School of Nursing and Knight Cancer Institute, Oregon Health Sciences University, Portland, OR.
Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Clinic, Heidelberg, GERMANY.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS.
School of Nursing, Northern Arizona University, Flagstaff, AZ.
Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, CANADA.
Cancer Rehabilitation Medicine Services, Swedish Cancer Institute, Swedish Health Services, Seattle, WA.
Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD.
Havard Medical School, Boston, MA.
Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA.
Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA.
Physical Therapy, Wingate University, Wingate, NC.
Epidemiology Research, American Cancer Society, Atlanta, GA.
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
Division of Cancer Control and Population Sciences, Behavioral Research Program, Health Behaviors Research Branch, National Cancer Institute, Rockville, MD.
Public Health Science, Penn State Cancer Institute, Penn State College of Medicine, Hershey, PA.



The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue.


A second Roundtable was convened in 2018 to advance exercise recommendations beyond public health guidelines and toward prescriptive programs specific to cancer type, treatments, and/or outcomes.


Overall findings retained the conclusions that exercise training and testing were generally safe for cancer survivors and that every survivor should "avoid inactivity." Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. Implications for other outcomes, such as peripheral neuropathy and cognitive functioning, remain uncertain.


The proposed recommendations should serve as a guide for the fitness and health care professional working with cancer survivors. More research is needed to fill remaining gaps in knowledge to better serve cancer survivors, as well as fitness and health care professionals, to improve clinical practice.

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