Multidisciplinary perspectives in exercise oncology across the translational research continuum.

Abstract

Exercise oncology is a multidisciplinary field that encompasses research across the translational continuum. Some of the major disciplines contributing to the field include biology, immunology, physiology, psychology, behavioral science, epidemiology, and clinical oncology. Here, we provide a brief overview of the field under the headings of preclinical studies, observational studies, interventional outcome studies, interventional behavioral studies, dissemination and implementation studies, and childhood cancer studies. Preclinical studies have generally demonstrated that exercise can reduce tumor growth, primarily by modulating the tumor microenvironment. Observational studies have generally demonstrated that higher postdiagnosis exercise is associated with lower rates of mortality, however, most studies have not considered the combination and sequencing of exercise with other cancer treatments. Interventional outcome studies have consistently demonstrated strong evidence that aerobic and/or resistance exercise have beneficial effects on fatigue, anxiety, depression, physical functioning, and quality of life in adult patients treated with curative intent. Childhood cancer studies have demonstrated beneficial effects on cardiorespiratory fitness and muscular strength; however, the quality of evidence is often low. Interventional behavioral studies have identified multiple effective exercise behavior change strategies, yet the evidence is limited by a lack of diversity, minimal attention to social determinants, and insufficient knowledge to tailor interventions. Dissemination and implementation studies are occurring globally, yet an evidence base identifying the most cost-effective, equitable, and sustainable strategies is limited. Notwithstanding substantial limitations and remaining research gaps, multidisciplinary exercise oncology research across the translational continuum has provided cancer patients with evidence-based recommendations for improving quality of life and possibly survival.