Finding the right time to initiate exercise rehabilitation following a cancer diagnosis: A systematic review and meta-analysis.
Germaine A Tan, Casey L Peiris, Nicholas F Taylor et al.
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In 30 seconds
This systematic review and meta-analysis examined whether the timing of exercise rehabilitation affects outcomes for adults and children with cancer. It included 15 randomised trials involving 1270 participants, most commonly with breast, colorectal or haematological cancers. Low- to moderate-certainty evidence indicated comparable improvements with earlier and later initiation across physical activity, fitness, walking capacity, fatigue and quality of life. Hospital length of stay also did not differ: MD 0 days, 95% CI -0.9 to 0.9. The findings suggest that exercise rehabilitation can provide similar benefits across the initiation times studied.
Key findings
- Physical activity improved similarly with earlier versus later initiation (SMD -0.03, 95% CI -0.60 to 0.54).
- Fitness, walking capacity, fatigue and quality of life showed comparable outcomes between initiation times.
- Hospital length of stay did not differ (MD 0 days, 95% CI -0.9 to 0.9).
- The review included 15 randomised trials and 1270 participants; certainty of evidence was low to moderate.
Why it matters
The findings suggest that exercise rehabilitation may offer comparable health benefits whether started earlier or later after a cancer diagnosis. This is relevant when treatment schedules, symptoms or service availability affect timing. However, the evidence does not establish that timing is irrelevant for every cancer population or outcome, and the certainty of evidence ranges from low to moderate.
What to keep in mind
Evidence certainty was low to moderate, and the included trials covered a range of cancer types and outcomes.