Exercise and Childhood Cancer-A Historical Review

Abstract

Childhood cancer survivors are at risk of developing important adverse effects, many of which persist for years after the end of treatment. The implementation of interventions aiming at attenuating tumor/treatment-associated adverse effects is therefore a major issue in pediatric oncology, and there is growing evidence that physical exercise could help in this regard. The present review aims to summarize the main milestones achieved in pediatric exercise oncology. For this purpose, we conducted a systematic review of relevant studies written in English in the electronic database PubMed (from inception to 14 August 2021). This review traces the field of pediatric exercise oncology throughout recent history based on three fundamental pillars: (i) exercise during childhood cancer treatment; (ii) exercise during/after hematopoietic stem cell transplantation; and (iii) exercise after childhood cancer treatment. Accumulating evidence--although still preliminary in many cases--supports the safety and potential benefits of regular exercise (with no major contraindications in general) in the childhood cancer continuum, even during the most aggressive phases of treatment. Exercise can indeed represent an effective coadjuvant therapy for attenuating cancer-related adverse effects.

Keywords: exercise is medicine; leukemia; physical activity; solid tumors; stem cell transplantation; survival.

Figure 1

Distribution of articles according to the main milestones that contributed to knowledge on the childhood cancer and physical exercise binomial. Abbreviations: ALL, acute lymphoblastic leukemia; HIUNJ, Hospital Infantil Universitario Niño Jesús; RCT, randomized controlled trial.

Figure 2

Potential exercise benefits in childhood cancer. Source: self-elaboration. Of note, strong evidence (e.g., based on meta-analyses) is still needed for some of the potential benefits, such as a decrease in hospitalization time or an actual decrease in adiposity (including central adiposity).