Effect of Physical Activity on Physical and Mental Health in Young Cancer Patients and Survivors: A Systematic Review of RCTs and CCTs
Authors: Schneider Ann Christin , Anzeneder Sofia , Rehbein Lars , Brack Eva Katharina , Schmidt Mirko , Benzing Valentin 
Published: January 2025

Introduction Young cancer patients (YCP) face high risks of acute and long-term physical and mental health effects resulting from their malignancy and its treatment (Benzing et al., 2022; Siegwart et al., 2020). Physical activity (PA) is increasingly recognized as a strategy to address physical, mental, cognitive, and social challenges faced by YCP and survivors (Braam et al., 2016). This systematic review aimed to summarize findings from randomized controlled trials (RCTs) and clinical control trials (CCTs) evaluating the impact of PA interventions on physical and mental health outcomes in YCP and survivors.
Methods A systematic search was conducted in APA PsycINFO, PubMed, SPORTDiscus, Web of Science, Embase, and Scopus. We examined RCTs and CCTs investigating PA interventions in children and adolescents with cancer, during or after treatment, that reported outcomes related to physical or mental health and/or quality of life. Two authors independently screened studies for inclusion, extracted data, and assessed the risk of bias.
Results Of 1,164 articles screened, 32 RCTs and CCTs met eligibility criteria, involving 1,315 participants aged 4–19 years. Studies included inpatients (18), survivors (11), or both (2). Chronic PA interventions, such as aerobic, resistance, or combined motor-cognitive training, were implemented. All studies reported physical health outcomes, primarily focusing on cardiorespiratory fitness, muscle strength, and fatigue, while 18 studies assessed psychological outcomes, including depression and quality of life. Four studies objectively evaluated cognitive functions. Benefits were most frequently observed (>50%) for strength, fatigue, and self-efficacy, with no negative effects reported.
Discussion/Conclusion Despite variability in session durations and intervention lengths, this review highlights the broad benefits of PA for YCP and survivors, with no indication of negative effects. Most studies have focused on physical and mental health outcomes (Braam et al., 2016), with limited attention to cognitive performance and motor ability, despite the high risk of cognitive late effects in this population (Krull et al., 2018). High-quality RCTs are needed to better understand the role of PA in motor and cognitive development among YCP and survivors.
References
Benzing, V., Siegwart, V., Spitzhüttl, J., Schmid, J., Grotzer, M., Roebers, C. M., Steinlin, M., Leibundgut, K., Everts, R., & Schmidt, M. (2021). Motor ability, physical self‐concept and health‐related quality of life in pediatric cancer survivors. Cancer Medicine, 10, 1860–1871. https://doi.org/10.1002/cam4.3750
Braam, K. I., van der Torre, P., Takken, T., Veening, M. A., van Dulmen‐den Broeder, E., & Kaspers, G. J. L. (2016). Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database of Systematic Reviews, 3, CD008796. https://doi.org/10.1002/14651858.CD008796.pub3
Krull, K. R., Hardy, K. K., Kahalley, L. S., Schuitema, I., & Kesler, S. R. (2018). Neurocognitive outcomes and interventions in long-term survivors of childhood cancer. Journal of Clinical Oncology, 36(21), 2181-2189. https://doi.org/10.1200/jco.2017.76.4696
Siegwart, V., Benzing, V., Spitzhuettl, J., Schmidt, M., Grotzer, M., Steinlin, M., Leibundgut, K., Roebers, C., & Everts, R. (2020). Cognition, psychosocial functioning, and health-related quality of life among childhood cancer survivors. Neuropsychological Rehabilitation, 32 (6), 922–945. https://doi.org/10.1080/09602011.2020.1844243