The role of exercise for pain management in adults living with and beyond cancer: a systematic review and meta-analysis.

BACKGROUND: Pain is a common side effect of cancer or cancer treatment that negatively impacts biopsychosocial wellbeing and quality of life. Exercise is a potential intervention to manage pain that is safe and has multiple benefits. The objective was to determine the role of exercise in cancer pain management. METHODS: We completed a systematic review and meta-analysis of exercise interventions in adults with any type or stage of cancer by searching Ovid MEDLINE®, Embase, APA PsycInfo, the Cochrane Central Register of Controlled Trials, CINAHL, and SPORTDiscus. We included experimental and quasi-experimental designs where pain was measured as an outcome. Data synthesis included narrative and tabular summary. A meta-analysis was performed on studies powered to detect the effect of exercise on pain. Study quality was evaluated using the Cochrane risk of bias tool and certainty of evidence was evaluated using the GRADE tool. RESULTS: Seventy-six studies were included. Studies were predominantly conducted in breast cancer and exercise usually included a combination of aerobic and strength training. Ten studies were included in the meta-analysis demonstrating a significant effect for exercise in decreasing pain (estimated average standard mean difference (SMD) was g = - 0.73 (95% CI: - 1.16 to - 0.30)); however, the overall effect prediction interval was large. Overall risk of bias for most studies was rated as some concerns and the grading of evidence certainty was low. CONCLUSION: There are limitations in the evidence for exercise to manage cancer-related pain. Further research is needed to understand the role of exercise in a multimodal pain management strategy.

Understanding the Experiences of Physical Activity, Body Image, and Quality of Life in Young Adult Males Living with and beyond Cancer.

For young adults (YAs), a cancer diagnosis and subsequent treatments may result in physical changes that can negatively impact body image (BI) and health-related quality of life (HRQL). Physical activity (PA) is an evidence-based tool found to impact both BI and HRQL. However, most research has focused on the perspectives of older adults with breast or prostate cancer. No research has explored the experiences of PA, BI, and HRQL in YA males affected by cancer. A qualitative study was designed for YA males diagnosed with cancer between the ages of 20 and 39 years. Eligible participants were recruited through pre-existing exercise oncology studies, support organizations, and social media. Semi-structured interviews were conducted to understand participants' experiences of PA, BI, and HRQL. All interviews were transcribed verbatim and analyzed using interpretive description. The participants were YA males (n = 7) with a mean age of 32.7 ± 4.0 years. Themes included a loss of identity due to cancer, building autonomy and identity using PA, and the "should" behind BI. PA for YA males living with and beyond cancer may support them in rebuilding their identity and BI. The development of exercise oncology resources for YA males may consider addressing BI through education or exercise prescription programs, with the goal of enhancing HRQL.