March 2025
High muscle strength and cardiorespiratory fitness associated with lower mortality risk in patients with cancer
By Dr Emily Lathlean MB BS, FRACGP
High muscle strength and cardiorespiratory fitness are significantly associated with a lower risk of all-cause mortality in patients diagnosed with cancer, according to a systematic review with meta-analysis.
The review, published in the British Journal of Sports Medicine, included 42 studies and almost 47,000 participants with cancer of any form or stage, with a median age of 64 years (range 58.8 to 70.5 years) and median body mass index of 24.8kg/m2 (range 22.7 to 26.6 kg/m2). Overall, patients with high muscle strength or cardio- respiratory fitness levels had a significant reduction in risk of all-cause mortality by 31 to 46% compared with those with low physical fitness levels. An 11% reduction was found per unit increment in muscle strength.
‘The study clearly shows the benefit of exercise in reducing mortality,’ said Associate Professor Rohit Joshi, who is a Medical Oncologist at Calvary Playford and Lyell McEwin Hospital, Adelaide. ‘Exercise and diet are the core of any treatment. We don’t give enough emphasis on this, which is a shame.’
In patients with lung and digestive cancers, high muscle strength and cardiorespiratory fitness were associated with a 19 to 41% reduced risk of all-cause mortality, and in patients with advanced cancer stages, a significantly reduced risk of all-cause mortality of between 8 and 46%.
Professor Joshi said that collaboration between primary care providers and the treating oncology team was crucial to facilitating holistic care for patients with cancer.
‘Chemotherapy or surgery are one part of the treatment, but it is vital to also focus on the health and wellbeing of the person and their family – physical, mental and spiritual.’
When considering cancer stage, the study found that muscle strength and cardiorespiratory fitness were significant predictors of all-cause mortality, especially in patients with advanced cancer. The researchers advocated for the implementation of tailored exercise prescriptions to enhance muscle strength and cardiorespiratory fitness throughout the cancer continuum.
‘If exercise was a “medication”, and we saw this amount of benefit, everyone would be prescribed the “exercise medication”,’ Professor Joshi said.