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How can Moving More help you? What the research says

How does Moving More impact your cancer outcomes, affect your quality of life, or impact your body terrain? We present the evidence.

For information and guidance on adding physical activity to your life, see our main page on Moving More ›

We strongly emphasize that Moving More by itself will not prevent, cure or control cancer or prevent recurrence. Like every other therapy or approach included on this website, Moving More is one component of an individualized integrative plan rather than a stand-alone therapy.

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Improving treatment outcomes

Is Moving More linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

The relationship between activity and survival becomes complex as people have more advanced disease or illness. People who are very ill may not be able to move much at all, but we wouldn’t conclude that more activity would delay death. However, evidence shows that even with advanced cancer, increasing activity within your limits is linked to better survival.

Similarly, pushing yourself to high levels of activity during treatment may not be wise. Guidelines encourage you to be as active as available given your situation. Follow your doctor’s recommendations, and also listen to your body’s need for rest.

Cancer as a whole

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately better survival among people with higher activity levels after diagnosis

Modest evidenceat least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis found no effect (this is the CancerChoices definition; other researchers and studies may define this differently) of possibly better chemotherapy completion rates, but no evidenceoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of improved response rate or survival among people with cancer participating in aerobic exercise during chemotherapy
Advanced cancer

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival among people with advanced cancer with more physical activity
Breast cancer

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately better survival among people with higher activity levels compared to low levels

Good evidence of moderately better survival among people increasing their activity levels after diagnosis

Preliminary evidence of better cancer-specific survival among people with any level of physical activity after a breast cancer diagnosis
Colorectal cancer

Strong evidence of moderately better survival among people participating in more physical activity

Strong evidence of moderately better survival among people who increased their physical activity after diagnosis

Modest evidence of moderately higher mortality among people with high levels of sedentarycharacterized by much sitting and little physical exercise time
Lymphoma

Good evidence of better survival among people with higher physical activity after a lymphoma diagnosis

Modest evidence of better survival among people participating in physical activity before diagnosis
Prostate cancer

Good evidence of improved survival and reduced disease progression among people with prostate cancer with higher levels of physical activity after diagnosis

No evidenceoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of a change in prostate-specific antigen (PSA) among men with prostate cancer participating in resistance exercise in a combined analysis of studies
Moving More combined with other practices and therapies

Modest evidence of better survival and lower risk of recurrence among people with high-risk positive stage 1–3 breast cancer but otherwise healthy with the highest scores for following a healthy lifestyle regarding physical activity; body weight; eating more fruits and vegetables and less red and processed meat or sugar-sweetened beverages; and low or no smoking or use of alcohol

Good evidence of better survival among people with colorectal cancer practicing healthy lifestyle behaviors

Good evidence of lower risk of lethal prostate cancer, but not overall prostate cancer, over 27 years among people with high genetic risk following a healthy lifestyle of a healthy weight, vigorous physical activity, not smoking, and a healthy diet

Preliminary evidence of decreasing PSA levels among men with early stage prostate cancer combining a low-fat, vegetarian diet with physical activity, group support and stress management

Preliminary evidence of better survival and lower risk of relapse among people with breast cancer combining diet and exercise

Preliminary evidence of better survival among people with colorectal cancer following diet and physical activity guidelines

Optimizing your body terrain

Does Moving More promote an environment within your body that is less supportive of cancer development, growth or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

Body weight

Strong evidence of less body fat and more lean body mass among people with cancer participating in exercise without regard to cancer treatment phase
High blood sugar and insulin resistance

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of better insulin balance among people with cancer as a whole participating in physical activity

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of some better markers of insulin balance and insulin-like growth factor (IGF) among people with breast cancer with higher levels of physical activity

Strong evidence of better insulin balance among people with colorectal cancer with higher levels of physical activity
Hormone imbalance

Changes in hormone levels seen in the studies here may not be beneficial in every situation. Your oncology team needs to determine whether any changes would be favorable for your condition.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better levels of leptin among people with or at high risk of breast cancer, but only among  people with body mass index above 25

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cortisol levels (a marker of stress) among people with major depressive disorder participating in exercise
Immune function

Increased immune system activation is not always beneficial, so your oncology team needs to determine whether immune activation would be favorable in your situation.

Preliminary evidence of higher immune activation among previously inactive women with breast cancer participating in an exercise intervention

Weak evidence of short-term higher markers of immune function among people with cancer performing a single 10-minute exercise session
Inflammation

Preliminary (conflicting) evidence of lower inflammation among people with cancer participating in physical activity
Oxidative stress

Good evidence of lower markers of oxidative stressoxidation is a process in which molecules combine with oxygen or lose electrons; losing an electron creates unstable free radicals that can damage cells, causing illness and aging among people exercising
Your microbiome

Modest evidence of healthier microbiota among healthy people with higher levels of physical activity
Vitamin D levels

Modest evidence of higher risk of low vitamin D levels among people with low levels of physical activity
Moving More combined with other practices or therapies

Preliminary evidence of more of a decrease in body weight and both visceral and subcutaneous fat among people with type 2 diabetes eating a vegetarian diet and also participating in exercise

Weak evidence of better markers of body mass index and cardiorespiratory fitness among people with breast cancer participating in an intervention of nutrition and exercise

Preliminary evidence of better insulin sensitivity and higher incidence of reduced diabetes medication among people with type 2 diabetes eating a vegetarian diet and participating in physical exercise

Weak evidence of lower markers of glycemic imbalance among men with prostate cancer participating in a diet and an exercise program

Weak evidence of better markers of insulin growth factor among men participating in a diet and exercise program

Weak evidence of better markers of blood sugar and insulin among people participating in both diet and exercise

Modest evidence of more benefits with breast cancer-related sex hormones among healthy, physically inactive postmenopausal women combining diet and exercise

Preliminary evidence of higher levels of adiponectin (important for regulating blood glucose, insulin sensitivity, and lipid metabolism) and lower levels of leptin (which inhibits hunger) among people with type 2 diabetes eating a vegetarian diet and participating in exercise

Weak evidence of better markers of inflammation among people with breast cancer participating in an intervention of nutrition and exercise

Preliminary evidence of lower body weight, smaller waist circumference, lower fasting insulin levels, fasting glucose levels, and a higher marker of antioxidant activity among elderly men and women participating in moderately intense walking, drinking green tea, and treated with vitamin E (not specific to cancer)

Preliminary evidence of weight loss and lower insulin and leptin levels among nondiabetic people participating in physical activity and treated with metformin

Weak evidence of lower body weight, waist circumference, blood sugar, and insulin resistance, as well as changes in thyroid hormone levels among people newly diagnosed with insulin resistance or diabetes participating in a diet and exercise intervention and treated with metformin

Managing side effects and promoting wellness

Is Moving More linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Treatment side effects as a whole

Modest evidence of less toxicity during chemotherapy among people with cancer participating in exercise
Anxiety

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of a small improvement in anxiety among people participating in exercise without regard to treatment phase

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of slightly less anxiety among people participating in exercise during chemotherapy, radiotherapy, adjuvant therapytreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation, or hormone therapy

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less prostate cancer-specific anxiety and fear of progression among people with prostate cancer on active surveillance participating in high-intensity interval training

Strong evidence of small to moderate improvement in anxiety among people participating in exercise after cancer treatment

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety among adults with advanced cancer participating in exercise in a combined analysis of studies
Body composition or cachexia

Strong evidence of more lean body mass among people with cancer participating in resistance training without regard to treatment phase

Strong evidence of increased lean body mass and less body fat or obesity among people receiving neoadjuvanttherapy used before a main treatment, such as chemotherapy, radiation therapy, and hormone therapy before surgery or adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation chemotherapy, radiotherapy, or hormone therapy, including androgen deprivation therapy, when participating in exercise
Bone and joint symptoms

Preliminary (conflicting) evidence of better bone mineral density among people with cancer participating in exercise
Breathlessness and other lung symptoms

Strong evidence of less breathlessness among people participating in aerobic, resistance, or both types of exercise without regard to treatment phase

Good evidence of less breathlessness among people with most advanced cancer types participating in physical activity

No evidence of an effect on breathlessness among people with advanced lung cancer participating in exercise in a combined analysis of studies

Good evidence of less breathlessness among people participating in exercise training before or after lung resection surgery
Cardiovascular symptoms

Therapies and practices that improve cardiovascular health and reduce the decline in cardiovascular function from some treatments deserve special attention from people with cancer.

Good evidence of less treatment-associated decline and better cardiovascular outcomes among people with cancer participating in exercise

Strong evidence of better cardiovascular fitness or function among people with breast cancer participating in exercise

Weak evidence of lower systolic and diastolic blood pressure and better cardiorespiratory fitness during treatment with androgen-deprivation therapy among people with locally advanced, relapsed, or metastatic prostate cancer participating in group aerobic and resistance training exercise

Preliminary evidence of less decline in cardiovascular function among people with breast cancer undergoing adjuvant treatment, and in particular among those receiving chemotherapy, with exercise training
Changes in appetite

No evidence of an effect of exercise on appetite among people with cancer in combined analyses of studies
Cognitive difficulties

Modest evidence of better cognitive scores among people with breast cancer participating in exercise

Preliminary evidence of better cognitive scores among people with grades 2–3 brain cancer (glioma) participating in an exercise program
Depression

Strong evidence of less depression among people with cancer participating in exercise without regard to treatment phase

Preliminary (conflicting) evidence of less depression among people participating in exercise during cancer treatment

Good evidence of less depression among people participating in exercise after cancer treatment

No evidence of an effect on depression among adults with advanced lung cancer participating in exercise training in a combined analysis of studies
Fatigue

Good evidence of less cancer-related fatigue among people participating in exercise without regard to treatment phase

Strong evidence of less cancer-related fatigue during treatment among people participating in exercise

Strong evidence of less cancer-related fatigue among people participating in exercise after treatment

Insufficient (conflicting) evidence of an impact on fatigue among people with advanced cancer participating in exercise
Gastrointestinal symptoms

No evidence of an impact of exercise on nausea and vomiting, constipation, or diarrhea among people with cancer in a combined analysis of studies
Lymphedema

Strong evidence of less lymphedema among people doing either aerobic and resistance exercise

No evidence of benefit for breast cancer-related lymphedema among people participating in aquatic exercise in a combined analysis of studies
Neurological symptoms

Good evidence of better balance, nerve conduction velocity, quality of life, and neuropathy-induced symptoms, and quicker movement initiation among people with peripheral neuropathydamage to the peripheral nerves outside the brain and spinal cord participating in exercise interventions
Pain

Good evidence of less pain among people with many types of cancer, but not lung cancer, participating in exercise without regard to treatment phase

Good evidence of less pain during cancer treatment except insufficient evidence regarding aromatase inhibitor-associated joint pain

Preliminary evidence of less pain among women recovering after breast cancer surgery participating in 12 months of physical activity
Physical function and quality of life

Good evidence of better quality of life, fitness, and strength among people with cancer participating in exercise without regard to treatment phase

Good evidence of better fitness, strength, and quality of life among people participating in exercise during treatment, except not among people with shoulder dysfunction due to treatment for head and neck cancer

Good evidence of better strength, fitness, and quality of life among people participating in exercise after treatment

Preliminary (conflicting) evidence of better quality of life, strength, and physical function among people with advanced cancers participating in exercise
Sexual difficulties

Modest evidence of better sexuality and body esteem scores among people participating in exercise

Modest evidence of better sexual function among women with cervical cancer participating in pelvic floor muscle training as part of a package of interventions

Modest evidence of better sexual function during androgen deprivation therapy (ADT) among people with prostate cancer participating in exercise

Preliminary evidence of greater sexual activity but no impact on sexual function among people with prostate cancer participating in exercise
Sleep disruption

Strong evidence of less sleep disruption and better sleep without regard to treatment among people with cancer participating in exercise

Strong evidence of better sleep among people with cancer participating in exercise, especially aerobic exercise, during treatment

Strong evidence of better sleep among people with cancer participating in exercise after treatment

Good evidence of less insomnia among people with advanced cancer participating in exercise
Stress

Preliminary evidence of less perceived stress during active surveillance among people with prostate cancer participating in high-intensity interval training
Other symptoms and side effects

Good evidence of more rapid recovery from surgery, shorter hospital stays, and substantially fewer complications from surgery among people participating in exercise training before surgery

No evidence of an effect on coughing among people with lung cancer participating in exercise in a combined analysis of studies
Symptoms not specific to cancer

Modest evidence of benefit, including among those with anxiety and stress-related disorders

Good evidence of lower heart rates and blood pressure among students, and especially adolescents and young adults, participating in mind-body physical activity such as yoga, tai chi, or qigong

Modest evidence of higher cognitive scores among adults spending more time in physical activity

Good evidence of fewer or less severe symptoms among people with a diagnosis of major depressive disorder or with depressive symptoms participating in exercise

Modest evidence of fewer symptoms among people with symptoms of constipation participating in exercise

No evidence of an effect of exercise on frequency or intensity of hot flashes among perimenopausal or postmenopausal women participating in exercise in a combined analysis of studies

Preliminary evidence of less reduction in the number of hot flashes among sedentary women with vasomotor symptoms participating in exercise compared to estrogen therapy

Good evidence of less pain among people participating in physical activity

Preliminary evidence of less pain after surgery among people participating in total-body exercise before surgery

Good evidence of small and moderate improvements in physical function and reported quality of life among people with chronic pain participating in physical activity

Modest evidence of lower physical markers of stress among people participating in exercise or movement
Moving More combined with other practices and therapies

Exercise is often combined with other therapies.

Reducing cancer risk

Is Moving More linked to lower risks of developing cancer or of recurrence? We present the evidence.

Cancer as a whole

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of recurrence among people participating in exercise

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of a lower risk of a cancer diagnosis among people with higher levels of physical activity

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of metastatic cancer among people participating in high-intensity exercise

Strong evidence of lower cancer mortality among people without cancer at baseline and who had the highest levels of physical activity
Bladder cancer

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of bladder cancer among people doing muscle-strengthening exercises
Breast cancer

Modest evidence of slightly lower risk of recurrence among people participating in higher levels of physical exercise

Strong evidence of a slightly lower risk of a breast cancer diagnosis among people participating in more physical activity

Strong evidence of a higher risk of breast cancer among people with more sitting time

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of lower breast cancer mortality among people without cancer at baseline participating in higher levels of physical activity
Colorectal cancer

Preliminary evidence of moderately to substantially lower risk of recurrence of colon cancer with higher levels of exercise after diagnosis

Strong evidence of lower risk of colon cancer among people with higher levels of physical activity

Preliminary (conflicting) evidence of lower risk of rectal cancer among people with higher levels of physical activity

Strong evidence of higher risk of colon cancer or neoplasia among people with more sedentary (sitting) time
Gastrointestinal cancer

Strong evidence of lower risk of esophageal adenocarcinomas among people participating in physical activity as a whole, but not in occupational physical activity

Good evidence of lower risk of gallbladder cancer with higher levels of physical activity

Strong evidence of lower risk of liver cancer among people with higher levels of physical activity

Good evidence of lower risk of mortality from liver cancer among people without cancer at baseline participating in higher levels of physical activity

Strong evidence of lower risk of stomach cancer among people with higher levels of physical activity
Gynecological cancer

Good evidence of lower risk of endometrial cancer among people with higher levels of physical activity
Head, neck, and oral cancers

Good evidence of lower risk of oropharyngeal cancer among people with higher levels of physical activity
Kidney cancer

Strong evidence of lower risk of kidney cancer among people with higher levels of physical activity
Lung cancer

Modest evidence of lower risk of lung cancer among current and former smokers with higher levels of physical activity

Insufficient evidence of an effect on lung cancer risk among nonsmokers with higher levels of physical activity

Modest evidence of higher risk of lung cancer among men with high levels of occupational activity

Modest evidence of lower risk of lung cancer among males who smoked and who had moderate and moderate or high cardiorespiratory fitness compared to low fitness
Lymphoma

Good evidence of lower risk of lymphoma among people with higher levels of physical activity
Melanoma

Weak evidence of lower risk of melanoma among people with higher levels of physical activity compared to low levels, but only if exposure to UV radiation is not increased with activity
Myeloma

Good evidence of lower risk of myeloma among people with higher levels of physical activity
Ovarian cancer

Good evidence of lower risk of ovarian cancer among people with higher levels of physical activity and less sitting time
Pancreatic cancer

Strong evidence of lower risk of pancreatic cancer among people with higher levels of overall physical activity

Preliminary evidence of lower risk of pancreatic cancer among people with recreational activity

Weak evidence of a slightly higher risk of pancreatic cancer among people doing muscle-strengthening exercises
Prostate cancer

Weak evidence of a lower risk of prostate cancer recurrence among men with the highest levels of physical activity

Preliminary evidence of lower risk of prostate cancer among people with higher levels of physical activity
Eating Well combined with other behaviors

Modest evidence of lower risk of cancer as a whole and of several specific cancer types among people with higher adherence to World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations regarding diet, physical activity, and body weight

Modest evidence of lower risk of lethal prostate cancer among men practicing healthy lifestyle behaviors, including physical activity

Authors

Jane Liaw, MPH

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Jane Liaw is a science writer and the assistant director of Art of Writing at UC Berkeley. She previously worked at the UC Berkeley School of Public Health as a researcher, program and grants administrator, and scientific writer and editor. She holds an MPH in Environmental Health Sciences from UC Berkeley, a graduate degree in science communication from UC Santa Cruz, and a BS in Earth Systems from Stanford University.

Jane Liaw, MPH

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Last update: October 3, 2024

Last full literature review: September 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

 

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