Muscular strength and cardiorespiratory fitness may be associated with a lower risk of all-cause mortality in patients with cancer, according to a recent study published by Bettariga et al in the British Journal of Sports Medicine. The findings indicated that a tailored exercise regimen may improve survival among this patient population.
Background
In 2022, there were 20 million newly diagnosed cases of cancer and more than 9.5 million cancer-related deaths across the world—trends that are projected to rise in the coming decades. Despite notable advances in cancer prevention, diagnosis, and treatment, the adverse effects of treatment, including those on the heart and muscles, can take their toll on survival.
Study Methods and Results
In a systematic review and meta-analysis, investigators examined whether muscular strength and cardiorespiratory fitness were associated with a lower risk of mortality in patients with cancer and whether cancer type and stage were factors that influenced the potential benefit of muscle strength and physical activity. They sought to inform potential options for extending survival.
The investigators identified 42 studies published in English up to August 2023 that involved nearly 47,000 patients with an average age of 64 years who had been diagnosed with various types and stages of cancers. They used handgrip strength to classify low muscle strength as either less than 13 kg to less than 25 kg in female patients and less than about 20 kg to less than 40 kg in male patients. Cardiorespiratory fitness was assessed using either cardiopulmonary exercise testing or the 6-minute walk test.
The pooled data analysis of the study results demonstrated that both muscular strength and cardiorespiratory fitness were correlated with the risk of all-cause and cancer-related mortality. Compared with those who had poor muscle strength and low levels of cardiorespiratory fitness, the patients with greater muscle strength and higher levels of cardiorespiratory fitness were 31% to 46% less likely to die from any cause. The risk fell by 11% with each 1 unit increase in muscular strength.
In addition, the combination of muscle strength and cardiorespiratory fitness was associated with an 8% to 46% lower risk of all-cause mortality among patients with stage III and IV cancer and a 19% to 41% lower risk of all-cause mortality among those with lung or digestive cancers. Each 1 unit increase in cardiorespiratory fitness level was associated with an 18% lower risk of cancer-related mortality.
Conclusions
“Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in patients [with cancer] in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy,” concluded the study authors.
Disclosure: For full disclosures of the study authors, visit bjsm.bmj.com.
