For years, exercise in oncology was viewed mainly as supportive care. That view is changing.
A new scoping review examining exercise engagement during lung cancer treatment highlights an important reality: many people with lung cancer want to remain active during treatment—but the design of the exercise program often determines whether that happens.
The review analyzed 25 studies and identified 31 barriers and 42 facilitators that influence whether patients participate in exercise while receiving lung cancer treatment.
Why This Matters for CancerFitness.org
Exercise Oncology continues to move from “proof of concept” toward implementation. While definitive evidence that exercise directly improves lung cancer treatment response is still evolving, researchers note biologically plausible mechanisms—including improved tumor oxygenation, reduced inflammation, and enhanced immune activity—that may support treatment effectiveness. At the same time, exercise consistently improves physical function, quality of life, and resilience during treatment.
But there is a problem:
Patients cannot benefit from exercise programs they cannot realistically complete.
The Biggest Barriers: Fatigue, Symptoms, and Life Itself
The most common obstacle was not motivation—it was fatigue.
Patients also struggled with:
- Treatment side effects that fluctuate across treatment cycles
- Shortness of breath
- Pain and discomfort
- Anxiety and depression
- Travel burden to exercise locations
- Competing treatment schedules
- Lack of information about what exercise is safe
- Fear that exercise could worsen symptoms
- Limited referral pathways from healthcare teams
These findings reinforce something CancerFitness.org has emphasized repeatedly:
Cancer patients are not failing exercise programs—exercise programs are often failing to adapt to cancer patients.
What Actually Helps Patients Stay Active?
The strongest facilitators were remarkably practical.
Programs worked better when they were:
- Personalized to symptoms, treatment schedules, and goals
- Flexible in intensity and duration
- Home-based or community-accessible
- Supervised (in person or virtually)
- Supported by peers and healthcare professionals
- Built with clear education and realistic expectations
- Structured with accountability and progress tracking
One of the most encouraging findings: among studies that reported safety outcomes, serious exercise-related adverse events were not observed. Only minor events such as fatigue and muscle soreness were reported.
The Bigger Opportunity: Exercise as Adjunctive Cancer Care
This review points toward an important future.
Rather than asking patients to fit into rigid exercise prescriptions, oncology programs should build treatment-specific, patient-centered Exercise Oncology services integrated into routine cancer care.
That means:
- Assessing fitness at diagnosis
- Tailoring exercise to treatment cycles
- Including nutrition and psychosocial support
- Engaging caregivers and family
- Offering hybrid in-person and virtual options
- Embedding exercise professionals into oncology teams
CancerFitness.org Call to Action
If you or someone you love is undergoing lung cancer treatment, do not assume exercise is “all or nothing.”
Small, individualized, supervised movement programs may help preserve strength, maintain independence, improve quality of life, and keep patients engaged in their care journey.
The future of Exercise Oncology is not prescribing more exercise.
It is delivering the right exercise, for the right patient, at the right time.
Reference: Barriers and facilitators to exercise engagement during lung cancertreatment: a scoping review. Matthew Beggs, Joanne Reid, Gerard G Hanna, Gillian Prue. Cancer Causes & Control (2026), https://doi.org/10.1007/s10552-026-02177-6
