Exercise is now recognized as an essential component of cancer care. Research consistently shows that physical activity can improve strength, reduce fatigue, enhance mental well-being, and improve quality of life for people living with and beyond cancer. But an important question remains: how should exercise be prescribed for individual cancer patients?
A recent systematic review and meta-analysis examined this issue by evaluating how exercise programs are individualized in oncology research and how these strategies affect symptoms such as cancer-related fatigue. The study analyzed 63 clinical trials involving 4,472 cancer patients, making it one of the most comprehensive reviews of personalized exercise prescription in cancer care.
The results highlight an important message for both cancer survivors and cancer healthcare providers: effective exercise programs must be tailored to the unique needs of each individual.
Why Individualized Exercise Matters
Cancer survivors frequently experience fluctuating symptoms such as fatigue, pain, sleep disturbance, and emotional stress. These symptoms can vary from day to day depending on treatment schedules, medications, and overall health.
Because of this variability, a standardized or “one-size-fits-all” exercise program may not provide optimal results. Instead, exercise prescriptions should be adapted to each patient’s physical condition, treatment status, and daily capacity.
Personalized exercise programs can help:
- Reduce cancer-related fatigue
- Improve physical function and strength
- Enhance quality of life
- Support long-term physical activity adherence
- Reduce injury risk
For cancer survivors, this means exercise becomes more than general fitness—it becomes a therapeutic component of survivorship care.
How Exercise Was Individualized in Studies
The review evaluated three key aspects of individualized exercise programs: why the program was personalized, when adjustments occurred, and how the exercise prescription was modified.
Objective Testing
About 41% of studies used objective testing to determine exercise prescriptions.
These tests included measures such as:
- Cardiopulmonary exercise testing
- Six-minute walk tests
- Strength assessments
- Heart rate monitoring
Objective testing helps clinicians determine a patient’s baseline fitness and establish safe exercise intensities.
Patient-Reported Feedback
Approximately 30% of studies used subjective information, such as patient-reported fatigue, physical ability, symptoms, and exercise preferences.
Interestingly, the review found that exercise programs adjusted based on patient feedback were significantly associated with greater reductions in fatigue. This suggests that listening to patients’ experiences during treatment is a critical part of effective exercise prescription.
Timing of Adjustments
Another key finding involved when exercise prescriptions were modified.
Programs were individualized at several points:
- Before the exercise program began
- Before each training session
- During exercise sessions
- Between exercise sessions
The researchers found that adjusting exercise programs between sessions produced the greatest improvement in cancer-related fatigue.
This approach allows clinicians to review how patients responded to previous sessions and modify upcoming workouts accordingly.
A Gap in Exercise Oncology Research
Despite widespread recognition of the importance of individualized exercise, the review revealed a major limitation in the literature.
Only about half of the studies clearly described how exercise programs were individualized, making it difficult for clinicians to replicate successful approaches in clinical practice.
Improved reporting and standardized methods for prescribing exercise will help translate research findings into better patient care.
The Promise of Autoregulated Exercise
One promising strategy highlighted in the review is exercise autoregulation, which adjusts exercise intensity based on how a patient feels on a given day.
For example:
- Reducing exercise intensity when fatigue is high
- Increasing workload when energy levels improve
- Modifying training volume during treatment cycles
Although experts increasingly recommend this approach, only two studies in the review explicitly used autoregulation, indicating an important opportunity for future research.
The Bottom Line
Exercise is increasingly recognized as a cornerstone of cancer survivorship care. However, the greatest benefits occur when exercise programs are personalized, flexible, and responsive to each patient’s symptoms and recovery process.
For cancer survivors and their healthcare providers, the message is clear:
Personalized exercise is not optional—it is essential for optimizing recovery, reducing fatigue, and improving long-term health after cancer.
Reference: Individualisation of Exercise Prescription in Cancer: A Systematic Review and Meta- Analysis. Brent Cunningham1, Jamie E. Chong, Ciaran M. Fairman, Matthew D. Jones, Tina L. Skinner and Grace L. Rose. Sports Medicine – Open (2026) 12:15
