Shugo Yajima, Shin Kobayashi, Tadayoshi Hashimoto and Hitoshi Masuda
Frontiers in Oncology frontiersin.org
Summary
This mini review from Japan highlights the pivotal role of physical activity across the cancer care continuum for older adults. With cancer incidence rising with age, older patients face challenges such as comorbidities, frailty, and functional decline. Current evidence indicates that regular moderate activity reduces the risk of several cancers by 10–20%, improves immune surveillance, attenuates inflammation, and enhances metabolic regulation. Epidemiological studies, including large, pooled cohorts and objective accelerometer data, consistently show lower cancer incidence among more active individuals.
In the perioperative context, prehabilitation—exercise combined with nutrition and psychological support—improves preoperative functional capacity and shortens hospital stay. Postoperatively, early mobilization supports gastrointestinal, pulmonary, and vascular recovery, while minimizing complications. Beyond structured exercise, reducing sedentary behavior and incorporating light daily activity are crucial, with even household tasks linked to survival benefits.
For cancer survivors, physical activity is associated with significant reductions in all-cause (≈37–39%) and cancer-specific mortality (≈37%), alongside lower recurrence risk. Quality of life is consistently enhanced, with improvements in fatigue, mood, sleep, and cognitive function. Mind-body practices such as yoga and Tai Chi represent accessible alternatives for older adults with physical limitations.
Clinical Implications
Clinicians should regard physical activity as a non-pharmacologic, evidence-based intervention integral to cancer care for older adults. Importantly:
- Assessment and prescription: Functional assessments (e.g., Short Physical Performance Battery, CARG score) can guide safe, individualized exercise prescriptions.
- Implementation barriers: Frailty, comorbidities, fear, and systemic issues (limited provider training, lack of referral pathways) impede adoption. Addressing these requires education, structured programs, and policy support.
- Tailored approaches: A “one-size-fits-all” model is inadequate. Exercise should be precision-prescribed, accounting for tumor type, treatment stage, and functional status.
Focused Summary for Clinicians
Physical activity should be embedded into standard geriatric oncology practice. Even modest or low-intensity activity confers meaningful benefits in prevention, perioperative recovery, survivorship, and overall quality of life. Clinicians should prioritize counseling, refer to qualified exercise professionals, and encourage sustainable, individualized activity plans to enhance resilience and outcomes in older cancer patients.
