Impact of exercise on psychological burden in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study Journal Article


Authors: Tonorezos, E. S.; Ford, J. S.; Wang, L.; Ness, K. K.; Yasui, Y.; Leisenring, W.; Sklar, C. A.; Robison, L. L.; Oeffinger, K. C.; Nathan, P. C.; Armstrong, G. T.; Krull, K.; Jones, L. W.
Article Title: Impact of exercise on psychological burden in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study
Abstract: Background: Childhood cancer survivors are at risk for adverse psychological outcomes. Whether exercise can attenuate this risk is unknown. Methods: In total, 6199 participants in the Childhood Cancer Survivor Study (median age, 34.3 years [range, 22.0-54.0 years]; median age at diagnosis, 10.0 years [range, 0-21.0 years]) completed a questionnaire assessing vigorous exercise and medical/psychological conditions. Outcomes were evaluated a median of 7.8 years (range, 0.1-10.0 years) later and were defined as: symptom level above the 90th percentile of population norms for depression, anxiety, or somatization on the Brief Symptom Inventory-18; cancer-related pain; cognitive impairment using a validated self-report neurocognitive questionnaire; or poor health-related quality of life. Log-binomial regression estimated associations between exercise (metabolic equivalent [MET]-hours per week−1) and outcomes adjusting for cancer diagnosis, treatment, demographics, and baseline conditions. Results: The prevalence of depression at follow-up was 11.4% (95% CI, 10.6%-12.3%), anxiety 7.4% (95% CI, 6.7%-8.2%) and somatization 13.9% (95% CI, 13.0%-14.9%). Vigorous exercise was associated with lower prevalence of depression and somatization. The adjusted prevalence ratio for depression was 0.87 (95% CI, 0.72-1.05) for 3 to 6 MET hours per week−1, 0.76 (95% CI, 0.62-0.94) for 9 to 12 MET-hours per week−1, and 0.74 (95% CI, 0.58-0.95) for 15 to 21 MET-hours per week−1. Compared with 0 MET hours per week−1, 15 to 21 MET-hours per week−1 were associated with an adjusted prevalence ratio of 0.79 (95% CI, 0.62-1.00) for somatization. Vigorous exercise also was associated with less impairment in the physical functioning, general health and vitality (Ptrend <.001), emotional role limitations (Ptrend =.02), and mental health (Ptrend =.02) domains as well as higher cognitive function in the domains of task completion, organization, and working memory (P <.05 for all), but not in the domain of cancer pain. Conclusions: Vigorous exercise is associated with less psychological burden and cognitive impairment in childhood cancer survivors. © 2019 American Cancer Society
Keywords: late effects; depression; survivorship; physical activity; psychosocial
Journal Title: Cancer
Volume: 125
Issue: 17
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2019-09-01
Start Page: 3059
End Page: 3067
Language: English
DOI: 10.1002/cncr.32173
PUBMED: 31067357
PROVIDER: scopus
PMCID: PMC6690787
DOI/URL:
Notes: Article -- Export Date: 30 August 2019 -- Source: Scopus
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MSK Authors
  1. Charles A Sklar
    286 Sklar
  2. Lee Winston Jones
    113 Jones