Doing this can improve quality of life for older cancer patients

Exercise can substantially reduce depression and anxiety, and improve quality of life for older people battling cancer, according to a paper in JAMA Network Open.

The meta-analysis and review published Feb. 4, 2025, looked at 27 randomized clinical trials involving nearly 2,000 participants over the age of 60. The authors estimated exercise reduced depression by about 50 percent and anxiety by about 40 percent, and improved quality of life by about 60 percent.

When the exercise included “mind body” activities such as yoga and tai chi, depression reduced by nearly 90 percent and anxiety by 77 percent. The results were calculated as standard mean differences, a method of making data from various studies comparable.

The authors wrote that 30-35 percent of cancer patients get diagnosed with a psychiatric disorder and have 4.4-times higher risk of suicide. Older adults, who comprise two-thirds of new cancer diagnoses, may also be frail, have comorbidities, such as diabetes or cardiovascular disease, and have lower physical and mental reserves to deal with problems arising from cancer and treatment, which usually involves surgery, radiation and chemotherapy and/or immunotherapy.

Exercise Helps

Physical activity boosts patients’ health and mood, said Kristine Whaples, a registered clinical physiologist who ran an exercise program for Cape Cod Healthcare adult cancer patients from 2013 until late 2024 and now works in Cape Cod Hospital’s cardiac maintenance program.

According to Whaples, exercise for older cancer patients:

• Reduces the fatigue patients develop while they’re going through their treatment.
• Improves strength.
• Improves cognitive issues.
• Can also improve sleep and foster the body’s production of neurotransmitters in the brain and certain hormones that boost mood.
• Helps monitor weight.
• Improves glucose control.
• Alleviates arthritis pain.

“They start feeling better because their comorbidities are being controlled,” she said.

The researchers wrote that previous studies had found exercise also helps mitigate side effects of chemotherapy and fights tumor growth and inflammation. They cited a 2018 American College of Sports Medicine Roundtable that said exercise can improve anxiety, depression and quality of life in all cancer patients. Mind-body exercise appeared to be more beneficial for older cancer patients than younger ones, who preferred more higher-activity exercise.

“To our knowledge, this is the first systemic review and meta-analysis investigating the association of exercise with improving anxiety, depression and HRQOL (health-related quality of life) in older adults with cancer,” they wrote.

Recommendations

Exercise can reverse the downward trend of cancer patients becoming more sedentary, which leads to muscle atrophy, weakness and fatigue, which, in turn, makes it more difficult to exercise, Whaples said. Older people are already prone to losing muscle as they age, a condition called sarcopenia.

“We want people to move as soon as possible,” she said. “When someone is tired, they stop exercising; they decondition.”

Older cancer patients should ease into exercise with regular moderate activity. If they push themselves too hard at first, they may feel sore and think they’ve hurt themselves.

“We want them to start slow,” Whaples said.

Patients should incorporate something like meditative walking as part of their cool down, Whaples said.

“We keep our minds too busy sometimes. We just need to quiet the mind,” she said, and mind-body exercises can help meet that goal.

She recommended some exercise every day, and switching up activities to keep it interesting. Adding balance work can help maintain the brain’s control of muscles and reduce falls, she added.

Cancer may cause feelings of fear and helplessness, as “a lot of this is out of their control,” Whaples said. Maintaining a regular exercise routine can provide patients a sense they’re doing something constructive in their fight.