Associations of Physical Activity and Exercise with Health-related Outcomes in Patients with Melanoma During and After Treatment: A Systematic Review

Abstract

Purpose: Although exercise medicine is recommended to counter treatment-related side-effects and improve health-related outcomes of patients affected by different cancers, no specific recommendations exist for patients with melanoma. As a result, we systematically examined the current evidence regarding the effects of physical activity and exercise on objectively-measured and patient-reported outcomes among patients with melanoma. Methods: Searches were conducted in PubMed, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases. This review included published data involving physical activity or exercise and objectively-measured or patient-reported outcomes of patients with cutaneous melanoma. The quality of included studies was assessed using the McMaster University Critical Appraisal Tool for Quantitative Studies. Results: Six studies including 882 patients with melanoma were included. Studies presented heterogeneity of design with 2 cross-sectional surveys, 2 retrospective analyses, and 2 non-randomized intervention trials. No statistically significant change in quality of life, fatigue, physical function, cardiorespiratory fitness, body composition, psychological distress, cognitive function, or treatment-related side-effects were attributable to physical activity or exercise. Importantly, physical activity or exercise during melanoma treatment or into survivorship did not adversely impact patients/survivors. Conclusion: In summary, physical activity or exercise did not adversely impact quality of life, objectively-measured or patient-reported outcomes in patients with melanoma. In addition, there is a paucity of quality studies examining the effects of physical activity or exercise on patients with melanoma throughout the cancer care continuum.

Impact of Physical Exercise on Melanoma Hallmarks: Current Status of Preclinical and Clinical Research

“…However, poor evidence is currently available concerning feasibility and benefits of physical activity in melanoma patients. Moreover, only few clinical studies have been conducted to examine the feasibility of exercise protocols executed during cancer therapy 120 .…”

“…However, preclinical studies in melanoma murine models, aiming at showing the desirable synergism with ICIs, were unsuccessful. Nonetheless, a recent clinical study tried to define feasibility, safety, and effects of a telehealth exercise program in patients (n = 11) with advanced melanoma (stage III-IV) receiving ICIs [122]. The 8-weeks long intervention included resistance, aerobic, and balance exercises, undertaken three times per week, with assessments at baseline and post-intervention.…”

Feasibility of supervised telehealth exercise for patients with advanced melanoma receiving checkpoint inhibitor therapy

“…When utilised as adjuvant therapy within these cancer populations, exercise can alleviate a range of treatment‐related side effects such as sarcopenia, lymphoedema, metabolic syndrome, myalgia and arthralgias, in addition to improvements in physical, functional and psychological distress outcomes 4–7 . However, for patients with melanoma, there is a paucity of evidence as to the feasibility and benefits of exercise 8 . As observed in a recent systematic review from our team, 8 most studies in patients with melanoma focused on cross‐sectional/retrospective data and only a few investigated feasibility when exercise is undertaken during treatment 8 .…”

“… 4 , 5 , 6 , 7 However, for patients with melanoma, there is a paucity of evidence as to the feasibility and benefits of exercise. 8 As observed in a recent systematic review from our team, 8 most studies in patients with melanoma focused on cross‐sectional/retrospective data and only a few investigated feasibility when exercise is undertaken during treatment. 8 This indicates that the positive effects of exercise seen in other cancers are yet to be demonstrated in patients with melanoma.…”

“… 8 As observed in a recent systematic review from our team, 8 most studies in patients with melanoma focused on cross‐sectional/retrospective data and only a few investigated feasibility when exercise is undertaken during treatment. 8 This indicates that the positive effects of exercise seen in other cancers are yet to be demonstrated in patients with melanoma. Concurrently, as melanoma is currently one of the few cancers for which immunotherapy is commonly prescribed, a novel opportunity exists to test exercise medicine in patients receiving this effective treatment.…”