Abstract
Existing literature suggests that cancer survivors present with high rates of morbidity due to various treatment and disease induced factors. Research globally has shown exercise to be beneficial in improving treatment outcomes and quality of life. India has a high prevalence of cancer and not much is known about exercise interventions for cancer survivors in India. This review was planned to review the state of exercise based interventions for cancer survivors in India. A comprehensive literature search was performed in PubMed, CINAHL, EMBASE, Scopus, Cochrane Library, PEDro, IndMed, and Shoda Ganga. The search results were screened and data extracted by two independent reviewers. All eligible studies were assessed for methodological quality rating using Downs and Black checklist. Data was extracted using a pilot tested pro forma to summarize information on site and stage of cancer, type of exercise intervention and outcome measures. The review identified 13 studies, published from 1991 to 2013, after screening 4060 articles. Exercise interventions fell into one of three categories: (1) yoga-based, (2) physiotherapy-based and (3) speech therapy based interventions; and exclusively involved either breast or head and neck cancers. Studies were generally of low to moderate quality. A broad range of outcomes were found including symptoms, speech and swallowing, and quality of life and largely supported the benefits of exercise-based interventions. At present, research involving exercise-based rehabilitation interventions in India is limited in volume, quality and scope. With the growing burden of cancer in the country, there is an immediate need for research on exercise based interventions for cancer survivors within the sociocultural context of India.
Highlights
India is a large low-middle income country with a significant cancer burden
Significant advances in diagnosis and treatment of cancer has led to an increase in the proportion of cancer survivors. 10 years survival for various cancer sites in India is estimated to range from 6.4 % for cancer of oesophagus to 50.9 % for cancer of lips (Takiar et al 2014)
We included randomized controlled trials (RCT), non-randomized controlled trials, single group pre-post intervention studies, case series and case reports that evaluated exercise interventions among cancer survivors in India
Summary
India is a large low-middle income country with a significant cancer burden. Cancer incidence in India is projected to increase from 1.01 million in 2012 to 1.4 million by 2025 (Mathers et al 2012). Significant advances in diagnosis and treatment of cancer has led to an increase in the proportion of cancer survivors. Cancer survivors frequently report adverse effects of surgery, chemotherapy and radiotherapy such as fatigue, anxiety, depression, loss of appetite, impaired joint range of motion, exercise intolerance and physical inactivity (Hewitt et al 2003; Jones et al 2009). These secondary complications of cancer treatment negatively impact quality of life of cancer survivors (Osborn et al 2006; Naughton and Weaver 2014; Curt et al 2000). Exercise interventions involving cancer survivors have been shown to reduce cancer related fatigue, body weight and body mass index (Brown et al 2011; Fong et al 2012; Strasser et al 2013); improve muscle function, body composition, peak oxygen consumption, peak power output and exercise tolerance (Jones et al 2009; Fong et al 2012; Strasser et al 2013); Samuel et al SpringerPlus (2015) 4:655 and improve quality of life and survival (Fong et al 2012; Mishra et al 2012; Meyerhardt et al 2006a, b)
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