Muscle strength and cardiorespiratory fitness linked to improved cancer survival rates

24th January 2025

Good physical fitness combined with muscular strength could reduce cancer patient deaths, a recent study suggests.

Researchers found that tailored exercise plans may prolong life for people living with cancer and boost their chances of survival. The study, published in the British Journal of Sports Medicine, could have implications for clinical practice, with muscle strength exercises employed to increase life expectancy.

The international researchers, led by Edith Cowan University in Australia, pooled data from 42 studies published in English in five databases up to August 2023 to examine whether physical fitness could extend survival rates in cancer patients. The 47,694 patients in the studies had an average age of 64 and had been diagnosed with various types and stages of cancer.

Muscle strength was determined by handgrip strength measurements. Depending on age, a handgrip strength of below 13 kg to below 25 kg was classified as low strength for women. Low strength was classified as below 20 kg to below 40 kg for men. Cardiorespiratory fitness was assessed using either cardiopulmonary exercise testing (CPET) or a six-minute walk test (MWT).

The analysis suggested that both muscular strength and good physical fitness are associated with a significantly lower risk of death from any cause in cancer patients. Patients who maintained strong muscles and good overall fitness had a 31-46% lower risk of dying from any cause compared to those with poor muscle strength and low cardiorespiratory fitness. This risk continued to fall by 11% for each unit increase in muscular strength and 18% for each unit increment in cardiorespiratory fitness.

In patients with advanced-stage cancer (stages 3 and 4), muscle strength and cardiorespiratory fitness were associated with an 8-46% reduced risk of all-cause mortality and a 19-41% lower risk of death from any cause among those with lung or digestive cancers.

‘Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in cancer patients in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy,’ the researchers concluded.

A previous study published in the same journal suggested that young men with a higher level of cardiorespiratory fitness had a significantly lower risk of developing several cancers in later life.

A version of this article was originally published by our sister publication Nursing in Practice.

Muscle-strengthening activities reduces CVD, cancer and all-cause mortality risk

11th March 2022

Muscle-strengthening activities independent of aerobic activity are linked to a reduced risk of CVD, cancer and all-cause mortality

Undertaking muscle-strengthening activities, independently of aerobics, reduces the risk of cardiovascular disease (CVD), total cancer and all-cause mortality. This was the main finding from a meta-analysis by researchers from the Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Miyagi, Japan.

Increasing muscle strength is recognised as a marker of good health and the World Health Organization recommends regular muscle-strengthening activity for all age groups. 

The importance of muscle-strengthening activities was highlighted in a 2018 review which concluded that higher levels of upper- and lower-body muscular strength are associated with a lower risk of mortality in the adult population, regardless of age and follow-up period.

Moreover, grip strength, which is a marker for overall strength, has also been found to be an independent predictor of all-cause mortality and cardiovascular diseases.

Although aerobic activities have become an established route for reducing both CVD and all-cause mortality risk, the relationship with muscular strength has been less well studied. For the present analysis, the Japanese team looked at the strength of the association between muscle-strengthening activities and the risk of CVD, cancer and mortality in adults.

In addition, they were wanted to determine the dose-response relationship with health outcomes and also whether there were synergistic benefits from combing muscle strengthening and aerobic activities.

The team searched all the major databases from inception to 2020 for studies which considered the health outcomes from muscle strengthening activities in those without severe health conditions such as cancer at baseline.

Muscle strengthening activities and health outcomes

A total of 16 studies were included in the final analysis which covered all-cause mortality (8), CVD (9), total cancer (7), type 2 diabetes (5) and site-specific cancers (2). The number of participants varied between 3809 to 479,856 and the median duration of follow-up was 25.2 years and included patients 18 to 97 years of age.

Among studies which considered all-cause mortality, muscle-strengthening activities were associated with a 15% reduced risk of death (relative risk, RR = 0.85, 95% CI 0.79 – 0.93, p < 0.001). With respect to the duration of activities, the lowest RR was seen at 40 minutes/week (RR = 0.83, 95% CI 0.79 – 0.86). Combing muscle and aerobic activities led to a 40% lower mortality risk (RR = 0.60, 95% CI 0.54 – 0.67) compared to no activity.

For CVD, there was a 17% lower risk from undertaking muscle-strengthening exercises (RR = 0.83, 95% CI 0.73 – 0.93) and the lowest relative risk occurred with training for at least 60 minutes/week (RR = 0.82, 95% CI 0.76 – 0.90).

Finally, muscle-strengthening activities led to a 12% lower risk of total cancer incidence (RR = 0.88) and a 17% lower incidence of diabetes (RR = 0.83).

Discussing their findings, the authors noted that there was a J-shaped relationship between muscle-strengthening activities and all-cause, CVD and total cancer mortality, with the greatest benefit (i.e., highest risk reduction) after 30 to 60 minutes/week of activities.

They concluded that the greatest benefit was accrued from combining muscle and aerobic activities although added the caveat that since the available data are currently limited, further studies are required to increase the certainty of the evidence.

Citation
Momma H et al. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies Br J Sports Med 2022