Promoting Physical Activity in Pediatric Oncology. Where Do We Go from Here

Advances in treatment and technology over the last 30 years are credited with the improved survival rates (in excess of 80%) in pediatric oncology (1). This growing survivor population has resulted in an increased awareness among clinicians about the negative side effects that may develop after treatments (1, 2). Physical side effects may include diminished muscular strength, peripheral neuropathy, decreased functional capacity, and increased fatigue (3–6). Psychosocial side effects may include elevated levels of fear and anxiety, poor social functioning, and decreased health related quality of life (HRQoL). These physical and psychosocial side effects are well-documented consequences of childhood cancer and occur in at least half of the population (4, 5, 7–10). These common physical and psychosocial side effects, in combination with a sedentary lifestyle, may further aggravate and accelerate the development of physical inactivity-related diseases such as hypertension, diabetes, coronary artery disease, osteoporosis, and cancer recurrence (11–13). The Childhood Cancer Survivor Study found that 62% of childhood cancer survivors had at least one chronic condition and 27.5% had a severe, life-threatening, or disabling condition (1). Recently, physical activity (PA) intervention research has emerged as a promising adjuvant therapy to mitigate the negative effects of cancer and its treatment. In this opinion article: (1) the rationale for PA in pediatric cancer (patients and survivors) will be summarized, (2) the challenges to promoting PA behaviors in this population will be discussed, and (3) our vision for the next steps (research, education, and knowledge translation) will be highlighted.