Aerobic Physical Activity Linked to Reduced Depression in Cancer Patients: JAMA

The research, published in JAMA Network Open, revealed that APA was linked to modest reductions in depression both in the short term and long term among adults with cancer. The researchers advise recommending aerobic physical activity to adults with cancer as a means to help reduce depression.

Depression is a common and debilitating condition that affects many individuals diagnosed with cancer. The emotional toll of a cancer diagnosis, along with the physical side effects of treatment, often exacerbates feelings of hopelessness and anxiety. Traditional therapeutic approaches for managing depression may not be sufficient on their own, prompting researchers to explore complementary strategies, such as physical activity.

While aerobic physical activity is recognized as an effective strategy for managing depression in the general population, its effectiveness in alleviating depressive symptoms among cancer patients needs further investigation. To fill this knowledge gap, Matthew Kulchycki, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, and colleagues aimed to assess whether APA reduces the severity of depression in cancer patients by synthesizing data from published randomized clinical trials (RCTs).

For this purpose, the researchers systematically searched six databases for relevant citations published from January 1, 1980, to July 5, 2023. This systematic review and meta-analysis included RCTs that compared APA interventions with usual care, waitlist control, or attention control for managing depression in cancer patients, regardless of age or cancer type.

Two reviewers independently conducted the screening and data extraction, assessing the risk of bias using the Cochrane Risk of Bias Tool, version 2, while adhering to the PRISMA guidelines. Standardized mean differences (SMDs) were calculated using a random-effects model. Data collection and analyses took place from June 2022 to March 2024.

The primary outcome measured was the severity of self-reported depression within one-month post-intervention (short-term). Secondary outcomes included depression severity between one and six months post-intervention (medium-term) and between six and twelve months post-intervention (long-term).

The meta-analysis included 25 randomized controlled trials (RCTs) involving 1,931 adults with cancer aged 18 to 80 years. Based on the study, the researchers reported the following findings:

• Among these studies, ten RCTs exhibited a low risk of bias.
• Aerobic physical activity was associated with a reduction in self-reported depression among the participants (SMD, −0.3).
• The reduction in depression scores was statistically significant for long-term outcomes in three trials (n = 299 participants; SMD, −0.32).
• There was no significant impact on medium-term depression across two trials (n = 143 participants; SMD, −0.27.

The findings of the review highlight the importance of prioritizing trials focused on understudied populations, such as children with cancer and individuals with metastatic disease. This approach is essential for gaining a more comprehensive understanding of the potential benefits of aerobic physical activity in alleviating depression within these groups.

"Future research should also explore the effectiveness of APA in conjunction with other strategies for managing depression among diverse cancer patient populations," the researchers concluded.

Reference:

Kulchycki M, Halder HR, Askin N, et al. Aerobic Physical Activity and Depression Among Patients With Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(10):e2437964. doi:10.1001/jamanetworkopen.2024.37964