{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:15:27Z","timestamp":1760055327523,"version":"build-2065373602"},"reference-count":77,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alberta Innovates Cancer Prevention Research Opportunity"},{"DOI":"10.13039\/501100000001","name":"Alberta Cancer Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000001","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Exercise has been found to be safe and beneficial for people with advanced cancers, but more research is needed to understand how best to design and implement exercise programming. The Alberta Cancer Exercise (ACE) study examines the effectiveness and implementation of a 12-week community-based exercise program in Alberta, Canada, for people diagnosed with cancer. Here, we describe the characteristics of individuals with metastatic cancer enrolled in the ACE program and report 12-week changes in self-reported and objective outcomes. Of 306 participants, 274 (89.5%) completed the 12-week study. Many participants were female (65.4%), with \u22651 comorbidity (71.9%), and on active cancer treatment (74.8%). Common cancer types included breast (33.7%), genitourinary (16.7%), and digestive (15.0%). Frequent sites of metastasis were bone (44.8%), liver (28.8%), and lung (25.8%). The mean exercise attendance rate was 73.6%. One exercise-related adverse event (0.3%) and one non-exercise-related adverse event (0.3%) occurred, both in individuals with brain metastases. Participants demonstrated strong interest and engagement in exercise, with significant improvements in weekly physical activity, symptoms, quality of life, and physical fitness. Greater benefits were found among subgroups of male participants, those not undergoing chemotherapy, and those receiving group personal training or virtual circuit training. A low rate of adverse events is anticipated.<\/jats:p>","DOI":"10.3390\/curroncol32100560","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T08:05:36Z","timestamp":1759824336000},"page":"560","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline Characteristics of Individuals with Metastatic Cancer Enrolled in the Alberta Cancer Exercise Study and 12-Week Findings for Symptom-Related and Physical Fitness Measures"],"prefix":"10.3390","volume":"32","author":[{"given":"Shirin M.","family":"Shallwani","sequence":"first","affiliation":[{"name":"Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Nicole","family":"Culos-Reed","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-3918","authenticated-orcid":false,"given":"Kerry S.","family":"Courneya","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB T6G 2H9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Williamson","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Sellar","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0947-933X","authenticated-orcid":false,"given":"Harold","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Calgary, 3395 Hospital Drive NW, Calgary, AB T2N 5G2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil Abraham","family":"Joy","sequence":"additional","affiliation":[{"name":"Medical Oncology, Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada"},{"name":"Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5270-1050","authenticated-orcid":false,"given":"Jacob C.","family":"Easaw","sequence":"additional","affiliation":[{"name":"Medical Oncology, Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada"},{"name":"Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Audoin","sequence":"additional","affiliation":[{"name":"Patient Partner, Cancer Rehabilitation Clinic, University of Alberta; 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith","family":"Pituskin","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4376-4847","authenticated-orcid":false,"given":"Margaret L.","family":"McNeely","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"},{"name":"Cross Cancer Institute, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"ref_1","first-page":"1160","article-title":"Survivorship care for people affected by advanced or metastatic cancer: MASCC-ASCO standards and practice recommendations","volume":"20","author":"Hart","year":"2024","journal-title":"Support Care Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1200\/JCO.2007.12.3075","article-title":"Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer","volume":"26","author":"Cheville","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1002\/pon.4290","article-title":"Systematic review of psychosocial outcomes for patients with advanced melanoma","volume":"26","author":"Dunn","year":"2017","journal-title":"Psycho-Oncology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103728","DOI":"10.1016\/j.critrevonc.2022.103728","article-title":"Unmet supportive care needs of people with advanced cancer and their caregivers: A systematic scoping review","volume":"176","author":"Hart","year":"2022","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e415","DOI":"10.1136\/bmjspcare-2021-002999","article-title":"Symptoms of advanced cancer in palliative medicine: A longitudinal study","volume":"13","author":"Hansen","year":"2023","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.breast.2016.04.004","article-title":"Evolving psychosocial, emotional, functional, and support needs of women with advanced breast cancer: Results from the Count Us, Know Us, Join Us and Here & Now surveys","volume":"28","author":"Cardoso","year":"2016","journal-title":"Breast"},{"key":"ref_7","first-page":"61","article-title":"The detection and treatment of cancer-related functional problems in an outpatient setting","volume":"17","author":"Cheville","year":"2009","journal-title":"Support. Care Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.breast.2016.10.022","article-title":"Is it time to address survivorship in advanced breast cancer? A review article","volume":"31","author":"Pagani","year":"2017","journal-title":"Breast"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.jpainsymman.2019.09.010","article-title":"Exercise training for improving patient-reported outcomes in patients with advanced-stage cancer: A systematic review and meta-analysis","volume":"59","author":"Chen","year":"2020","journal-title":"J. Pain Symptom Manag."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"De Lazzari, N., Niels, T., Tewes, M., and G\u00f6tte, M. (2021). A Systematic review of the safety, feasibility and benefits of exercise for patients with advanced cancer. Cancers, 13.","DOI":"10.3390\/cancers13174478"},{"key":"ref_11","first-page":"3031","article-title":"Safety and feasibility of exercise interventions in patients with advanced cancer: A systematic review","volume":"25","author":"Heywood","year":"2017","journal-title":"Support. Care Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1016\/j.apmr.2018.04.008","article-title":"Efficacy of exercise interventions in patients with advanced cancer: A systematic review","volume":"99","author":"Heywood","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.jpainsymman.2019.07.005","article-title":"The effect of exercise on quality of life, fatigue, physical function, and safety in advanced solid tumor cancers: A meta-analysis of randomized control trials","volume":"58","author":"Nadler","year":"2019","journal-title":"J. Pain Symptom Manag."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1080\/09699260.2015.1123441","article-title":"\u2018I am actually doing something to keep well. That feels really good\u2019: Experiences of exercise within hospice care","volume":"24","author":"Turner","year":"2016","journal-title":"Prog. Palliat. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3714","DOI":"10.1002\/cam4.4746","article-title":"Impact of physical exercise in advanced-stage cancer patients: Systematic review and meta-analysis","volume":"11","year":"2022","journal-title":"Cancer Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1080\/02701367.2019.1687808","article-title":"Physical activity in hospice care: A social ecological perspective to inform policy and practice","volume":"91","author":"Burke","year":"2020","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jpainsymman.2011.08.009","article-title":"Insights into the reluctance of patients with late-stage cancer to adopt exercise as a means to reduce their symptoms and improve their function","volume":"44","author":"Cheville","year":"2012","journal-title":"J. Pain Symptom Manag."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Frikkel, J., G\u00f6tte, M., Beckmann, M., Kasper, S., Hense, J., Teufel, M., Schuler, M., and Tewes, M. (2020). Fatigue, barriers to physical activity and predictors for motivation to exercise in advanced cancer patients. BMC Palliat Care, 19.","DOI":"10.1186\/s12904-020-00542-z"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ejon.2019.04.005","article-title":"Attitudes towards physical activity and exercise in older patients with advanced cancer during oncological treatment\u2014A qualitative interview study","volume":"41","author":"Mikkelsen","year":"2019","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_20","first-page":"1747","article-title":"The views of patients with metastatic prostate cancer towards physical activity: A qualitative exploration","volume":"26","author":"Sheill","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1080\/09638288.2023.2200037","article-title":"Perspectives and experiences of leisure-time physical activity in adults with stage 4 cancer: A qualitative interpretive-description study","volume":"46","author":"Shallwani","year":"2024","journal-title":"Disabil. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Shallwani, S.M., King, J., Thomas, R., Thevenot, O., De Angelis, G., Aburub, A.S., and Brosseau, L. (2019). Methodological quality of clinical practice guidelines with physical activity recommendations for people diagnosed with cancer: A systematic critical appraisal using the AGREE II tool. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0214846"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1017\/S1478951520001327","article-title":"A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer","volume":"19","author":"Shallwani","year":"2021","journal-title":"Palliat. Support. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e029975","DOI":"10.1136\/bmjopen-2019-029975","article-title":"Community-based exercise for health promotion and secondary cancer prevention in Canada: Protocol for a hybrid effectiveness-implementation study","volume":"9","author":"McNeely","year":"2019","journal-title":"BMJ Open"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"McNeely, M.L., Shallwani, S.M., Williamson, T., Sellar, C., Gobeil, E., Joy, A.A., Lau, H., Easaw, J., Sexsmith, J., and Courneya, K.S. (2025). Baseline characteristics of participants in the Alberta Cancer Exercise hybrid effectiveness\u2013implementation study: A wake-up call for action. Cancers, 17.","DOI":"10.3390\/cancers17050772"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lowe, S.S., Watanabe, S.M., Baracos, V.E., and Courneya, K.S. (2013). Home-based functional walking program for advanced cancer patients receiving palliative care: A case series. BMC Palliat. Care, 12.","DOI":"10.1186\/1472-684X-12-22"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e013719","DOI":"10.1136\/bmjopen-2016-013719","article-title":"CanWalk: A feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer","volume":"7","author":"Tsianakas","year":"2017","journal-title":"BMJ Open"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wang, T., Molassiotis, A., Chung, B.P.M., and Tan, J.-Y. (2018). Unmet care needs of advanced cancer patients and their informal caregivers: A systematic review. BMC Palliat. Care, 17.","DOI":"10.1186\/s12904-018-0346-9"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1158\/1055-9965.EPI-10-1319","article-title":"Associations between physical activity and quality of life in a population-based sample of kidney cancer survivors","volume":"20","author":"Trinh","year":"2011","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4103\/aca.ACA_157_18","article-title":"Descriptive statistics and normality tests for statistical data","volume":"22","author":"Mishra","year":"2019","journal-title":"Ann. Card. Anaesth."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0885-3924(02)00529-8","article-title":"Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales","volume":"24","author":"Cella","year":"2002","journal-title":"J. Pain Symptom Manag."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e442","DOI":"10.1200\/OP.21.00407","article-title":"Association between health-related quality of life and progression-free survival in patients with advanced cancer: A secondary analysis of SWOG clinical trials","volume":"18","author":"Hui","year":"2022","journal-title":"JCO Oncol. Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jpainsymman.2016.10.370","article-title":"The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments","volume":"53","author":"Hui","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jpainsymman.2009.06.010","article-title":"A single set of numerical cutpoints to define moderate and severe symptoms for the Edmonton Symptom Assessment System","volume":"39","author":"Selby","year":"2010","journal-title":"J. Pain Symptom Manag."},{"key":"ref_36","unstructured":"EuroQol Research Foundation (2019). EQ-5D-5L User Guide, EuroQol Research Foundation. Available online: https:\/\/euroqol.org\/publications\/user-guides."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1212\/WNL.0000000000003847","article-title":"Reference values for developing responsive functional outcome measures across the lifespan","volume":"88","author":"McKay","year":"2017","journal-title":"Neurology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1123\/japa.7.2.162","article-title":"Functional fitness normative scores for community-residing older adults, ages 60\u201394","volume":"7","author":"Rikli","year":"1999","journal-title":"J. Aging Phys. Act."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/geront\/gns071","article-title":"Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years","volume":"53","author":"Rikli","year":"2013","journal-title":"Gerontologist"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1519\/00139143-200704000-00003","article-title":"Normative values for the unipedal stance test with eyes open and closed","volume":"30","author":"Springer","year":"2007","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e011560","DOI":"10.1136\/bmjopen-2016-011560","article-title":"Review of how we should define (and measure) adherence in studies examining older adults\u2019 participation in exercise classes","volume":"6","author":"Horne","year":"2016","journal-title":"BMJ Open"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Bullard, T., Ji, M., An, R., Trinh, L., Mackenzie, M., and Mullen, S.P. (2019). A systematic review and meta-analysis of adherence to physical activity interventions among three chronic conditions: Cancer, cardiovascular disease, and diabetes. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-6877-z"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2333721418823604","DOI":"10.1177\/2333721418823604","article-title":"Adherence to exercise programs in older adults: Informative report","volume":"5","author":"Fahey","year":"2019","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1017\/S1478951519000312","article-title":"Exercise interventions for patients with advanced cancer: A systematic review of recruitment, attrition, and exercise adherence rates","volume":"17","author":"Sheill","year":"2019","journal-title":"Palliat. Support. Care"},{"key":"ref_45","unstructured":"U.S. Department of Health and Human Services (2025, June 17). Common Terminology Criteria for Adverse Events (CTCAE), Available online: https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/ctcae_v5_quick_reference_5x7.pdf."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jclinepi.2017.06.009","article-title":"Minimal important difference to infer changes in health-related quality of life-a systematic review","volume":"89","author":"Jayadevappa","year":"2017","journal-title":"J. Clin. Epidemiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1477-7525-1-79","article-title":"The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: Properties, applications, and interpretation","volume":"1","author":"Webster","year":"2003","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1002\/cncr.29437","article-title":"Minimal clinically important differences in the Edmonton Symptom Assessment Scale in cancer patients: A prospective, multicenter study","volume":"121","author":"Hui","year":"2015","journal-title":"Cancer"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.jpainsymman.2015.10.004","article-title":"Minimal clinically important difference in the physical, emotional, and total symptom distress scores of the Edmonton Symptom Assessment System","volume":"51","author":"Hui","year":"2016","journal-title":"J. Pain Symptom Manag."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12955-024-02294-3","article-title":"Estimating the minimally important difference for the EQ-5D-5L and EORTC QLQ-C30 in cancer","volume":"22","author":"Bourke","year":"2024","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2519\/jospt.2011.3515","article-title":"A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis","volume":"41","author":"Wright","year":"2011","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.4187\/respcare.06694","article-title":"Minimum clinically important difference in 30-s sit-to-stand test after pulmonary rehabilitation in subjects with COPD","volume":"64","author":"Zanini","year":"2019","journal-title":"Respir. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.gaitpost.2011.02.020","article-title":"Minimum detectable change for single-leg-stance-time in older adults","volume":"33","author":"Goldberg","year":"2011","journal-title":"Gait Posture"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/jep.12629","article-title":"Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: A systematic review","volume":"23","author":"Bohannon","year":"2017","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1111\/j.1532-5415.2006.00701.x","article-title":"Meaningful change and responsiveness in common physical performance measures in older adults","volume":"54","author":"Perera","year":"2006","journal-title":"J Am. Geriatr. Soc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s12603-009-0104-z","article-title":"What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study)","volume":"13","author":"Kwon","year":"2009","journal-title":"J. Nutr. Health Aging"},{"key":"ref_57","first-page":"98","article-title":"Evaluating change in clinical status: Reliability and measures of agreement for the assessment of glenohumeral range of motion","volume":"5","author":"Muir","year":"2010","journal-title":"N. Am. J. Sports Phys. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1093\/jnci\/djac158","article-title":"Estimation of the number of individuals living with metastatic cancer in the United States","volume":"114","author":"Gallicchio","year":"2022","journal-title":"JNCI J. Natl. Cancer Inst."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3304","DOI":"10.1200\/JCO.22.02212","article-title":"Evolving landscape of metastatic cancer survivorship: Reconsidering clinical care, policy, and research priorities for the modern era","volume":"41","author":"Heynemann","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_60","first-page":"1223","article-title":"Symptom clusters in patients with advanced cancers","volume":"17","author":"Cheung","year":"2009","journal-title":"Support. Care Cancer"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.lungcan.2016.06.018","article-title":"Quality of life, symptom status and physical performance in patients with advanced non-small cell lung cancer undergoing chemotherapy: An exploratory analysis of secondary data","volume":"99","author":"Shallwani","year":"2016","journal-title":"Lung Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1097\/IGC.0000000000001287","article-title":"Symptom experience and self-rated physical functioning in patients with ovarian cancer receiving chemotherapy","volume":"28","author":"Vistad","year":"2018","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1002\/hed.20607","article-title":"Changes in body mass, energy balance, physical function, and inflammatory state in patients with locally advanced head and neck cancer treated with concurrent chemoradiation after low-dose induction chemotherapy","volume":"29","author":"Silver","year":"2007","journal-title":"Head Neck"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jgo.2018.04.001","article-title":"Patient- and tumor-related predictors of chemotherapy intolerance in older patients with cancer: A systematic review","volume":"10","author":"Hoeben","year":"2019","journal-title":"J. Geriatr. Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1249\/MSS.0000000000002828","article-title":"Physical fitness and chemotherapy tolerance in patients with early-stage breast cancer","volume":"54","author":"Groen","year":"2022","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"5767","DOI":"10.1002\/cncr.25681","article-title":"Symptom burden and performance status in a population-based cohort of ambulatory cancer patients","volume":"116","author":"Barbera","year":"2010","journal-title":"Cancer"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2750","DOI":"10.1002\/cncr.32860","article-title":"An exercise oncology clinical pathway: Screening and referral for personalized interventions","volume":"126","author":"Stout","year":"2020","journal-title":"Cancer"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"103433","DOI":"10.1016\/j.critrevonc.2021.103433","article-title":"Exercise for individuals with bone metastases: A systematic review","volume":"166","author":"Weller","year":"2021","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1249\/ESM.0000000000000014","article-title":"Adverse event assessment and reporting in exercise oncology: A review","volume":"1","author":"Dunn","year":"2023","journal-title":"Exerc. Sport Mov."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"101937","DOI":"10.1016\/j.eclinm.2023.101937","article-title":"Harms of exercise training in patients with cancer undergoing systemic treatment: A systematic review and meta-analysis of published and unpublished controlled trials","volume":"59","author":"Thomsen","year":"2023","journal-title":"eClinicalMedicine"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e697","DOI":"10.1200\/OP.21.00454","article-title":"Exercise recommendation for people with bone metastases: Expert consensus for health care providers and exercise professionals","volume":"18","author":"Campbell","year":"2022","journal-title":"JCO Oncol. Pract."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1139\/h11-043","article-title":"Evidence-based risk assessment and recommendations for physical activity clearance","volume":"36","author":"Jones","year":"2011","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e067998","DOI":"10.1136\/bmjopen-2022-067998","article-title":"Practical suggestions for harms reporting in exercise oncology: The Exercise Harms Reporting Method (ExHaRM)","volume":"12","author":"Spence","year":"2022","journal-title":"BMJ Open"},{"key":"ref_74","unstructured":"Statistics Canada (2025, July 01). 2021 Census of Population, Available online: https:\/\/www12.statcan.gc.ca\/census-recensement\/2021\/dp-pd\/prof\/index.cfm?Lang=E."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"155","DOI":"10.31189\/2165-7629-9.4.155","article-title":"Narrowing the Gap for Minority Cancer Survivors: Exercise Oncology in the Past, Present, and Future","volume":"9","author":"Norris","year":"2020","journal-title":"J. Clin. Exerc. Physiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e35515","DOI":"10.1002\/cncr.35515","article-title":"Proximity to cancer rehabilitation and exercise oncology by geography, race, and socioeconomic status","volume":"131","author":"Schmitz","year":"2025","journal-title":"Cancer"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1158\/1055-9965.EPI-24-0650","article-title":"Racial, ethnic, and socioeconomic disparities in meeting physical activity guidelines among female breast cancer survivors in the United States","volume":"33","author":"Wojcik","year":"2024","journal-title":"Cancer Epidemiol. Biomark. Prev."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/560\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T04:14:27Z","timestamp":1759983267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,7]]},"references-count":77,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["curroncol32100560"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32100560","relation":{},"ISSN":["1718-7729"],"issn-type":[{"type":"electronic","value":"1718-7729"}],"subject":[],"published":{"date-parts":[[2025,10,7]]}}}