title: Physical exercise and immune system function in cancer survivors: a comprehensive review and future directions.
abstract: BACKGROUND
  There are a limited number of interventions for cancer survivors following completion of primary therapy that might reduce the risk of cancer recurrence and/or secondary malignancies and increase survival times. It has been proposed that physical exercise may be beneficial by enhancing the anticancer immune system response. The purpose of the current article is to: 1) briefly describe the immune system response to tumors, 2) discuss the impact of anticancer therapy on immune system function in cancer survivors, 3) provide a systematic and comprehensive review of the extant literature examining physical exercise and immune system function in cancer survivors, and 4) offer a critical analysis of this literature and outline directions for future research.
  
  
  METHODS
  A comprehensive literature search up to March 2001 identified empirical articles that examined the effects of physical exercise training on immune system function in cancer survivors from CD-ROM database searches and manual searches.
  
  
  RESULTS
  To the authors' knowledge, six empirical studies published between 1994 and 2000 have examined physical exercise and immune system function in cancer survivors. Overall, four out of six studies reported statistically significant improvements in a number of cancer-related immune system components as a result of exercise. However, there are several limitations that must be considered when interpreting the findings of these studies. These limitations involve the samples, designs, physical exercise interventions, physical fitness assessments, and immunologic assessments.
  
  
  CONCLUSIONS
  Additional research is needed to determine if physical exercise in cancer survivors may reduce the risk of cancer recurrence and secondary malignancies and increase survival times.
authors.affiliation: Center for Health Promotion Studies, University of Alberta, Edmonton, Canada.
authors.forename: Adrian S
authors.initials: AS
authors.lastname: Fairey
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Field
authors.forename: John R
authors.initials: JR
authors.lastname: Mackey
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002986:Clinical Trials as Topic; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007107:Immune System / Q000502:physiology*; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D010809:Physical Fitness; D015996:Survival Rate