Pre-habilitation-Promoting Exercise in Adolescent and Young Adult Cancer Survivors for Improving Lifelong Health – A Narrative Review

Given the crucial role of exercise in the enhancement of cancer survivors’ long-term health and wellbeing, the aim of the current paper is to review what is known regarding the physiological mechanisms underlying treatment for cancer in adolescent and young adults (AYAs), summarize the interventions that have been implemented to date to increase AYA survivor exercise, and provide recommendations for specific strategies to promote exercise engagement with consideration of developmental issues relevant to AYA survivors. As musculoskeletal function is among the greatest determinants of morbidity and mortality across the life course, and the strength-structural properties of the musculoskeletal system are largely established in adolescence and young adulthood, perturbations during this time may have profound implications as AYA survivors age. While evidence exists supporting interventions delivered at any time point in the cancer journey, the most effective interventions may be those implemented prior to the onset of late effects or noted declines in key health behaviors. Targeting adolescents is of vital importance as physical activity in AYAs continues to decline with age and onset of chronic conditions. As an endocrine organ, contractions of skeletal muscle via resistance exercise exert indirect effects on overall metabolic pathways via the paracrine and endocrine effects of skeletal muscle and direct effects via muscle hypertrophy. By intervening at an earlier stage of survivorship, prior to the onset of many late effects, and by providing supervised strength training with immediate feedback to survivors, interventions may be associated with increased efficacy in the mitigation of long-term health risks.