Addressing Fear of Cancer Recurrence Through Remotely-Delivered Exercise

Fear of cancer recurrence (FCR) is a prevalent and distressing concern among cancer survivors. Although psychological interventions have demonstrated efficacy in reducing FCR, they often require significant resources and specialized personnel, limiting their accessibility. Remotely delivered exercise programs offer a scalable and cost-effective alternative, yet their impact on FCR remains underexplored.

To evaluate the effectiveness of a 12-week remote exercise intervention in reducing FCR among patients with cancer.

This study combines data from pilot studies assessing the feasibility of a remote exercise intervention. Patients were recruited from June 2022 to January 2024 from five Brazilian states, representing diverse geographic regions. Eligible participants were adults undergoing active cancer treatment with moderate-severe FCR (FCR-7 score ≥ 17). The intervention included a 12-week remote exercise program with weekly virtual consultations with an exercise physiologist and tailored exercise prescriptions. Primary and secondary outcomes included changes in FCR-7 and Functional Assessment of Cancer Therapy-General (FACT-G) scores. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and mixed-effects modeling.

A total of 149 patients with moderate-severe FCR were included; 86.5% adhered to the program. The mean FCR-7 score decreased significantly from 20.2 (SD = 4.6) at baseline to 12.8 (SD = 4.6) at 12 weeks (p = 0.001, Cohen's d = 1.6). FACT-G scores improved significantly from 84.4 (SD = 11.5) to 95.6 (SD = 9.2) (p = 0.001, Cohen's d = 1.0). Mixed-effects modeling confirmed a significant reduction in FCR-7 scores over time (F = 377.176, p < 0.001), with a significant overall effect across participants (F = 2210.733, p < 0.001).

This study suggests that a 12-week remote exercise program may reduce FCR among patients with cancer. Given its accessibility and scalability, remote exercise programs should be further explored as a feasible strategy for addressing FCR in diverse populations. However, these findings are preliminary and should be confirmed in larger, controlled trials.