The purpose of this study is to establish a safe and systematic exercise assessment and prescription program for cancer survivors. It can be challenging for cancer patients to start exercising due to various health risks, so this study aims to create a personalized and easily reproducible workflow. The study will include cancer patients who have completed their primary curative treatments at least 2 months ago.
Participants will undergo a comprehensive health and fitness evaluation led by a study physician. This evaluation includes:
* A review of medical history and cardiovascular risk. * Functional physical fitness tests. * Cardiopulmonary Exercise Testing (CPET) to carefully evaluate heart and lung function during physical exertion. * A musculoskeletal ultrasound, if deemed necessary. Based on these combined results, the medical team will determine each participant's exercise risk level and design a personalized exercise prescription. Participants will then be assigned to an appropriate and safe exercise setting.
To ensure safety and maximize health benefits, the study includes a continuous tracking system. Participants will report their exercise progress every 4 weeks and undergo a full reassessment every 3 months. The medical team will use this feedback to safely adjust the participant's risk level and exercise prescription over time.
Aged 18 to 80 years.
Cancer Cohorts: Pathologically confirmed diagnosis of AJCC TNM stage I-III, and having completed curative-intent treatment (including surgery ± adjuvant chemotherapy/radiotherapy, etc) for at least 2 months.
Cancer cohort must have an Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0-2.
Ability to comply with weekly structured exercise training (3-4 professionally supervised sessions per week) and willingness to accept telephone follow-ups or report exercise status via exercise logs/wearable devices.
Cardiovascular instability: History of acute coronary syndrome (ACS), myocardial infarction (MI), acute exacerbation of heart failure, or hospitalization for heart failure within the past 3 months; unstable angina; uncontrolled arrhythmia; or uncontrolled hypertension (resting blood pressure > 180/110 mmHg).
Hypoxemia: Resting oxygen saturation (SpO2) < 90%.
Metabolic instability: Severe hypoglycemic event or diabetic ketoacidosis (DKA) within the past 3 months.
Musculoskeletal or neurological risks: Unstable bone metastasis or bone metastasis with a high risk of fracture; recent major fracture or orthopedic surgery where weight-bearing is not yet permitted; or other severe neuromuscular diseases that compromise the safety of exercise.
Single group
structured exercise training
Other interventionThis study utilizes a "Personalized Precision Exercise Training Program." Following baseline Cardiopulmonary Exercise Testing (CPET) and comprehensive fitness assessments, physicians prescribe individualized regimens adhering to ACSM guidelines for cancer survivors, applying the FITT principle: * Aerobic Exercise: 3-5 days/week at moderate intensity, tailored to treatment tolerance. ≥30 mins/session, flexibly adjusted for treatment side effects. Focuses on rhythmic activities (walking, cycling). * Resistance Training: 2-3 days/week (48h rest per muscle group) at 60-80% 1-RM or a load for 6-15 reps. Employs progressive overload without requiring muscular failure. Involves 8-10 major muscle groups; ≥1 set/exercise, ≥6 reps/set, with ≥60s rest between sets. Modalities adapt to patient status. * Flexibility Training: ≥2-3 days/week (up to daily). Static stretches (10-30s hold, 2-4 reps, stretching to mild discomfort but avoiding pain) covering all major muscles.
Dominant Handgrip Strength Test
The participant is evaluated in a seated or standing position with the shoulder adducted, the elbow flexed at approximately 90 degrees, and the forearm and wrist in a neutral position. Using a calibrated handgrip dynamometer, the participant performs a maximal voluntary contraction (MVC) with the dominant hand for approximately 3 seconds. The test is repeated 3 times with at least a 30-second rest interval between trials. The highest value obtained from the three trials is recorded as the final result.
30-Second Arm Curl Test
The participant sits in a chair with their back straight and feet flat on the floor, holding a standard dumbbell in the dominant hand (8 lbs / 3.63 kg for males; 5 lbs / 2.27 kg for females). The participant performs repeated full elbow flexion and extension movements over a 30-second period while maintaining shoulder stability. The total number of correctly completed repetitions within the full range of motion is recorded.
30-Second Chair Stand Test
Using a standard-height chair without armrests, the participant sits with arms crossed over the chest and their back resting against the backrest. Upon the start signal, the participant repeatedly rises to a full standing position and returns to a fully seated position within a 30-second timeframe. The total number of completed stands is recorded.
Single-Leg Stance Test
The participant places both hands on their hips and stands on the dominant leg with the contralateral leg lifted off the floor. Timing commences with the participant's eyes open and focused straight ahead, and ceases when any of the following compensatory movements occur: the arms are moved from the hips, the lifted leg moves (toward or away from the stance leg, or touches the floor), the stance foot shifts or lifts, or a loss of balance is observed. The test is repeated 3 times with at least a 30-second rest interval between trials. The average duration of the three trials is recorded as the final result.
Short Form-36 (SF-36)
The SF-36 is a 36-item patient-reported questionnaire that measures health-related quality of life across eight domains: physical functioning, role limitations due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, and mental health. Each domain is scored on a scale from 0 to 100. Higher scores indicate a more favorable health state and better quality of life.
Functional Assessment of Cancer Therapy-General (FACT-G)
The FACT-G is a 27-item questionnaire designed to measure health-related quality of life in patients receiving cancer therapy. It assesses four primary domains: Physical Well-Being (7 items), Social/Family Well-Being (7 items), Emotional Well-Being (6 items), and Functional Well-Being (7 items). Each item is rated on a 5-point Likert scale ranging from 0 (not at all) to 4 (very much). The subscale scores are summed to yield a total score ranging from 0 to 108, with higher scores representing a better quality of life and lower symptom burden.
Brief Fatigue Inventory (BFI)
The BFI is a 9-item questionnaire used to rapidly assess the severity of fatigue and its impact on daily functioning, particularly in cancer patients. Patients rate their fatigue severity (at its "worst," "usual," and "now" over the past 24 hours) and the extent to which fatigue interferes with six domains of daily life (general activity, mood, walking ability, normal work, relations with other people, and enjoyment of life). All items are scored on an 11-point numeric rating scale from 0 (no fatigue / does not interfere) to 10 (as bad as you can imagine / completely interferes). A global fatigue score is calculated as the mean of all answered items, ranging from 0 to 10, with higher scores indicating more severe fatigue and greater interference with daily life.
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