ACSM Issues First Exercise Guidelines for Kids and Teens with Cancer

Cancer in children and adolescents is biologically and clinically distinct from adult malignancies, and its treatments carry serious long-term consequences for physical fitness, organ function, and quality of life. Yet until now, no formal exercise guidelines existed specifically for this population. The American College of Sports Medicine has addressed that gap with its first expert consensus statement on exercise for children and adolescents with cancer.

The expert panel systematically identified outcomes of clinical relevance — including muscle strength, physical function, cardiorespiratory fitness, cardiac function, bone health, and immune function — then evaluated the body of evidence from randomized controlled trials to determine where exercise recommendations could be responsibly made.

The key finding is that exercise training is generally safe for young cancer patients and survivors. Moderate evidence supports that concurrent training — combining aerobic and resistance exercise — improves muscle strength and physical function both during and after treatment. Aerobic training specifically improves cardiorespiratory fitness, but this benefit was demonstrated only after treatment completion, not during active therapy. Evidence was insufficient to make recommendations for cardiac function, bone health, or immune outcomes.

For clinicians and fitness professionals, the guidance provides a practical framework: prioritize concurrent training programs and set realistic expectations about which outcomes are likely to respond. The findings validate that exercise should be integrated into standard oncology care for pediatric patients, not treated as an optional add-on.

Several important caveats temper enthusiasm. The evidence base remains limited and heterogeneous, particularly during active treatment phases. The panel's inability to recommend exercise for multiple clinically important outcomes underscores how much research is still needed. This consensus statement is best understood as a starting point — a foundation for future trials and clinical protocols rather than a comprehensive prescription.