- Exercise should be embedded as part of standard practice in cancer care.
- A personalized program under the guidance of an experienced exercise professional should be followed.
- All stakeholders including clinicians and parents should promote physical activity.
- Inactivity should be avoided, even in patients undergoing intensive treatment or who have a poor prognosis. Recommendation for ≥150 minutes of moderate-intensity or 75 minutes vigorous-intensity exercise per week, achieved in 2-5 sessions of 10-60 minutes each.
- Considerable variation in tumor pathophysiology, therapies, and prognosis call for flexibility in exercise goals and schedule; personalization is necessary.
- Cancer treatment can result in significant decreases in fitness; any improvement, and even maintenance or fewer negative effects, should be recognized as positive.
- Experienced professionals should deliver an exercise program to ensure safety and effectiveness.
- Professional supervision will improve adherence.
- Clinicians should encourage children to participate in physical activity.
- Identification and management of consistent exercise contraindications in children and adolescents with cancer are challenging.
- Benefits of exercise and sports go beyond physical fitness, and benefits to emotional, mental, and social experiences and resilience need to be recognized.
- Patients, families, health care teams, and all other stakeholders must be made more aware of the advantages of physical activity in cancer care.