Systematic Review of Functional Outcomes in Cancer Rehabilitation.

No study reached the top evidence grade, and only 18 of 362 met the second. Most (321) were graded low, largely because function was measured by what patients reported rather than by objective testing. 102 of 362 studies found no significant improvement in their main functional outcome, and the proportion of null results varied widely by area, from 17% to 40%. Because the cancers, stages and interventions differed so much, the authors could not pool the results into any overall estimate of how much rehabilitation helps. Studies labelled pilot or feasibility, and anything published before 2008, were excluded, so smaller and older work does not appear here even if eligible by the original criteria. Psychosocial interventions were left out, so the review says nothing about mood, anxiety, coping or social participation. The search stopped in March 2019, so more recent trials are missing. Most studies took place after active cancer treatment finished. Prehabilitation and palliative care were barely covered, and return to work and sexual function had only six studies each. The authors themselves note that some changes may have been clinically meaningful without reaching statistical significance. No total number of patients is given, so it is impossible to judge how many people the findings rest on.

The paper states no funding source for the review itself; an informationist from the National Institutes of Health Biomedical Library helped design the search, and NIH research support is recorded for the work. The only declaration is a list of individual interests: one author reports a consulting role with a University of Pittsburgh programme (LeaRRN), one sits on the scientific advisory board of the International Society of Physical Medicine & Rehabilitation and on the board of the Foundation for Physical Medicine & Rehabilitation, and one is a paid consultant for Select Medical and is employed by the Ivy Rehab Network.

Do not read these percentages as proof that cancer rehabilitation works. Each figure is the share of studies that reported a significant result, not the share of patients who improved, and every study counts once no matter how many people it enrolled. Most studies were graded as weak evidence, roughly one in six to two in five found nothing depending on the outcome, and the authors could not pool the results, so no single intervention can be called effective on the strength of this review.