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Invited Commentary
August 19, 2021

The Power of Exercise to Influence Cardiovascular and Oncologic Outcomes—Survival of the Fittest

Author Affiliations
  • 1Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Oncol. Published online August 19, 2021. doi:10.1001/jamaoncol.2021.3065

A remarkable 1 in 2 US adults older than 64 years experience at least 2 chronic health conditions. If one is cancer, the top 3 other medical ailments are hypertension, cardiovascular disease, and diabetes—what we oncologists refer to as comorbidities.1 The growing body of evidence confirming favorable cancer-specific survival without therapeutic intervention in certain low-risk cancers is a reminder that the instinct to prioritize “the big C” above all is not always medically warranted, and sometimes the other morbidity is, in fact, the morbidity. Considering that US adults 65 years and older currently represent approximately 17% of the population (expected to increase to 21.6% by 2040), combined with the current US life expectancy at birth of 77.8 years, the personal and societal costs of these morbidities are staggering.2 The well-established virtues of structured aerobic exercise on physical and psychological well-being, including improved body mass, blood pressure, and lipid profile, together with its inexpensive and low-risk nature, render it an attractive mechanism for mitigating the negative consequences of these highly prevalent noncancer conditions.3

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