PURPOSE: To systematically review and synthesize results of studies that examined the effects of exercise on persons with metastatic cancer. METHODS: Databases searched were Medline, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials. Search terms used were 'metastatic or advanced or palliative AND cancer or neoplasms AND exercise or physical activity or exercise therapy or physical fitness'. The search identified 8 studies published in 10 articles between 2000 and 2007. Two quality-assessment tools were used, and levels of evidence were assigned according to the Oxford Centre for Evidence-Based Medicine (CEBM) guidelines. RESULTS: Of the eight studies, three were randomized controlled trials (RCTs) and five were case series. Because three of the RCTs were based on the same sample, only one was included in the results and discussion sections. CEBM levels of evidence ranged from 2b to 4. Two overall recommendations were made, one grade A and one grade C. Exercise interventions ranged from aerobic exercise and strength training to multidimensional programmes with exercise as one component. All studies used physical and/or quality-of-life outcome measures. CONCLUSIONS: Review findings suggest that exercise may be beneficial for persons with metastatic cancer. Future research should clarify optimal exercise dose parameters.

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