Abstract
Background: Cancer treatments often reduce quality of life (QoL), and non-pharmacological options are limited. Supervised exercise shows promise, but its effectiveness across exercise types and patient subgroups is unclear. Objective: This study aimed to assess the impact of supervised exercise on QoL in breast and prostate cancer patients, considering exercise type, duration, and patient characteristics. Methods: A systematic review and meta-analysis including 26 randomized controlled trials (RCTs) and approximately 3500 participants was conducted according to PRISMA guidelines. PubMed, Web of Science, PEDro, SciELO, Cochrane, and Scopus were searched for randomized controlled trials (RCTs) published between 2014 and 2024. Eligible studies involved adults with breast or prostate cancer undergoing supervised exercise versus usual care or unsupervised activity. Risk of bias was assessed with the Cochrane RoB 2.0 tool, methodological quality with the PEDro scale, and certainty of evidence using the GRADE approach. Results: Supervised exercise was associated with significant improvements in QoL (SMD = 0.46; 95% CI: 0.22-0.70; p < 0.001), with considerable heterogeneity (I(2) = 91.5%). Combined programs had the greatest effect (SMD = 0.77), followed by high-intensity interval training (HIIT) (SMD = 0.30). Shorter interventions (≤12 weeks) yielded larger improvements. Effects were more consistent in women with breast cancer. Overall, the certainty of the evidence was low. Conclusions: Supervised therapeutic exercise is associated with significant improvements in QoL in breast and prostate cancer patients. Combined and well-structured programs, particularly of short duration, appear especially beneficial. These findings support the integration of supervised exercise into standard oncological care. Further research should explore long-term sustainability and optimize interventions for specific patient profiles.