Physical activity and exercise in pediatric oncology: conceptual distinctions and clinical implications

Survival in childhood cancers has markedly improved, yet many children experience treatment-related difficulties such as persistent fatigue, muscle weakness, reduced endurance, and impaired quality of life. As interest in non-pharmacological approaches grows, movement-based strategies, ranging from general physical activity to structured exercise, have become increasingly prominent in pediatric oncology care. This review aims to clarify the conceptual and practical differences between physical activity and structured exercise, and to summarize current evidence on movement-based interventions used during active treatment and survivorship in children and adolescents with cancer. Drawing on quantitative and qualitative studies published between 2000 and 2025, it shows that priorities shift across treatment phases: safety and feasibility are emphasized during active therapy, whereas long-term health and functional recovery gain importance in survivorship. The findings highlight the need for clearer terminology, coordinated multidisciplinary practice, meaningful family involvement, and consistent outcome measures with longer-term follow-up in future research.