Introduction
Many organizations promote wilderness experiences for cancer patients and survivors. Data suggest that moderate-to-vigorous exercise may reduce fatigue and depression in adults undergoing cancer treatment. The psychology literature suggests additional benefits of nature-based programming, including increased self-esteem and decreased anxiety. However, rigorous studies of the impact of wilderness-based programs are lacking.
Objective
To evaluate the impact of wilderness programs on cancer patients and survivors.
Methods
We searched PubMed, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials through March 2016. Search terms included adventure or wilderness or nature; therapy, rehabilitation, or treatment; and cancer. We reviewed the bibliographies of relevant articles for additional citations. Two authors independently analyzed the results for relevance and study design. Systematic reviews and controlled trials were selected for inclusion.
Results
Forty-nine articles were identified: 38 were not relevant and 7 were case reports. Four studies were identified that met inclusion criteria, including 1 systematic review and 3 controlled trials. Outcomes of the controlled trials were heterogeneous, precluding meta-analysis. Two studies analyzed the impact of wilderness therapy programming on the physical activity levels of participants. The other 2 studies explored self-reported psychological benefits. Analysis of the 4 articles suggests benefits to program participants, including an increase in regular physical activity and improved perception of self-esteem, body image, quality of life, and mood. No studies assessed physical health outcomes or impact on disease progression.
Conclusions
There are few rigorous studies evaluating the impact of adventure and wilderness programming on cancer patients and survivors, and no studies exploring medical effects. Preliminary data suggest positive, though potentially transient, benefits, including an increase in exercise frequency and improved self-esteem and mood. Given the popularity of these programs and potential benefits, further research is indicated to quantify the medical and psychological impact of wilderness programming on cancer patients and survivors.