Abstract
Introduction
Cancer and its treatment often impose significant physical, psychological, and functional burdens on patients and survivors. 1 Integrative oncology seeks to address this through evidence-informed, non-pharmacologic interventions that complement disease-directed treatment and enhance quality of life across the cancer continuum. 1
Physical activity and structured exercise are key components of supportive cancer care. 2 Clinical guidelines encourage both cancer patients and survivors to remain physically active and engage in structured exercise to improve cardiovascular fitness, strength, cancer-related fatigue, and quality of life.2,3 Recent evidence suggests structured exercise may even reduce recurrence and mortality in selected cancers.3,4 However, barriers such as physical limitations, low motivation, and limited cultural relevance can reduce adherence to conventional programs. 2 Dance offers an embodied alternative by integrating movement with emotional expression, cognitive engagement, and social connection in culturally meaningful ways.5,6
Dance-based interventions span a continuum from traditional and culturally grounded social dance programs to dance/movement therapy (DMT). Traditional dance refers to movement practices rooted in longstanding cultural heritage and transmitted across generations, whereas cultural dance reflects a broader range of forms that express or adapt to participants’ cultural identities within contemporary supportive-care contexts. 7 These approaches differ from DMT, the psychotherapeutic use of movement facilitated by trained clinicians to promote emotional, cognitive, and physical integration. 8 Together, these various dance interventions expand the scope of exercise oncology by situating physical activity within relational, cultural, and narrative dimensions of survivorship.5,6,9 Positioning dance within integrative oncology reframes movement not only as an exercise prescription but also as a culturally responsive pathway that may enhance engagement in supportive care.
Embodiment and Neurobiological Mechanisms of Dance-Based Care
Dance is a multimodal practice integrating physical movement, emotional expression, and social engagement. 10 Through proprioceptive awareness, rhythm, and expressive movement, dance may support body awareness and perceived agency during illness, especially when pain, fatigue, or treatment effects alter a patient’s relationship with movement. 11 Embodied approaches—including traditional and cultural dance as well as DMT—promote perceived control and emotion regulation, contributing to psychological resilience.9–11 From a neurobiological perspective, dance connects auditory rhythms with motor output, engaging reward pathways and motor-learning circuits. 12 Neuroimaging and theoretical models suggest rhythmic movement can foster both intra- and inter-brain synchrony, which is associated with cognitive flexibility and social cohesion.12,13 By activating sensorimotor and affective networks simultaneously, dance may enhance mood, regulate stress, and sustain cognitive engagement. Beyond individual mechanisms, group dance promotes interpersonal synchrony and social support,14–16 while shared movement to music enhances connection and a sense of belonging. 17 Together, these processes may help explain observed improvements in function, stress regulation, and engagement compared with more traditional exercise approaches,5,12,13,15 thus positioning dance as a biopsychosocial intervention integrating physical activity with relational engagement.13–17
Clinical Evidence and Outcomes
Dance intensity and guideline alignment
Many dance forms can reach moderate-to-vigorous intensity,2,18 meeting survivorship exercise guidelines. 2 For example, selected folk, salsa, and ballroom dances fall within ranges reported in the Adult Compendium of Physical Activities. 18 Moreover, an international exercise consensus affirms that adapted aerobic and strength exercise, including dance, is both safe and effective in cancer survivors. 2 Thus, dance can be framed as a guideline-concordant modality for delivering recommended exercise in oncology settings, though screening and modification remain essential. Individuals with lymphedema may require gradual progression, while those with chemotherapy-induced neuropathy may need balance support or partnered formats to reduce fall risk. Programs led by trained instructors or therapists are recommended to ensure safe participation across functional levels. 2 Instructors must adapt tempo and intensity for participants’ fitness levels, provide modifications for a limited range of motion, and respect religious or cultural restrictions (appropriate music or attire).
Psychosocial benefits
A growing body of literature shows that dance interventions yield meaningful psychosocial improvements among cancer patients. A meta-analysis by Koch et al. and a systematic review by Fong et al. found overall positive psychological effects of dance and DMT.10,19 Notably, an oncology-focused systematic review and meta-analysis by Abu-Odah et al. reported improvements in depression, anxiety, fatigue, and quality of life following dance-based interventions. 6 These benefits align with clinical priorities in oncology. 1
Dance-based interventions may offer complementary advantages by simultaneously engaging emotional, cognitive, and physical processes.10,19 For example, choreography learning enhances cognitive engagement, whilemovement-based interventions support emotional processing and body awareness,9,10,20,21 with rhythmic and social components engaging reward and synchrony mechanisms. 13 Importantly, systematic reviews consistently report quality-of-life improvements after dance programs.6,10 Further, a mixed-methods review found that community dance programs improve functional capacity and health-related quality of life. 5
Anxiety and depression
Anxiety and depression are highly prevalent among cancer patients and strongly influence adherence and outcomes. 1 Several trials of dance therapy in oncology report reductions in anxiety and mood symptoms. 6 A 12-week randomized trial of free-form dance therapy in women undergoing breast cancer surgery found a significant reduction in anxiety (p ≤ 0.001) in the dance group versus control. 22 These findings align with broader literature. Koch et al. noted DMT significantly decreased depression and anxiety and improved quality of life in clinical populations. 10 While more oncology-specific RCT’s are needed, current evidence suggests dance can be an effective adjunctive therapy for emotional distress.
Chemotherapy-induced peripheral neuropathy (CIPN)
CIPN (nerve damage from chemotherapy) causes numbness, balance impairment, and increased fall risk in up to 80% of survivors treated with taxanes, platinum agents, or vinca alkaloids. 23 Traditional rehabilitation (walking, resistance exercise) has some benefits, but adherence is challenging. 2 Adapted dance, such as Argentine tango, is being explored as a novel approach. 24 Tango involves continuous weight shifts, postural adjustments, and partnered steps that train balance and sensory motor integration.12,13 Preliminary work in Ohio State found that even brief social dance sessions (20 min, a few times a week) may improve sensory-motor integration and dual-task gait performance in breast cancer survivors with neuropathy. 24 These pilot data, along with trials of tango for other neuropathic conditions, suggest potential mechanisms relevant to neuroplastic recovery in CIPN beyond conventional exercise alone.25,26
Traditional and Culturally Grounded Dance as Supportive Care
Tradition, identity, and motivation
Traditional dances are deeply intertwined with cultural identity and communal meaning. Participating in one’s heritage dance connects survivors to a sense of history and belonging. This cultural resonance can be a powerful motivator. Loo et al. found that a hula dance program for breast cancer felt less like exercise and more like cultural expression, which supported long-term engagement. 27 Engaging in dance that aligns with the person’s identity may thus overcome cultural barriers and increase adherence.5,28 Moreover, group dance inherently builds social networks of peers and community leaders, mitigating isolation often reported in survivorship.15,17
Emotional expression and narrative
Dance also provides a creative and accessible nonverbal means of emotional expression. Traditional dances often convey stories or symbolize collective experiences. Performing them may allow persons with cancer to express grief, fear, or resilience when words are insufficient. Dance may also function as a relational movement practice that supports social identity and meaning-making within survivorship contexts. 11 For example, some participants report increased body awareness and emotional expression through movement-based interventions.5,9,21 In practice, DMT literature emphasizes how movement metaphors can externalize inner conflicts.9,10 Though systematic evidence is limited, qualitative reports from cancer populations describe relief and meaning-making through culturally familiar dance rituals, reinforcing belonging and hope.5,21
Equity, accessibility, and implementation
Standard exercise programs (such as gym-based or clinical rehabilitation) can inadvertently exclude underrepresented groups due to cost, cultural misalignment, or intimidation. 1 In contrast, traditional dance classes often exist in community centers, places of worship, or schools at low or no cost, and are inherently social. 5 Culturally tailored dance programs have improved functional capacity and reduced fatigue in underserved survivors.27,29 By embedding exercise within trusted cultural settings, tailored dance programs may help reduce barriers to participation and supportive care, although access remains influenced by local resources and implementation strategies. Implementation specialists advocate partnering with cultural leaders (dance masters, faith organizations) to safely adapt dance, thereby building trust and sustainability.2,8 Culturally grounded dance can expand the reach of exercise oncology by meeting patients where they are socio-culturally.
Examples of tradition-specific dance interventions
Integrating Traditional Dance in Cancer Programs
Traditional, cultural, and therapeutic dance is an integral supportive care modality. 6 By definition, traditional dances carry collective narratives and rituals; thus, they may facilitate narrative expression through movement. 11 For a patient whose illness disrupts familiar roles (parent, worker, community member), learning and performing heritage dance may reconnect them with broader identity and resilience. 28 From a psychosocial perspective, the intentional community aspect of dance combats isolation and loss of agency often accompanying cancer.15,17 This paradigm addresses a key gap in oncology care, as standard exercise prescriptions often emphasize abstract physiological targets. 2 Engaging in culturally meaningful dance may therefore improve motivation and adherence—critical given evidence that sustained physical activity confers the greatest long-term survivorship benefit.3,4 Survivors who participated in a dance program often continued exercises beyond the study, propelled by enjoyment and social bonds.5,27 Taken together, the clinical, neurobiological, and cultural findings suggest that dance-based care may function less as an alternative to exercise and more as a multidimensional delivery model through which exercise, emotional processing, and social identity converge within integrative oncology practice.
Ethically and practically, integrating cultural dances into cancer programs requires partnership with cultural barriers and flexibility. When implemented thoughtfully, however, dance can bridge evidence-based exercise guidelines with patients’ lived experience. It exemplifies the “whole person” focus of integrative oncology by simultaneously honoring the patient’s body, mind, and cultural spirit.
Conclusion
Dance-based interventions, including both traditional and culturally grounded social dance as well as dance/movement therapy (DMT), represent a promising, scalable modality in supportive cancer care. By integrating moderate physical activity with creative expression and social interaction, dance addresses both the emotional and functional sequelae of cancer within a single multimodal practice that can reduce stress, enhance mood, and improve physical function. Unlike conventional exercise alone, dance leverages intrinsic reward and communal engagement, which may enhance adherence to long-term activity. Importantly, culturally responsive dance programs extend these benefits into identity and equity. Grounding movement and familiar traditions can strengthen motivation and trust, particularly among patients who feel alienated by standard medical settings. When aligned with exercise guidelines and delivered with cultural sensitivity, dance has the potential to expand access to supportive care across diverse populations. As integrative oncology evolves, traditional and cultural dance should be recognized as a therapeutic modality, one that moves the body, resonates with the soul, and honors the cultural stories that sustain patients through the cancer journey.
Footnotes
Author Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received for this article.