# “Phoenix Rising”: A scoping review on the impacts of dragon boating exercise on well-being among breast cancer survivors and factors affecting their participation

## TL;DR

Dragon boating helps breast cancer survivors' physical and mental health, but more research is needed to confirm its benefits and address participation challenges.

## Contribution

First scoping review to examine dragon boating's impact on breast cancer survivors' well-being and factors influencing participation.

## Key findings

- Dragon boating improves physical functioning and psychosocial well-being in breast cancer survivors.
- Common barriers to participation include fitness concerns and cancer-related anxieties.
- Benefits on biochemical indicators like anti-inflammatory markers are inconclusive.

## Abstract

Breast cancer survivors (BCS) often experience declines in physical and psychosocial well-being post-treatment, making supportive interventions essential. Dragon boating(team-based paddling in a long boat) has emerged as a promising, popular exercise for BCS. However, no comprehensive reviews exist on its impacts or participation factors. This scoping review addressed these gaps by examining two research questions (RQ): RQ1) the impacts of dragon boating on BCS’ well-being, and RQ2) facilitators and barriers influencing their participation.

Seven databases (PubMed, Embase, CINAHL, Web of Science, PsycInfo, Scopus, CNKI) were used to search for eligible studies from January 1996 to November 2025 involving BCS engaging in dragon boating. Screening from 245 records, 33 articles (18 quantitative, 14 qualitative, 1 mixed-methods) were identified.

Among studies addressing RQ1 (n = 27), 24 studies reported at least one benefit on well-being. Dragon boating improved BCS’ physical functioning (e.g., upper limb strength, range of motion), psychosocial well-being(e.g.,mental health, posttraumatic growth), and health behaviors(healthier lifestyle), without increasing lymphedema risk. Benefits on biochemical indicators (e.g., anti-inflammatory markers/antioxidant capacity) were less conclusive. For RQ2 (n = 10), common facilitators for joining dragon boating were social support, focus away from cancer, information sharing, and being physically active/competitive; common barriers included feeling not fit enough to participate, reminders of death/cancer recurrence, concerns about cancer identity disclosure, time commitment, and location constraints.

Most studies demonstrated the benefits of dragon boating for BCS' physical and psychosocial well-being, but evidence did not support its superiority to other activities. To maximize impacts, addressing facilitators/barriers of participation will be important when designing and implementing dragon boating programs for BCS.