Nutritional and Exercise Interventions in Cancer-Related Cachexia: An Extensive Narrative Review

Abstract

One of the common traits found in cancer patients is malnutrition and cachexia, which affects between 25% to 60% of the patients, depending on the type of cancer, diagnosis, and treatment. Given the lack of current effective pharmacological solutions for low muscle mass and sarcopenia, holistic interventions are essential to patient care, as well as exercise and nutrition. Thus, the present narrative review aimed to analyze the nutritional, pharmacological, ergonutritional, and physical exercise strategies in cancer-related cachexia. The integration of multidisciplinary interventions could help to improve the final intervention in patients, improving their prognosis, quality of life, and life expectancy. To reach these aims, an extensive narrative review was conducted. The databases used were MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. Cancer-related cachexia is a complex multifactorial phenomenon in which systemic inflammation plays a key role in the development and maintenance of the symptomatology. Pharmacological interventions seem to produce a positive effect on inflammatory state and cachexia. Nutritional interventions are focused on a high-energy diet with high-density foods and the supplementation with antioxidants, while physical activity is focused on strength-based training. The implementation of multidisciplinary non-pharmacological interventions in cancer-related cachexia could be an important tool to improve traditional treatments and improve patients’ quality of life.

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The Mediterranean Lifestyle to Contrast Low-Grade Inflammation Behavior in Cancer

“…Exercises carried out gradually and consistently may enhance certain benefits related to the tumor’s pathology and the treatments given, lower the risk of cardiovascular disease, and prevent the reappearance of neoplastic disease [ 48 , 49 ]. Aerobic exercise enhances cardiovascular and respiratory health as well as strength, endurance, and musculoskeletal health in cancer patients [ 50 , 51 ]. Exercise prevents weight gain, diminished muscular strength, and cardiotoxicity in individuals on androgen deprivation for prostate cancer [ 52 ].…”

Targeting cancer cachexia: Molecular mechanisms and clinical study

“…Exercise therapy plays an important role in the treatment of cancer cachexia, thereby attracting considerable interest in recent years. 277 , 278 , 279 , 280 , 281 , 282 , 283 Exercise can enhance metabolite interactions among the heart, liver, and muscle, 284 , 285 indicating that exercise can regulate metabolic homeostasis among multiple organs. In terms of the benefits of exercise on the heart, exercise can reduce myocardial necrosis, fibrosis, and inflammation, reduce the levels of TGF‐β1 and BNIP3 mRNA, and increase the level of mitochondrial complex IV protein, resulting the effect of agonist ventricular remodeling.…”

“…Exercise therapy plays an important role in the treatment of cancer cachexia, thereby attracting considerable interest in recent years 277–283 . Exercise can enhance metabolite interactions among the heart, liver, and muscle, 284,285 indicating that exercise can regulate metabolic homeostasis among multiple organs.…”