Colon and colorectal cancer treatments are frequently associated with cancer-related fatigue, physical deconditioning, and reduced health-related quality of life (HRQoL). Exercise has been proposed as a supportive care strategy, but evidence remains heterogeneous. This systematic review aimed to evaluate the effects of exercise interventions on cancer-related fatigue, physical function, HRQoL, and selected biological outcomes in adults with colon or colorectal cancer. Searches were conducted in PubMed, PEDro, and Scopus following PRISMA 2020 guidelines. Randomized and controlled clinical trials assessing structured exercise interventions were included. Methodological quality was evaluated using the McMaster Critical Review Form and the PEDro scale. Due to heterogeneity, results were synthesized qualitatively, with limited quantitative synthesis based on single-study effect estimates. Five studies met the inclusion criteria. Exercise interventions delivered during chemotherapy or survivorship consistently reduced cancer-related fatigue, showing moderate-to-large effect. Small-to-moderate improvements in physical function and muscular strength were observed. HRQoL outcomes were generally favorable, particularly in physical and functional domains. Evidence regarding biological outcomes was limited but suggested potential benefits for gastrointestinal function, sleep quality, and selected biomarkers. Overall, structured exercise appears to be a feasible and clinically relevant supportive care intervention for patients with colon and colorectal cancer. Further high-quality trials with standardized protocols are required.

Small intestinal bacterial overgrowth (SIBO) is characterized by an excessive proliferation of bacteria within the small intestine, resulting in chronic gastrointestinal symptoms, impaired quality of life, and frequent recurrence. Although rifaximin remains the cornerstone of treatment, increasing interest has focused on microbiota-directed therapeutic strategies aimed at restoring intestinal homeostasis and addressing mechanisms beyond bacterial eradication. This systematic review and meta-analysis evaluated the efficacy, safety, and clinical relevance of microbiota-directed interventions compared with conventional antibiotic therapy, placebo, or no intervention in adults with breath test-confirmed SIBO. A systematic search identified nine eligible studies involving 782 participants. Methodological quality was assessed using the CASP and PEDro tools, while risk of bias was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool and ROBINS-I. A random-effects meta-analysis was performed whenever clinically comparable studies reporting extractable dichotomous data were available. The primary meta-analysis demonstrated that adjunctive microbiota-directed therapies combined with antibiotics significantly improved breath test-confirmed SIBO eradication compared with antibiotic monotherapy (RR 1.36, 95% CI 1.13–1.65; I² = 0%). An exploratory meta-analysis including all eligible interventions yielded consistent findings (RR 1.34, 95% CI 1.14–1.57; I² = 1.1%). The qualitative synthesis identified symptomatic improvements in some individual studies; however, these findings were heterogeneous across symptom domains, assessment methods, and underlying clinical populations. Evidence regarding health-related quality of life and selected microbiota-related and inflammatory biomarkers was also limited, whereas adverse events were generally mild and infrequent. Overall, the available evidence suggests that microbiota-directed therapies, particularly when used as adjuncts to antibiotic treatment, may represent a promising complementary approach for improving SIBO eradication without compromising safety. However, the certainty of the available evidence remains limited by the small number of studies, heterogeneous interventions, and variability in outcome reporting. Larger, well-designed randomized controlled trials are warranted to confirm these findings and define the optimal microbiota-directed therapeutic strategy.

Prostate cancer is the most frequently diagnosed malignancy among men worldwide. Despite improved survival, patients often experience persistent adverse effects such as cancer-related fatigue, reduced muscle strength, impaired physical fitness, and decreased health-related quality of life (HRQoL), particularly during and after radiotherapy and androgen deprivation therapy (ADT). This systematic review aimed to evaluate the effects of structured exercise interventions on physical function, physical fitness, cancer-related fatigue, and HRQoL in men with prostate cancer during and after oncological treatment. The review was conducted in accordance with PRISMA 2020 guidelines. PubMed/Medline, PEDro, and Scopus were searched for studies published up to December 2025. Randomized and non-randomized controlled trials and pre-post intervention studies were included if they implemented structured exercise programs in patients with prostate cancer. Methodological quality was evaluated using the McMaster Critical Review Form. Five studies met the inclusion criteria. Most interventions involved supervised aerobic and/or resistance exercise delivered during radiotherapy, ADT, or survivorship. Exercise was associated with improvements in cancer-related fatigue, muscular strength, and physical fitness, with moderate-to-large effect estimates for fatigue and strength. HRQoL outcomes were mixed. Structured exercise appears to be a feasible and clinically relevant supportive care strategy; however, further well-designed randomized controlled trials with standardized protocols are needed.