Cancer treatment and its side effects may cause muscle wasting. Physical exercise has the potential to increase muscle mass and strength and to improve physical function in cancer patients undergoing treatment. A systematic review was conducted to study the effect of physical exercise (aerobic, resistance or a combination of both) on muscle mass and strength in cancer patients with different type and stage of cancer disease. Electronic searches were performed up to January 11th 2012, identifying 16 randomised controlled trials for final data synthesis. The studies demonstrated that aerobic and resistance exercise improves upper and lower body muscle strength more than usual care. Few studies have assessed the effect of exercise on muscle mass. Most studies were performed in patients with early stage breast or prostate cancer. Evidence on the effect of physical exercise on muscle strength and mass in cancer patients with advanced disease is lacking. More exercise studies in patients with advanced cancer and at risk of cancer cachexia are warranted.

The aim of this meta-analysis was to examine the effects of nutritional and physical exercise interventions and interventions combining these interventions during radiotherapy treatment for patients with head and neck cancer on body composition, objectively measured physical function and nutritional status. Systematic electronic searches were conducted in MEDLINE (PubMed interface), EMBASE (Ovid interface), CINAHL (EBSCO interface) and Cochrane Library (Wiley interface). We identified 13 randomized controlled trials (RCTs) that included 858 patients. For body composition, using only nutrition as intervention, a significant difference between treatment and control group were observed (SMD 0.42 (95CI 0.23–0.62), p < 0.001). Only pilot RCTs investigated combination treatment and no significant difference between the treatment and control groups were found (SMD 0.21 (95CI −0.16–0.58), p = 0.259). For physical function, a significant difference between treatment and control group with a better outcome for the treatment group were observed (SMD 0.78 (95CI 0.51–1.04), p < 0.001). No effects on nutritional status were found. This meta-analysis found significantly positive effects of nutrition and physical exercise interventions alone in favor of the treatment groups. No effects in studies with combined interventions were observed. Future full-scaled RCTs combining nutrition and physical exercise is warranted.

Background: Muscle mass and physical function (PF) are common co-primary endpoints in cancer cachexia trials, but there is a lack of data on how these outcomes interact over time. The aim of this secondary analysis of data from a trial investigating multimodal intervention for cancer cachexia (ClinicalTrials.gov: NCT01419145) is to explore whether changes in muscle mass and PF are associated with weight loss and cachexia status at baseline. Methods: Secondary analysis was conducted using data from a phase II randomized controlled trial including 46 patients with stage III–IV non-small cell lung cancer (n = 26) or inoperable pancreatic cancer (n = 20) due to commence chemotherapy. Cachexia status at baseline was classified according to international consensus. Muscle mass (assessed using computed tomography (CT)) and PF outcomes, i.e., Karnofsky performance status (KPS), self-reported PF (self-PF), handgrip strength (HGS), 6-minute walk test (6MWT), and physical activity (PA), were measured at baseline and after six weeks. Results: When compared according to cachexia status at baseline, patients with no/pre-cachexia had a mean loss of muscle mass (−5.3 cm², p = 0.020) but no statistically significant change in PF outcomes. Patients with cachexia also lost muscle mass but to a lesser extent (−2.8 cm², p = 0.146), but demonstrated a statistically significant decline in PF; KPS (−3.8 points, p = 0.030), self-PF (−8.8 points, p = 0.027), and HGS (−2.7 kg, p = 0.026). Conclusions: Weight loss history and cachexia status at baseline are of importance if one aims to detect changes in PF outcomes in cancer cachexia trials. To improve the use of co-primary endpoints that include PF in future trials, outcomes that have the potential to detect change relative to weight loss should be investigated further.

Background: Colorectal cancer (CRC) is the third most common cancer worldwide, and a large proportion of the patients receive adjuvant oxaliplatin-based chemotherapy. Most of these experience chemotherapy-induced peripheral neuropathy (CIPN), affecting quality of life. Evidence to advise exercise to reduce CIPN is limited. The primary aim of this study was to investigate the feasibility of an exercise intervention and data collection among CRC patients during adjuvant chemotherapy. Material and methods: This non-randomized feasibility study included CRC patients admitted to adjuvant chemotherapy to an intervention consisting of supervised aerobic endurance, resistance, and balance exercises twice a week at the hospital in addition to home-based exercise once a week. A physiotherapist supervised the patients, and the intervention lasted throughout the period of adjuvant chemotherapy (12–24 weeks). Participants performed physical tests and filled in questionnaires at baseline, 3, 6, 9, and 12 months. Results and conclusion: Nineteen (63%) of 30 invited patients consented. A major barrier to recruit or consent to participation was long travel distance to the hospital. The completion rate of questionnaires and physical tests were near 100%. Seven participants dropped out, five before the intervention started. Median attendance to supervised exercise was 85%. There were no serious adverse events related to the intervention. Except for a planned higher intensity of endurance exercise, we found the intervention feasible and safe. Based on experiences in this study, some adjustments have been made for an upcoming randomized trial, including the supervised exercise taking place close to participants’ homes. Trial registration: NCT03885817, March 22, 2019, retrospectively registered.

Background: Early prevention of sarcopenia through exercise is vital to health, independence and mortality risk in older adults; however, there is a scarcity of evidence concerning the long‐term effects of aerobic exercise alone. We tested the primary hypothesis that a 5‐year decline in key defining components of sarcopenia is less in an aerobic exercise group compared with a control group. Secondly, we tested the same hypothesis using a model of ‘clinically defined sarcopenia’. Methods: Norwegian community dwelling older adults ( n = 1567; aged 70–75 years at inclusion) participated in the Generation 100 Study. They were randomized in a 1:1:2 ratio—stratified by sex and cohabitation status to either moderate intensity continuous training (MICT, n = 387) or high intensity interval training (HIIT, n = 400), or to a control group following the Norwegian physical activity guidelines (CON, n = 780). Key defining components of sarcopenia were grip strength (kilograms), skeletal muscle index (kg/m ² ) and gait speed (m/s). Clinically defined sarcopenia was based on the European Working Group on Sarcopenia in Older People and recent normative data for the Norwegian population. An intention to treat linear mixed model and an ordinal logistic regression mixed model were used to examine the effects of aerobic exercise on sarcopenia on the 1, 3 and 5 years follow‐up. p values for the main hypothesis were adjusted using the Benjamini–Hochberg correction. Results: Mean age across groups was 72 years of age, including ~50% women, ~50% with higher education, 86%–90% with good or very good health and 73%–76% considered physically active. Compared with CON, grip strength declined less for HIIT at Year 1 (estimated difference of 0.98 kg; p < 0.001) and Year 3 (estimated difference of 0.03 kg; p = 0.016). At Year 3, HIIT increased their gait speed by 0.01 m/s (estimated difference between HIIT vs. CON of 0.03 m/s; p = 0.016). At Year 5, all groups declined from baseline (CON −0.07; MICT −0.10 and HIIT −0.04 m/s). Participants determined as having ‘clinically defined sarcopenia’ at baseline, Years 3 and 5 were: 22%, 58% and 63% (CON); 20%, 55% and 67% (MICT) and 19%, 50% and 56% (HIIT). Odds for developing clinically defined sarcopenia were significantly lower for HIIT (OR = 0.51; p = 0.018 at Year 3; OR = 0.47; p = 0.009 at Year 5) as compared with CON. No effects were found for MICT. Conclusions: The study demonstrates that in addition to having a protective cardiovascular effect, HIIT also has a beneficial effect on muscle strength and physical performance in a relatively healthy population of older adults.

Objective: To map existing research on community‐based multidimensional cancer rehabilitation, specifically relating to characteristics of studies, participants, intervention formats, outcomes, and outcome measures. Data Sources: Searches were performed in MEDLINE, Embase, CINAHL, and Web of Science databases in May 2022 and updated in February/March 2024. Review Methods: The review followed the methodological guidance for scoping reviews developed by the Joanna Briggs Institute. We considered evidence from primary research, knowledge syntheses, and research protocols, and imposed no limits on study design. All authors screened independently for eligibility, using a standardized template for data extraction. We used descriptive statistics and presented the results in tables and narrative summaries. Results: The search retrieved 6424 records, of which 104 were selected for full‐text screening. Twelve publications were included in the review, representing nine unique rehabilitation interventions. The included studies comprised 594 participants with a mean age of 59.6 years. The cancer types were mixed with an overrepresentation of breast and prostate cancer. Seven of the publications were feasibility, pilot, protocol, or intervention development studies, and only two were randomized controlled trials. Physical activity/exercise was the most common component within physical functioning, and social support/peer support was most common within psychosocial functioning. Sixty‐five tools were used to measure a range of outcomes, the most frequent being health‐related quality of life. Conclusion: The findings demonstrate that this field of research is in its infancy in Europe. Improving homogeneity in outcomes and outcome measures would enhance comparisons and pooling of results in future research.