The role of aerobic and resistance exercise for cancer cachexia management - A systematic scoping review.

Objective: Cancer cachexia is highly prevalent in digestive and head and neck cancer patients who often face mechanical eating difficulties and metabolic disturbances. However, terminological and diagnostic ambiguities surround cachexia, limiting the evaluation of the effects of management interventions for these patients. Whole-body exercise plays a key role in mitigating weight and muscle mass losses. This scoping review provides an updated synthesis of the effects of exercise interventions and offers practical guidelines for patients with digestive or head and neck cancers experiencing undernutrition, anorexia, sarcopenia, and/or cachexia. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a systematic search of the published literature was carried out in the PubMed, Google Scholar, and EBSCOhost databases. Studies eligible for inclusion investigated the feasibility and effects of whole-body exercise interventions in digestive or head and neck cancer patients with altered nutritional status. The findings from each study were tabulated and synthesized according to the type of exercise intervention. Results: Twenty-six full texts out of 603 studies met the inclusion criteria, encompassing a total of 1936 patients participated (mean age: 63.80 ​± ​6.22 years; 822 [31.62%] women). Exercise interventions did not result in adverse outcomes. The most assessed parameters included functional and aerobic capacity, muscle strength, body weight, quality of life, and physical activity levels, with findings ranging from positive effects and trends to non-significant changes. Interventions incorporating endurance exercises demonstrated greater improvements in functional and aerobic capacity compared to those focusing solely on resistance training. Supervised interventions yielded the most significant improvements. Conclusions: Exercise interventions are safe and feasible for patients with digestive and head and neck cancers identified as suffering from undernutrition, anorexia, sarcopenia, and/or cachexia. Future research should focus on tailoring exercise characteristics to achieve greatest benefits in patients with cachexia. Studies should also explore real-life implementation strategies to optimize patient engagement and adherence while accommodating medical and personal constraints. Systematic review registration: CRD42024602857.