The role of exercise intervention in the management of cancer cachexia

Abstract

Cancer cachexia is a multifactorial disease which was characterized by the progressive loss of skeletal muscle mass and/or fat mass. Many organs such as tumor tissue, immunocytes, muscle, adipose tissue, gut, and central nervous system are involved in the pathophysiology of the cancer cachexia. Age‐related sarcopenia, coexistent diseases, and anticancer treatment further modify its pathophysiology. Patients with cancer cachexia have decreased physical capacity, poor tolerance to anticancer treatment, and poor prognosis. The treatment options include cancer treatment itself, the management of toxicities of cancer treatment, medications for cachexia, nutritional and psychosocial support, and exercise intervention. The expected role of exercise intervention in cancer cachexia is to minimize or delay the deterioration of patients' activity of daily living by maintaining muscle strength and cardiopulmonary fitness. In addition, exercise might attenuate the consequences of cancer cachexia by modulating muscle metabolism, insulin sensitivity, and level of inflammation. However, little is known about the precise characteristics of physical dysfunction in cancer patients and the standard exercise prescription based on the large randomized controlled study has not been established. In this presentation, we review the current evidences of exercise intervention in cancer cachexia showing our data obtained from ongoing prospective clinical study in elderly patients with advanced non‐small‐cell lung cancer.