Exercise for cancer cachexia in adults

Grande, Antônio José; Silva, Valter; Neto, Larissa Sawaris; Basmage, João Pedro Teixeira; Peccin, Maria Stella; Maddocks, Matthew

doi:10.1002/14651858.cd010804.pub3

Cited by 48 publications

(50 citation statements)

References 81 publications

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“…Of these, 144 were examined in detail; 36 met eligibility criteria and comprised the evidence base for the guideline recommendations. These publications consisted of 20 systematic reviews [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] and 13 additional RCTs (16 publications). [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] A summary of the literature search results is provided in the Data Supplement.…”

Section: Resultsmentioning

confidence: 99%

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Management of Cancer Cachexia: ASCO Guideline

Roeland

Bohlke

Baracos

et al. 2020

JCO

383

425

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PURPOSE To provide evidence-based guidance on the clinical management of cancer cachexia in adult patients with advanced cancer. METHODS A systematic review of the literature collected evidence regarding nutritional, pharmacologic, and other interventions, such as exercise, for cancer cachexia. PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and systematic reviews of RCTs published from 1966 through October 17, 2019. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The review included 20 systematic reviews and 13 additional RCTs. Dietary counseling, with or without oral nutritional supplements, was reported to increase body weight in some trials, but evidence remains limited. Pharmacologic interventions associated with improvements in appetite and/or body weight include progesterone analogs and corticosteroids. The other evaluated interventions either had no benefit or insufficient evidence of benefit to draw conclusions on efficacy. Limitations of the evidence include high drop-out rates, consistent with advanced cancer, as well as variability across studies in outcomes of interest and methods for outcome assessment. RECOMMENDATIONS Dietary counseling may be offered with the goals of providing patients and caregivers with advice for the management of cachexia. Enteral feeding tubes and parenteral nutrition should not be used routinely. In the absence of more robust evidence, no specific pharmacological intervention can be recommended as the standard of care; therefore, clinicians may choose not to prescribe medications specifically for the treatment of cancer cachexia. Nonetheless, when it is decided to trial a drug to improve appetite and/or improve weight gain, currently available pharmacologic interventions that may be used include progesterone analogs and short-term (weeks) corticosteroids.

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Section: Resultsmentioning

confidence: 99%

“…Literature review and analysis. A 2014 Cochrane review of exercise for cancer cachexia identified no eligible trials, 27 and no eligible trials were identified by the systematic review conducted for this guideline.…”

Section: Recommendationmentioning

confidence: 99%

Management of Cancer Cachexia: ASCO Guideline

Roeland

Bohlke

Baracos

et al. 2020

JCO

383

425

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“…Therefore, exercise is another possible treatment that may benefit patients by modulating levels of inflammation and altering muscle metabolism. [ 9 12 ] However, a Cochrane review on randomized controlled trials found no evidence to demonstrate a beneficial effect of exercise on cancer cachexia. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

Review of the Effects and Safety of Traditional Chinese Medicine in the Treatment of Cancer Cachexia

Cheng

2021

Asia-Pacific Journal of Oncology Nursing

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“…Considering the high prevalence and clinical relevance of cancer cachexia, it was surprising that at the time of screening no human RCT or CT that specifically screened for cachectic symptoms has been published. In fact, this lack of human trials was previously identified by a Cochrane review that was published six years ago 20 and appears not having improved ever since. The reasons for this paucity may be related to the criteria of cancer cachexia, which have been established as late as 2012 and, thus, a framework of precise classification and treatment was missing.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 However, studies examining the efficacy of exercise training in cachectic cancer patients are still limited. 20 Therefore, the purpose of this systematic literature review and meta-analysis was to elucidate the effects of exercise training as a countermeasure for cancer cachexia in both human and animal models. Special consideration was given to the effects of different exercise training interventions on total body mass (BM) as the primary outcome and muscle mass and muscle cross-sectional area (CSA) as secondary outcomes.…”

Section: Introductionmentioning

confidence: 99%

Can Exercise Counteract Cancer Cachexia? A Systematic Literature Review and Meta-Analysis

et al. 2020

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Background: Cancer-cachexia is associated with chronic inflammation, impaired muscle metabolism and body mass loss, all of which are classical targets of physical exercise. Objectives: This systematic review and meta-analysis aimed to determine the effects of exercise on body and muscle mass in cachectic cancer hosts. Data Sources: PubMed/Medline, EMBASE, CINHAL, ISI Web of Science, and Cochrane Library were searched until July 2019. Study Selection: Trials had to be randomized controlled trials or controlled trials including cancer patients or animal models with cachexia-inducing tumors. Only sole exercise interventions over at least 7 days performed in a controlled environment were included. Data Extraction: Risk of bias was assessed and a random-effects model was used to pool effect sizes by standardized mean differences (SMD). Results: All eligible 20 studies were performed in rodents. Studies prescribed aerobic (n = 15), strength (n = 3) or combined training (n = 2). No statistical differences were observed for body mass and muscle weight of the gastrocnemius, soleus, and tibialis muscles between the exercise and control conditions (SMD = ‒0.05, 95%CI-0.64-0.55, P = 0.87). Exercise duration prior to tumor inoculation was a statistical moderator for changes in body mass under tumor presence ( P = 0.04). Limitations: No human trials were identified. A large study heterogeneity was present, probably due to different exercise modalities and outcome reporting. Conclusion: Exercise does not seem to affect cancer-cachexia in rodents. However, the linear regression revealed that exercise duration prior to tumor inoculation led to reduced cachexia-severity, possibly strengthening the rationale for the use of exercise in cancer patients at cachexia risk.

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Exercise for cancer cachexia in adults

Cited by 48 publications

References 81 publications

Management of Cancer Cachexia: ASCO Guideline

Management of Cancer Cachexia: ASCO Guideline

Review of the Effects and Safety of Traditional Chinese Medicine in the Treatment of Cancer Cachexia

Can Exercise Counteract Cancer Cachexia? A Systematic Literature Review and Meta-Analysis

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