Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline.
Level 1 - systematic review of randomized trials
Clinical practice guideline based on a systematic review of 52 systematic reviews and 23 randomized controlled trials.
PubMed 35576506 · doi:10.1200/JCO.22.00687
What was done
An American Society of Clinical Oncology (ASCO) Expert Panel conducted a systematic literature search in PubMed and the Cochrane Library from January 2000 to May 2021. The review evaluated systematic reviews and randomized controlled trials on aerobic and resistance exercise, specific diets or foods, and intentional weight loss or avoidance of weight gain among adults undergoing active cancer treatment. Evaluated outcomes included quality of life, treatment-related toxicity, and cancer control.
What was found
The evidence base included 52 systematic reviews (42 on exercise, 9 on diet, 1 on weight management) and 23 additional randomized controlled trials, primarily studying breast, prostate, lung, and colorectal cancers. No numerical effect sizes, confidence intervals, or p-values were reported in the abstract. Exercise during treatment improved cardiorespiratory fitness, muscle strength, fatigue, and other patient-reported outcomes. Preoperative exercise for lung cancer patients reduced postoperative hospital stay and surgical complications. Neutropenic diets showed no reduction in infection risk. Evidence for other dietary modifications and weight management interventions during active treatment was reported as very limited.
Why it matters
This guideline provides clear oncology recommendations supporting regular aerobic and resistance exercise during active curative cancer treatment and advises against the routine prescription of neutropenic diets.
Limits
The abstract reports purely directional findings with zero quantitative data or effect sizes. The underlying evidence is heavily skewed toward exercise and restricted largely to four cancer types (breast, prostate, lung, colorectal). Data regarding specific nutritional interventions, intentional weight loss, and exercise in advanced or metastatic cancer populations remain sparse.
Cited by
- supports In 2022, the American Society of Clinical Oncology (ASCO) published guidelines recommending aerobic and resistance exercise for all cancer patients being treated with curative intent.