Exercise, Diet, and Weight Management During Cancer Treatment

Publication Date: May 15, 2022
Last Updated: February 6, 2024

Treatment

Exercise

Recommendation 1.1

Oncology providers should recommend aerobic and resistance exercise during active treatment with curative intent to mitigate side effects of cancer treatment. (Evidence Quality: Moderate/Low) (EB, B, M, S)
Note: Exercise interventions during active treatment reduce fatigue; preserve cardiorespiratory fitness, physical functioning, and strength; and in some populations, improve quality of life and reduce anxiety and depression. In addition, exercise interventions during treatment have low risk of adverse events. Evidence was not sufficient to recommend for or against exercise during treatment to improve cancer control outcomes (recurrence or survival) or treatment completion rates.
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Recommendation 1.2

Oncology providers may recommend preoperative exercise for patients undergoing surgery for lung cancer to reduce length of hospital stay and post-operative complications. (EB, B, L, W)
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Diet

Recommendation 2.1

There is currently insufficient evidence to recommend for or against dietary interventions such as ketogenic or low carbohydrate diets, low fat diets, functional foods, or fasting to improve outcomes related to quality of life, treatment toxicity, or cancer control. (, , , )
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Recommendation 2.2

Neutropenic diets (specifically diets that exclude raw fruits and vegetables) are not recommended to prevent infection in cancer patients during active treatment. (EB, H, L, W)
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Recommendation 3

There is currently insufficient evidence to recommend for or against intentional weight loss or prevention of weight gain interventions during active treatment to improve outcomes related to quality of life, treatment toxicity, or cancer control. (, , , )
Note: The Expert Panel felt strongly that the current lack of evidence regarding diet and weight management interventions during cancer treatment should be a call to conduct more research in these critical areas. Diet and weight management strategies that provide health benefits to the general population could also provide important benefits to people who are undergoing cancer treatment. The Expert Panel is not discouraging clinicians from discussing healthy diet and weight with their patients, but did refrain from making specific recommendations, given gaps in the evidence.
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ASCO believes that cancer clinical trials are vital to inform medical decisions and improve cancer care and that all patients should have the opportunity to participate.

Additional information, which may include data supplements, slide sets, and other clinical tools and resources, is available at www.asco.org/supportive-care-guidelines.

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Exercise, Diet, and Weight Management During Cancer Treatment

Authoring Organization

American Society of Clinical Oncology

Publication Month/Year

May 15, 2022

Last Updated Month/Year

October 1, 2024

Supplemental Implementation Tools

Document Type

Guideline

Country of Publication

US

Document Objectives

To provide guidance on exercise, diet, and weight management during active cancer treatment in adults.

Target Patient Population

Adults with cancer receiving systemic antineoplastic therapy or radiotherapy, or who are in the perioperative period

Target Provider Population

Clinicians who provide care to adults with cancer

PICO Questions

  1. Does exercise during cancer treatment safely improve outcomes related to QoL, treatment toxicity, or cancer control?

  2. Does consuming a particular dietary pattern or food(s) during cancer treatment safely improve outcomes related to QoL, treatment toxicity, or cancer control?

  3. Do interventions to promote intentional weight loss or avoidance of weight gain during cancer treatment safely improve outcomes related to QoL, treatment toxicity, or cancer control?

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Home health, Hospital, Outpatient

Intended Users

Dietician nutritionist, nurse, nurse practitioner, physical therapist, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D000066888 - Diet, Food, and Nutrition, D001835 - Body Weight, D015444 - Exercise

Keywords

diet, exercise, cancer, Weight Management

Source Citation

Ligibel JA, Bohlke K, May AM, et al. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol. 2022 May 16. doi: 10.1200/JCO.22.00687

Supplemental Methodology Resources

Data Supplement, Evidence Tables

Methodology

Number of Source Documents
123
Literature Search Start Date
December 31, 1999
Literature Search End Date
April 30, 2021