The role of structured exercise and further adjuvant lifestyle interventions in clinical oncology

Understanding the molecular mechanisms of evidence-based lifestyle interventions provides a new adjuvant therapeutic toolset for the clinical oncology practice. Elimination of ultra-processed foods (UPFs) is of paramount importance, as they compromise the intestinal barrier and induce microbiome dysbiosis. The subsequent chronic inflammation not only impairs treatment efficacy and tolerability but can also act as a direct oncogenic driver. Conversely, personalized medical nutrition therapy leverages differential stress resistance (DSR) to protect healthy cells, thereby mitigating the adverse effects of cytotoxic therapies. This is complemented by structured exercise therapy, which enhances insulin sensitivity and, through the release of antitumoral myokines, shifts the tumor microenvironment toward an immunologically reactive state. Chronic “alertness” and biological stress, however, have an immunosuppressive effect. Methods aimed at increasing the tone of the vagus nerve can effectively improve the neuro-immunological homeostasis. Furthermore, sleep disturbances and circadian dysregulation lead to disruptions in cell cycle control. In contrast, optimizing sleep architecture and restoring melatonin secretion bolsters endogenous antioxidant defenses and the effector immune response.

Personalized, structured lifestyle interventions are currently a clinically proven therapeutic modality that significantly improves the effectiveness of oncological treatments and the quality of life of patients, therefore they should be made available not only in a general educational form, but also within the framework of specific protocols.