{"entity":{"id":"resistance-training-cachexia","kind":"technology","name":"Resistance training and protein for cachexia and sarcopenia","aka":[],"tldr":"Lifting weights and eating enough protein is the only treatment shown to build muscle in people with cancer wasting, but most are too unwell to do it alone and the trials are small.","summary":"Skeletal muscle in cachexia remains anabolically responsive if enough protein (1.2-1.5 g/kg/day, ESPEN 2021) and mechanical loading are provided. Small randomised trials and the multimodal MENAC feasibility trial (exercise, nutrition, NSAID) show preserved or increased lean mass and function, but no adequately powered trial has yet shown that exercise prolongs survival or reverses established refractory cachexia. Adherence is the constraint: the patients who most need it are the least able to attend. Combination with appetite or anti-GDF-15 drugs is the rational next step and is being planned.","status":"emerging","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Cachexia","links":[{"label":"MENAC feasibility (BMJ Support Palliat Care 2018)","url":"https://doi.org/10.1136/bmjspcare-2017-001440"},{"label":"ESPEN practical guideline 2021","url":"https://doi.org/10.1016/j.clnu.2021.02.005"}],"tags":[],"related":["idea-bio2-gdf15-plus-exercise","idea-moon-cachexia-as-treatable-disease"],"cancers":["pancreatic","nsclc","gastric","head-and-neck"],"sections":["nutrition-lifestyle","supportive-care","rejuvenation"],"technologies":["exercise-oncology","oncology-nutrition","cachexia-therapy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":["cachexia-biology"],"terms":["cachexia","sarcopenia","body-composition"],"trials":[],"people":[],"bottlenecks":["b-cachexia-supportive"],"keyPapers":["paper-muscaritoli-clin-nutr","paper-solheim-bmj-support-palliat-care"],"journals":[],"dependsOn":[],"notes":[],"principle":"Progressive resistance exercise activates mTOR-dependent muscle protein synthesis and blunts the ubiquitin-proteasome degradation driven by inflammatory cytokines; protein and leucine supply the substrate.","strengths":["Only intervention that directly rebuilds muscle","Cheap and combinable with drugs","Improves function, the endpoint patients value"],"limitations":["Feasibility falls as cachexia advances","No survival data","Dose, timing and supervision unstandardised"]},"route":"/technologies/resistance-training-cachexia/","neighbours":{"idea":[{"id":"idea-bio2-gdf15-plus-exercise","kind":"idea","name":"Combine the new anti-wasting antibody with exercise and protein","route":"/ideas/idea-bio2-gdf15-plus-exercise/"},{"id":"idea-nl-glp1-adjuvant-hr-breast","kind":"idea","name":"GLP-1 receptor agonists as adjuvant weight-loss therapy in HR-positive breast cancer","route":"/ideas/idea-nl-glp1-adjuvant-hr-breast/"},{"id":"idea-moon-cachexia-as-treatable-disease","kind":"idea","name":"Treat cachexia as a disease: GDF-15 blockade plus anabolic and nutrition bundles","route":"/ideas/idea-moon-cachexia-as-treatable-disease/"}],"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"section":[{"id":"nutrition-lifestyle","kind":"section","name":"Diet, Exercise & Lifestyle","route":"/fronts/nutrition-lifestyle/"},{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"cachexia-appetite-pharmacotherapy","kind":"technology","name":"Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine","route":"/technologies/cachexia-appetite-pharmacotherapy/"},{"id":"cachexia-therapy","kind":"technology","name":"Cachexia-directed therapy (GDF-15 blockade)","route":"/technologies/cachexia-therapy/"},{"id":"exercise-oncology","kind":"technology","name":"Exercise & lifestyle oncology","route":"/technologies/exercise-oncology/"},{"id":"omega3-epa-cachexia","kind":"technology","name":"Fish oil (EPA) for cancer weight loss","route":"/technologies/omega3-epa-cachexia/"},{"id":"rejuv-measure-body-composition","kind":"technology","name":"Measuring muscle and fat on scans the patient already had","route":"/technologies/rejuv-measure-body-composition/"},{"id":"muscle-recovery-after-cancer-treatment","kind":"technology","name":"Muscle and strength after treatment: sarcopenia, cachexia and what rebuilds","route":"/technologies/muscle-recovery-after-cancer-treatment/"},{"id":"oncology-nutrition","kind":"technology","name":"Nutrition support and cachexia management","route":"/technologies/oncology-nutrition/"},{"id":"exercise-prescription-after-cancer","kind":"technology","name":"The exercise prescription after cancer: the dose the guidelines state","route":"/technologies/exercise-prescription-after-cancer/"}],"pathway":[{"id":"cachexia-biology","kind":"pathway","name":"Cancer cachexia","route":"/pathways/cachexia-biology/"}],"term":[{"id":"body-composition","kind":"term","name":"Body composition (lean mass, fat mass, visceral fat)","route":"/terms/body-composition/"},{"id":"cachexia","kind":"term","name":"Cancer cachexia","route":"/terms/cachexia/"},{"id":"sarcopenia","kind":"term","name":"Sarcopenia","route":"/terms/sarcopenia/"}],"bottleneck":[{"id":"b-cachexia-supportive","kind":"bottleneck","name":"Cachexia, toxicity and the limits of the patient","route":"/bottlenecks/b-cachexia-supportive/"}],"paper":[{"id":"paper-solheim-bmj-support-palliat-care","kind":"paper","name":"Cancer cachexia: rationale for the MENAC (Multimodal-Exercise, Nutrition and Anti-inflammatory medication for Cachexia) trial","route":"/key-papers/paper-solheim-bmj-support-palliat-care/"},{"id":"paper-muscaritoli-clin-nutr","kind":"paper","name":"ESPEN practical guideline: Clinical Nutrition in cancer","route":"/key-papers/paper-muscaritoli-clin-nutr/"}],"roadmap":[{"id":"nutrition-lifestyle-roadmap","kind":"roadmap","name":"Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment","route":"/roadmaps/nutrition-lifestyle-roadmap/"},{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}