The importance of skeletal muscle in the outcomes of our individuals with cancer, with the new direction of immunotherapy and CAR T-cell therapy

Sami (Papacek) Mansfield, is the founder of Cancer Wellness for Life shared a post by Robert Newton, Professor of Exercise Medicine at Edith Cowan University on LinkedIn:

“While my response to Robert Newton’s repost is a bit slow, the urgency of this conversation is accelerating especially with us less than 80 days from 2025 when so many decide that this is “their year!”

We cannot lose sight of:
1. The importance of skeletal muscle in the outcomes of our individuals with cancer, with the new direction of immunotherapy and CARt, we are seeing conversations around oncometabolics, which is exciting and also terrifying given the sarcopenic obesity we are experiencing.
2. Individuals with cancer often care about weight and regardless of how much it can impact their quality of life to lose weight “in the wrong way” will be thrilled when they get skinnier.

Our role is education, empowerment and support. First, we must educate! Our providers, allied health, community and patients.”

Quoting Robert Newton‘s post:

“My biggest concern in the oncology setting is that all weight loss drugs (e.g. Ozempic, Wegovy, Tirzepatide) result in one third of weight loss being muscle mass.

It has also been reported from high quality clinical trials that most patients regain the weight after ceasing the drug therapy, but through increased fat mass rather than muscle.

The result is worse body composition, metabolic health, and more cancer promoting systemic environment.

It has been established in number of cancer types (e.g. breast, prostate) that low muscle mass is a strong prognostic indicator for overall and cancer specific mortality through mechanisms mediated by skeletal muscle signaling.

Patients with cancer also experience worse side effects of chemotherapy and dose reduction if they have low muscle mass. For a person with cancer, the evidence is that low muscle mass is more of a concern for health and survival than high fat mass.

Hence it is critical that any drug, surgical or diet therapy for fat loss in a person with cancer must be accompanied by a sophisticated exercise medicine prescription to drive muscle growth and ameliorate this devastating side effect.”

Links to the articles:
Exercise-induced myokines and their effect on prostate cancer.

Associations of fat and muscle mass with overall survival in men with prostate cancer: a systematic review with meta-analysis

Sami (Papacek) Mansfield is the founder of Cancer Wellness for Life. She’s been a certified cancer exercise specialist since 2003 and has dedicated her career to implementing evidence-based lifestyle education, resources and tools into cancer care for both the patients and the providers. She is also a Chair of Cancer Member Interest Group, at the American College of Lifestyle Medicine and Breast Cancer Taskforce Co-Chair at Colorado Cancer Coalition.