Physical activity and exercise in liver cancer

Sarcopenia and physical deconditioning are common complications in patients with liver cancer, which are frequently caused by insufficient physical activity and poor nutritional status, resulting in physical frailty and a significant impact on the patient’s physical fitness. Notably, sarcopenia, frailty, and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer. Exercise intervention significantly improves various health parameters in liver cancer patients, including metabolic syndrome, muscle wasting, cardiorespiratory endurance, health-related quality of life, and reduction in hepatic venous pressure gradient. However, the link between physical exercise and liver cancer is commonly overlooked. In this article, we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer. This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors. In brief, physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications. •Physical inactivity and frailty are highly prevalent and independently predict morbidity and mortality in liver cancer.•PA improves frailty and quality of life, and lowers the hepatic venous portal gradient without adverse effects.•Exercise programs for liver cancer survivors should be individualized, gradual, and persistent.•Wearable devices paired with APP can help liver cancer patients smoothly shift their PA from the hospital to their home.