Lifestyle medicine for cancer survivorship

PURPOSE OF REVIEW: Cancer survivorship is increasingly characterized by long-term treatment sequelae, including cardiometabolic disease, fatigue, sleep disturbance, psychological distress, and risk of second malignancies. As survivorship populations expand, there is growing recognition that traditional symptom-focused follow-up does not adequately address modifiable drivers of long-term morbidity. This review evaluates lifestyle medicine as a structured framework integrating physical activity, nutrition, sleep health, psychological well being, and substance cessation to improve survivorship outcomes across solid tumors and hematologic malignancies. RECENT FINDINGS: Evidence from randomized trials, cohort studies, and consensus guidelines demonstrates that lifestyle interventions influence systemic inflammation, immune function, metabolic regulation, and functional capacity. Physical activity improves fatigue, cardiorespiratory fitness, and quality of life, while plant-forward dietary patterns are associated with improved survival outcomes. Sleep optimization and stress reduction interventions improve inflammatory signaling and psychological outcomes. Tobacco cessation and alcohol reduction reduce recurrence risk and mortality. Emerging literature highlights the relevance of cardiometabolic pathways and behavioral interventions as modifiable determinants of survivorship trajectories. SUMMARY: Lifestyle medicine provides a biologically plausible and clinically actionable framework to address shared mechanisms underlying cancer recurrence, treatment toxicity, and chronic disease risk. Integration of multidisciplinary interventions and digital health tools may enable scalable survivorship models focused on prevention, functional recovery, and long-term health optimization. Future research should prioritize mechanistic studies and pragmatic trials evaluating multimodal interventions across diverse cancer populations.