Adolescents and young adults with cancer represent a distinct and historically underserved population, whose clinical and psychosocial needs are not adequately addressed by traditional pediatric or adult oncology training pathways. While awareness of AYA-specific challenges has increased over the last two decades, substantial gaps in professional education and training persist across Europe. The Joint Action Networks of Expertise (JANE) has recently enabled the creation of a formal European Network of Expertise (NoE) dedicated to AYAs with cancer, offering a unique opportunity to address these gaps in a coordinated and sustainable manner. In this paper, we describe the educational needs in AYA oncology, summarize existing recommendations on AYA-specific training, and present the vision and planned actions of the JANE NoE on AYAs with cancer to develop structured, multidisciplinary, trans-age educational programmes across Europe.
Purpose: This network meta-analysis aimed to evaluate and rank the comparative efficacy of aerobic training (AT), resistance training (RT), combined AT and RT (CT), and high-intensity interval training (HIIT) primarily on body weight and secondarily on body mass index, fat-free mass, fasting glucose, fasting insulin, handgrip strength, physical activity, cardiorespiratory fitness, fatigue, quality of life, anxiety, depression, and exercise adherence in colorectal cancer (CRC) survivors. Methods: MEDLINE/PubMed, Scopus, Web of Science, CENTRAL, and MedRxiv were searched for randomized controlled trials (RCTs) from inception up to July 1, 2025. RCTs published in English comparing exercise to controls (CON) or to another exercise type in CRC patients after colon resection surgery were qualified. Results: Thirty-two studies involving 2,001 CRC survivors (51.3/48.7 male-female ratio; mean ± SD: age, 58.0 ± 10.2 years; BMI, 27.1 ± 3.9 kg·m -2 ) were included. HIIT and CT were more effective than CON in improving cardiorespiratory fitness and fasting insulin, respectively. No exercise type was identified as being more efficacious than CON in improving any other outcome measures. Nevertheless, HIIT had the highest probability of being the best exercise intervention for improving body weight, physical activity, cardiorespiratory fitness, and quality of life. AT had the highest likelihood of reducing body mass index, fasting glucose, and anxiety. CT had the highest probability of improving fasting insulin, fatigue, depression, and exercise adherence, while RT showed the highest probability of being the most effective exercise type in increasing handgrip strength and fat-free mass. Conclusions: The current evidence indicates few confirmed benefits of exercise in CRC survivors, suggesting which types of exercise are most promising for a given psychophysiological outcome and may inform further large-scale RCTs of high methodological quality.
The metabolic and inflammatory burden of cardiac surgery results in increased protein catabolism, elevated energy expenditure and thereby a consequent increased risk of postoperative complications. Therefore, it is imperative to optimise nutritional status preoperatively and postoperatively to ameliorate these effects on wound healing, immune function, and recovery of the myocardium, in addition to other clinical outcomes. Despite its benefits, structured perioperative nutritional care is rarely undertaken. In this narrative review, we will summarise contemporary literature (2017-2026) and international guideline recommendations to outline phase-specific nutritional strategies for patients undergoing cardiac surgery. In the early postoperative period, early initiation of enteral nutrition, adequate protein provision (1.2-2.0 g/kg/day), and careful fluid and glycaemic management are critical to attenuate catabolic stress and reduce complications. During hospital recovery and discharge to home, emphasis should shift towards caloric adequacy, micronutrient optimisation-particularly vitamins C and D, zinc, and iron-and management of medication-related gastrointestinal effects. In the long-term phase, adoption of cardioprotective dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets supports secondary prevention and cardiovascular risk reduction. Elderly patients who are sarcopenic, individuals with diabetes mellitus or chronic kidney disease (CKD), overweight individuals and people on anticoagulation warrant special consideration. Integrating nutritional assessment and intervention into Enhanced Recovery After Cardiac Surgery (ERACS) pathways may help improve recovery trajectories and reduce morbidity. Further high-quality research should be conducted to define procedure-specific and individualised nutritional protocols in the cardiac surgical population.
