Dietary and Physical Activity Interventions in Gynecologic Oncology: Mechanisms, Guidelines, and Clinical Evidence

Background: Obesity and modifiable lifestyle factors contribute significantly to the rising global burden of cancer, particularly gynecologic malignancies such as endometrial and ovarian cancer. Despite strong biological plausibility, the role of lifestyle interventions in improving outcomes for women with gynecologic cancers remains underexplored. Objective: This review synthesizes current evidence on the impact of dietary and physical activity interventions on gynecologic cancer outcomes, highlighting links and existing clinical guidelines. Methods: Literature exploring the influence of obesity, inflammation hormonal dysregulation, insulin resistance, and gut microbiome alterations on cancer progression were assessed, and studies assessing the effects of lifestyle interventions in gynecologic cancers were explored. Results: Obesity-induced inflammation and hormonal imbalances are key drivers of tumorigenesis. Structured exercise and adherence to anti-inflammatory diets, such as the Mediterranean diet, can reduce pro-inflammatory cytokines, improve insulin sensitivity, regulate estrogen metabolism, and enhance immune function. These interventions also modulate angiogenesis and promote a favorable gut microbiome, offering a biologically plausible approach to slowing cancer progression. Conclusion: Diet and exercise represent promising, low-risk strategies to improve quality of life and potentially enhance survival in women with gynecologic cancers. Greater integration of lifestyle interventions into gynecologic oncology care is warranted, guided by evidence and recommendations from national cancer organizations.