Can non-pharmacological strategies in cancer patients support perceived appetite? A scoping review

This review aims to identify and synthesize existing literature on non-pharmacological interventions in cancer patients in which perceived appetite was assessed as a specific outcome, either alone or as part of broader symptom or quality-of-life measures.

Systematic searches were performed using Embase, PubMed, CINAHL, and PsycINFO databases. Eligible studies included quantitative research involving adult cancer patients with poor appetite. All records were screened independently by two reviewers.

A total of 3021 records were screened, and 29 studies met the inclusion criteria. These studies were grouped into four categories: mindfulness and relaxation, psychological or psychosocial, education and self-care, and multicomponent/comprehensive supportive-care programs. Interventions were heterogeneous in type, intensity, and delivery. Across categories, structured, repeated, and actively guided interventions were more consistently associated with improvements in perceived appetite, whereas brief or passive interventions showed limited effects. Interventions that incorporated personalization and required active patient engagement demonstrated greater effectiveness, suggesting the importance of sustained and individualized support. To support interpretation of these heterogeneous findings, results were synthesized using a conceptual framework linking intervention characteristics to psychological, sensory, physiological, and behavioral mechanisms influencing appetite perception. Within this framework, non-pharmacological appetite support appears to operate indirectly through pathways such as emotional regulation, sensory engagement, stress reduction, and active coping, rather than through appetite-specific mechanisms alone.

Structured, actively guided, and repeated non-pharmacological interventions show potential to improve perceived appetite in cancer patients, whereas brief or passive interventions appear less effective. Findings suggest that appetite support operates primarily through indirect psychological, sensory, and behavioral pathways, as captured in a conceptual framework. Further research should develop and evaluate well-defined, mechanism-informed interventions.