Blood Flow Restriction Training in Older Adults with Cancer: Rationale, Clinical Applications and Future Perspectives

Cancer predominantly affects older adults, who frequently present with frailty, sarcopenia, cachexia, multimorbidity, and functional decline that limit tolerance to conventional exercise interventions. Blood flow restriction (BFR) training has emerged as a potential low-load exercise strategy capable of promoting muscular adaptations while reducing mechanical stress. This narrative review synthesizes current evidence on the physiological rationale, clinical applications, safety considerations, and implementation of BFR training in older adults with cancer. Literature from PubMed, Scopus, and Web of Science was reviewed, with emphasis on studies investigating BFR, exercise interventions, geriatric syndromes, and oncology rehabilitation. Evidence from older adult populations demonstrates that low-load BFR training may improve muscle strength, muscle mass, and functional performance while maintaining a generally favorable safety profile when individualized and appropriately supervised. Although oncology-specific evidence remains limited, preliminary studies suggest that BFR is feasible, acceptable, and may attenuate treatment-related declines in physical function, particularly in patients with sarcopenia, frailty, and reduced exercise tolerance. However, substantial heterogeneity in study populations and intervention protocols, together with limited long-term safety data, precludes definitive clinical recommendations. BFR training represents a promising adjunct to individualized exercise programs for older adults with cancer, particularly when conventional high-load exercise is poorly tolerated. Nevertheless, adequately powered oncology-specific trials are needed to establish standardized protocols, confirm safety, and define its role in routine geriatric oncology care.