Purpose <p>This umbrella review systematically evaluate and synthesize current evidence for improving sarcopenia-related outcomes (muscle mass, strength, physical function) in cancer patients and survivors, to inform evidence-based exercise recommendations.</p> Methods <p>We searched PubMed, Embase, Web of Science, and Cochrane Library (Jan 2010-Dec 2025) for systematic reviews/meta-analyses of exercise interventions targeting sarcopenia-related outcomes in cancer patients and survivors. Two reviewers screened studies, extracted data, and assessed quality via AMSTAR 2. High heterogeneity led to content analysis instead of quantitative synthesis.</p> Results <p>Fourteen eligible studies covering 16,406 cancer patients and survivors (breast, colorectal, liver cancer, etc.) were included. Content analysis revealed: 1) 4 studies indicated combined exercise (resistance + aerobic) provided the most comprehensive benefits (e.g., optimized body composition, reduced cancer-related fatigue); 2) 9 studies showed resistance training excelled in improving lean muscle mass and strength; 3) 1 study found aerobic exercise better enhanced functional capacity; 4) 1 study incorporating balance/flexibility training and home-based exercise reported improved muscular outcomes.</p> Conclusions <p>Combined exercise is first-line for improving sarcopenia-related outcomes in cancer patients and survivors. However, the small volume of published reviews focusing on this modality should be noted, as it may compromise the reliability of this conclusion; Resistance training is preferred for standalone muscle mass preservation; Aerobic exercise suits patients with poor physical status. Individualized protocols should align with cancer type, treatment phase, and tolerance. High-quality studies are needed to define optimal exercise dosage.</p>