Exercise Combats Fatigue During and After Cancer Treatment

It has been well established that exercise and a healthful diet aid in the prevention of many types of cancer. Exercise is also beneficial during cancer treatment, but the effects of exercise during treatment and after treatment are different, according to the findings of a new systematic review conducted by researchers at Emory University in Atlanta.¹ The researchers concluded that exercise has a palliative effect in patients during cancer treatment and a recuperative effect after treatment.

In the first systematic review of studies evaluating the effect of exercise on cancer-related fatigue either during treatment or after cancer treatment, the authors identified 70 studies involving 4881 cancer patients. All studies included in this review had a cancer-related fatigue outcome that was measured at baseline and after the intervention, which was either an exercise or non-exercise allocation.

Patients who exercised during and after cancer treatment had significant reductions in cancer-related fatigue compared with patients who did not exercise. The mean effect (delta) of exercise in terms of cancer-related fatigue was 0.32 during treatment and 0.38 after treatment (confidence interval, 95%).¹ During treatment, the largest improvements in fatigue were gained by patients who had lower fatigue scores at baseline and higher exercise adherence rates. After cancer treatment, the greatest improvements in cancer-related fatigue were found in patients in trials with longer periods between treatment completion and exercise initiation, patients in trials with shorter exercise program lengths, and patients in trials that used wait-list comparisons.

In general, patients who receive a diagnosis of cancer tend to become less active. Not only can a diagnosis of cancer increase stress or depression, which are both related to increases in lethargy and inactivity, feeling sick and fatigued from the disease itself and its treatments can further decrease activity levels.² After treatment, however, many patients will remain sedentary. Adopting an exercise routine that ideally includes both aerobic exercise and weight training is a simple way that cancer survivors not only can decrease the risk of cancer recurrence but also boost their mood and self-confidence, decrease fatigue, and improve their cardiovascular and metabolic health. An additional benefit of exercise after completion of treatment in women with breast cancer is less disease recurrence.²

Pertinent Points:
- Exercise significantly reduces cancer-related fatigue both during and following cancer treatment.
- During cancer treatment, exercise has a palliative effect in patients. After completing cancer treatment, exercise has a recuperative effect.

References:

1. Puetz TW, Herring MP. Differential effects of exercise on cancer-related fatigue during and following treatment: a meta-analysis. Am J Prev Med. 2012;43(20):e1-e24. doi: 10.1016/j.amepre.2012.04.027.
2. Hoffman M. Exercise for cancer patients: fitness after treatment. Available at: http://www.webmd.com/cancer/features/exercise-for-cancer-patients. Accessed December 21, 2012.