Exercise may be the best way to battle cancer-related fatigue

Washington, April 16 : A new review of studies suggests that exercise may be helpful in fighting cancer-related fatigue when its treatments leave a patient with a relentless weariness of body and mind.

The review, appearing in The Cochrane Library, involved 28 studies of cancer-related fatigue.

Its results showed exercise to be more effective at combating the problem than the usual care provided to patients.

"A lot of the time, the medical response to patients is that they should expect to be fatigued, that it is a normal side effect. If patients are told that fatigue is just a side effect and to accept it, what they are not getting is any advice or support to help them cope," said lead review author Fiona Cramp, a lecturer at the University of the West of England in Bristol.

A weighed-down feeling and constant lack of energy are the common complaints made by people suffering from cancer-related fatigue. Such symptoms can result in diminished interest in work and family life.

The studies tested exercise programs that lasted from three weeks to eight months, but the typical intervention lasted twelve weeks.

Many studies measured the effect of walking or stationary bike riding, but the length, type and intensity of exercise varied widely across the studies.

In all, the researchers studied data pertaining to more than 2,000 people with cancer.

"Exercise shouldn't be used in isolation but should definitely be included as one of the components in the package of interventions used during and after treatment," said Cramp.

Exercise researcher Karen Mustian points out that the first-step to treating cancer-related fatigue is to uncover and alleviate any underlying medical conditions, like anaemia or an under-active thyroid, which can cause fatigue-like symptoms.

"There will still be a fair amount of patients dealing with fatigue after we get other situations under control," said Mustian of the University of Rochester School of Medicine, who was not involved in the review.

"I think it's safe to say at this point that the sort of generalized guidelines of walking 30 minutes a day three to five times a week generally helps patients. We can't say what specific doses are best. With the evidence currently out there, we can't say much beyond that," Mustian added.

Cramp said that it was yet to be determined what intensity, frequency, duration and kinds of exercise are optimal for people with cancer.

"I believe, in the future, exercise in oncology can play a role, as much a role as exercise plays in cardiac rehab, but we need to do the types of large trials, appropriately powered to answer these questions," Mustian said.

Meanwhile, Cramp said the available evidence should help convince health policy makers that exercise therapists, physical therapists, and exercise physiologists need to be a part of the treatment team to support people with cancer.

ANI