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Cancer-related fatigue is one of the most common and disabling side effects of cancer both during and after treatment. The fatigue can persist for some time after treatment ends. In addition, depression, anxiety, sleep problems and pain can conspire to make fatigue worse.

Cancer-related fatigue not only affects a person’s quality of life but can also interfere with their ability to continue treatment.

The common approaches to dealing with cancer-related fatigue include exercise, psychological counselling and medication. These therapies have many years of study behind them as part of randomised clinical trials and the benefit for each treatment looks promising.

What clinicians have lacked is firm direction in knowing what type of therapy, or combination, could be the more effective for their patients.

Reviewing 113 studies involving over 11,000 adults with cancer, researchers assessed the severity of cancer-related fatigue when treated by exercise, psychological support, exercise plus psychological support, or pharmaceutical interventions.

The type of fatigue that received the focus in the review was that triggered by cancer itself, rather than a side effect of treatments such as radiotherapy or chemotherapy.

All four interventions improved fatigue. Exercise and psychological therapies, either alone or together, gave similar positive results and were more effective than treating with medication. The forms of exercise undertaken included walking, swimming and weight-lifting.

The intensity of the exercise was moderate as almost all of the studies involved people who had been sedentary. Mental health interventions involved helping patients understand and adapt to their current state.

Implications

Exercise and psychological support should be considered as first-line treatments when dealing with cancer-related fatigue.

Fatigue can make even the thought of mild exercise exhausting. So for people who have not been previously active, it is best to start slowly. Even small amounts of exercise like gentle stretching or a 10-minute walk around the block on bad days could offer some benefit.

Last Reviewed: 11/01/2020

© Norman Swan Medical Communications.



References

Mustian KM et al. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncology Epub online March 2, 2017. doi: 10.1001/jamaoncol.2016.6914.