Fatigue in cancer patients

The majority of cancer patients who receive chemotherapy and / or radiotherapy tend to experience a basket of symptoms secondary to the disease process or the treatment itself. The most common and burdensome symptoms for these patients is fatigue. Will exercise help in reducing the feeling of fatigue?

Researchers from the University of Copenhagen studied the effect of a supervised exercise program on fatigue in 235 cancer patients who were receiving treatment for solid and haematological tumours (BMJ 2009; 339: b3410). These patients were randomly assigned to the intervention group (n=118) or control group (n=117). The control group received usual medical care and was permitted to increase physical activity as they desired. The intervention group, supervised by trained nurses and physiotherapists, undertook high-intensity exercise training on Mondays, Wednesdays and Fridays and low-intensity exercise on Tuesdays and Thursdays for 6 weeks. Each week they received 9 hours of intervention in groups of 7 to 10. High-intensity exercise consisted of 30 minutes of warm-up, 45 minutes of resistance training and 15 minutes of cardiovascular training. Low-intensity training consisted of relaxation for 30 minutes weekly, body awareness and restorative training for 90 minutes weekly and massage for 30 minutes weekly. The study found that, in the intervention group, there was a significant reduction of fatigue. The patients also showed significant improvement on 7 of 10 Short Form-36 subscales on general well-being, physical functioning, vitality, mental health, physical and mental components scale. The leisure time physical activity was 66% in the intervention group compared to 33% in the control group. In the intervention group, muscle strength improved 29.6%. The researchers concluded that a structured exercise program improved fatigue and physical and mental functioning among patients with advanced cancer who were receiving chemotherapy.

Quite often my cancer patients will ask if they should exercise. However, family members tend to discourage the patient because they fear exercise will make the patient even more tired. Whenever I am asked if a patient should exercise, my answer is invariably yes.  Yes because physical activity will not only make the patients get out of the house but also will help take their mind off their condition.

Next time, when your loved one who is undergoing chemotherapy / radiotherapy wants to go for a walk, try saying ‘Yes, lets.’