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For patients with cancer-related fatigue, exercise is likely to be last on the list of appealing activities. According to a new study, however, physical activity is the best way to combat this common side effect.
Researchers compared a variety of treatments for cancer-related fatigue to find that exercise or psychological interventions fared best, while drug treatments were less effective.
Based on their findings, the authors suggest that doctors should recommend exercise or psychological therapies to patients with cancer-related fatigue in the first instance, rather than turning to medications.
Lead author Karen Mustian, Ph.D. - associate professor in the Cancer Control Program of the Department of Surgery at the University of Rochester Medical Center in New York - and colleagues recently published their findings in JAMA Oncology.
Fatigue is the most common side effect for patients being treated for cancer. As well as tiredness and lack of energy, cancer-related fatigue may cause confusion, irritability, poor memory, and depression.
Not only can this reduce patients' quality of life by preventing them from engaging in day-to-day activities, but it may also discourage them from completing their cancer treatment.
Current guidelines suggest that exercise, medication, and psychological interventions such as cognitive behavioral therapy, may be effective for reducing cancer-related fatigue, but which treatment is best? Mustian and colleagues set out to answer this question.
Exercise more effective than medication
The researchers analyzed data from 113 randomized clinical trials that evaluated the effects of physical activity, medication, and psychological interventions, as well as a combination of both physical activity and psychological interventions, on cancer-related fatigue.
In total, the studies included 11,525 patients aged between 35 and 72 who had been diagnosed with cancer, all of whom had cancer-related fatigue. Almost half of the studies consisted of women with breast cancer, while 10 of the studies enrolled men with other cancer types.
The researchers found that exercise and psychological interventions were equally effective for reducing cancer-related fatigue, as determined by measures on various fatigue assessments - including the Piper Fatigue Scale and the Multidimensional Fatigue Inventory.
Drug treatments, which included modafinil and Ritalin, were found to be less effective than both exercise and psychological interventions.
Based on these findings, the team says that doctors should focus less on recommending drug treatments for patients with cancer-related fatigue, and more on physical activity and psychological therapies.
"The literature bears out that these drugs don't work very well although they are continually prescribed," says Mustian. "Cancer patients already take a lot of medications and they all come with risks and side effects. So any time you can subtract a pharmaceutical from the picture it usually benefits patients."
"If a cancer patient is having trouble with fatigue, rather than looking for extra cups of coffee, a nap, or a pharmaceutical solution, consider a 15-minute walk.
It's a really simple concept but it's very hard for patients and the medical community to wrap their heads around it because these interventions have not been front-and-center in the past. Our research gives clinicians a valuable asset to alleviate cancer-related fatigue."
Karen Mustian, Ph.D.