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Study: Physical activity may decrease fatigue associated with cancer treatment

Many cancer survivors experience fatigue during and after they complete treatment. This study looked at the effect of home-based physical activity on fatigue in cancer survivors. It also looked at whether frequent counseling encouraged people to start and continue their exercise routines.  (Posted 8/1/22). Este artículo está disponible en español.

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Contents

At a glance Questions for your doctor
Study findings Guidelines
Strengths and limitations Clinical trials
What does this mean for me? Related resources

STUDY AT A GLANCE

What is this study about?

This study is about the effects of at-home exercise routines on fatigue in cancer survivors.

Why is this study important?

Exercise is an essential part of a healthy lifestyle after cancer treatment. Survivors frequently report fatigue or extreme tiredness and an inability to function due to a lack of energy, depression and anxiety, all of which can be reduced by exercise. However, only about one-quarter of cancer survivors meet recommended guidelines for physical activity. The goal of this study was to understand whether exercising at home reduces fatigue for cancer survivors and whether exercise counseling helps patients form healthy, sustainable exercise habits.

Study findings

In this (a study that looks at data from several prior independent studies on the same subject) the authors reviewed the overall trends of 11 studies consisting of 1,066 cancer survivors.  In these studies, participants took part in low- to moderate-intensity exercise activities, including walking, biking, swimming and using at-home exercise equipment. In most studies, participants engaged in a minimum of 150 minutes of physical activity each week. They self-monitored their activity levels using pedometers (step counters), activity logs and in some cases, heart rate monitors. Nine of the 11 studies examined the effects of exercise on fatigue, while two looked at its effects on depression and anxiety.

Some studies included telephone counseling for the participants from a research staff member throughout the study period. The conversations focused on encouragement, goal-setting, building motivation and self-confidence and problem-solving about exercise barriers. Several studies also provided participants with workbooks containing strategies for beginning and maintaining an exercise routine and exercise tip sheets for cancer survivors.

Below is a table summarizing the exercise type, whether participants received counseling, how long and how often participants engaged in at-home exercise and the results of the nine fatigue-related studies.

Exercise type

Counseling

Duration

Frequency

Fatigue improved compared to control?

Brisk walking

Yes, frequent

12 weeks

From 3 days per week for 20 minutes daily to 5 days per week for 30 to 40 minutes

Yes

Walking, biking, or use of home exercise equipment

Yes, frequent

12 weeks

From 2 days per week for 10 minutes daily to 5 days per week for 30 minutes

Yes

Brisk walking, biking or swimming

Yes, frequent

12 weeks

From 2 days per week for 10 minutes daily to 5 days per week for 30 minutes

Yes

Brisk walking

No

12 weeks

5 days per week for 30 minutes daily

Yes

Brisk walking

Yes, frequent

6 months

150 minutes per week

Yes

Walking or other form if preferred

Yes, infrequent

6 months

30 minutes on most days of the week

Yes

Brisk walking, biking, swimming or use of home exercise equipment

Yes, frequent

12 weeks

From 2 days per week for 10 minutes daily to 5 days per week for 30 minutes daily

Yes

Walking

No

6 weeks

150 minutes per week

Yes

Walking

No

6 weeks

150 minutes per week

No

When the researchers analyzed the results of these studies, they found that physical activity interventions significantly reduced fatigue in participants. Participants who took part in frequent counseling (less than three weeks between phone calls/sessions) had greater reductions in fatigue than those who experienced infrequent or no counseling.

Strengths and limitations

Strengths

  • While the effect of exercise on fatigue in cancer survivors has been studied previously, this review of the literature provides a more comprehensive view of how physical activity interventions, especially those that are home-based, affect fatigue symptoms.
  • The effects of varying levels of counseling on survivors’ fatigue levels had not yet been studied; this review is the first to examine how frequent counseling influences fatigue in cancer survivors participating in a physical activity intervention.

Limitations

  • The participants were mostly white female breast cancer survivors with high socioeconomic status, so the results may not be generalizable to diverse populations with different cancer diagnoses. Importantly, not everyone may have equal access to safe places to exercise close to home.
  • Participants knew to which group they were assigned (with or without the physical activity). This could create behavioral changes or differences in self-reported fatigue that are not due to physical activity and could affect the results.
  • The studies included in the meta-analysis had relatively small sample sizes (number of participants), limiting the generalizability of the results.

What does this mean for me?

People who are diagnosed with cancer often experience effects from their cancer or treatment, including fatigue, depression and anxiety. An exercise routine that includes walking and other low- to moderate-intensity activities might reduce your fatigue and improve depression and anxiety.

Finding a space to exercise in or near your home might help you stick to a routine and form a habit of exercising. Pairing your physical activity with frequent counseling that targets behavioral change, goal setting and problem-solving could further help you manage your fatigue, depression and anxiety through exercise.

Reference

Huizinga F, Westerink N, Berendsen A, et al. Home-based physical activity to alleviate fatigue in cancer survivors: a systematic review and meta-analysis. Medicine & Science in Sports & Exercise 2021; 53(12): 2661-74. Published online December 2021.

Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

 

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Expert Guidelines

The National Comprehensive Cancer Network (NCCN) in their Survivorship Guidelines has specific recommendations related to fatigue in people diagnosed with cancer.

  • Patients should be told that fatigue management is an important part of their care and that fatigue can persist even after treatment ends. 
  • Patients should be screened for fatigue at their first visit and at regular intervals during and after treatment as indicated. 
  • Treating fatigue is best managed by a team of experts with specialties in different areas of supportive care, including:
    • survivorship
    • nutrition
    • integrative medicine
    • mental health
    • physical therapy
    • occupational therapy
    • sleep therapy
  • Patients should be screened and treated for symptoms that may be seen along with fatigue, including pain, emotional distress and sleep disruption. 
  • Interventions may include:
    • physical activity
    • rehabilitation, physical therapy
    • yoga
    • acupunture
    • massage therapy
    • behavioral therapy
    • nutrition consultation
    • consider stimulant drugs
    • treatment for sleep dysfunction

Updated: 08/06/2022

Questions To Ask Your Doctor

  • What physical activities are safe for me?
  • What are the physical activity guidelines for my age group?
  • What exercise counseling options are available to me?
  • How can I work physical activity into my daily life?
  • How frequently or vigorously should I exercise?
  • Are there any physical activities I should avoid and for how long?

Open Clinical Trials

The following studies look at the management of side effects: 

Multiple cancers

Breast cancer

Colorectal cancer

Ovarian cancer

Prostate cancer

Updated: 03/11/2025

Find Experts

Many cancer centers offer survivorship expertise and services, including fatigue clinics, sleep centers, experts, and pain management experts. Ask your doctor to refer you to experts who can address your symptoms and concerns. The following resources can help you find experts:

Updated: 08/06/2022