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.
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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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
- 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?
The following studies look at the management of side effects:
Multiple cancers
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study examines how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT05056077: Tools to be Fit. This quality-of-life study examines the best tools for helping cancer survivors improve their diet, and exercise for people with bladder, breast, colon, endometrial, kidney (renal cell carcinoma), ovarian, prostate or rectal cancer.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in Cancer Survivors. This study tests how well the drug bupropion (Wellbutrin) reduces cancer-related fatigue for survivors.
Breast cancer
- NCT04586530: Telehealth and Memory Study (TAMS). This trial seeks to confirm the effectiveness of Memory and Attention Adaptation Training (TAMS), a cognitive-behavioral therapy as a treatment for chemotherapy-related cognitive dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced cognitive and brain changes in older adults with breast cancer. This study investigates cognitive abilities and brain images before and after chemotherapy to identify people at risk for cognitive side effects and to better understand the effects of treatment on brain structure and function.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study looks at whether beta-blocker drugs could help prevent this from happening.
Colorectal cancer
- NCT05239338: Preserving Fertility After Colorectal Cancer Study (PREFACE). This study investigates the reproductive health and clinical outcomes among individuals ages 18 to 49 who are diagnosed with colorectal cancer.
- NCT06420726: Resistance Exercise and Creatine in Colorectal Cancer. This study assesses the feasibility of combining creatine supplementation with resistance training versus resistance training alone in colorectal cancer survivors.
Ovarian cancer
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. This study tests whether structured activity for women undergoing chemotherapy improves their physical state before surgery and thus improves outcomes.
Prostate cancer
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Prostate Cancer Survivors (MMF). This study looks at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen the side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial studies whether pelvic fascia-sparing radical prostatectomy has similar cancer control and sexual function outcomes and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.
Updated: 03/11/2025
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:
- The American Academy of Sleep Medicine's website SleepEducation.org includes a section on finding a sleep center by location.
- The American Physical Therapy Association's ChoosePT.com website allows you to search for a physical therapist in your area.
- Eatright.org, the website for the Academy of Nutrition and Dietetics, has an online tool to find a nutritionist in your area. You can search for nutritionists by specialty, including "cancer," "weight management" and "heart health."
- The National Certification Commission for Acupuncture and Oriental Medicine has a searchable directory of licensed acupuncturists.
- The Lymphatic Education & Resource Network has tips and tools for finding lymphedema experts.
- The Menopause Society is an organization for menopause experts. Their website has a tool to help you find a qualified menopause expert in your area.
Updated: 08/06/2022