Cancer-related fatigue is a complex and common experience, affecting 70–100% of the cancer patient population. Other symptoms such as nausea and vomiting, pain, shortness of breath, poor sleep, loss of appetite, constipation and diarrhoea are also common.
Aerobic exercise (walking, cycling), strength training or a mix of both immediately before, during or after cancer therapy.
Cancer-related fatigue is a complex and common experience, affecting 70–100% of the cancer patient population.
Fatigue and other symptoms associated with cancer and its treatment.
Cancer-related fatigue can have a profound physical, emotional, mental and social effect. It may also negatively affect a patient’s chance of remission or even cure, as it can reduce the desire to continue with treatment such as chemotherapy. Other symptoms such as pain, shortness of breath, poor sleep, nausea and vomiting, loss of appetite, constipation and diarrhoea are also problematic
Exercise immediately before, during, or after cancer treatment has been shown to safely reduce fatigue with small improvements in insomnia, shortness of breath and pain.
However, exercise will not help with gastro-intestinal symptoms of loss of appetite, nausea, vomiting, constipation or diarrhoea but it will not make these symptoms worse
Supervision by an exercise physiologist or physiotherapist may be particularly beneficial for people who are new to exercise or who have become deconditioned. (See Consumer resources.)
Typical exercise regimens used in the trials consisted of two to five sessions per week (about 30 minutes per session) for up to 16 weeks and included both supervised and unsupervised (home) exercise sessions.
In these sessions, strength (muscle) exercise regimes included the use of resistance bands, body weight as in squats or step-ups, and dumbbell weights. These resistance techniques led to an increase in muscle strength.
Aerobic exercise was undertaken on stationary bikes or treadmills, but any form of aerobic exercise is acceptable as long as it is of moderate or more intensity.
Tips and challenges
In the past, people with cancer were encouraged to rest if they felt fatigued or had other symptoms due to their disease or treatment. However, this can lead to further deconditioning. Exercise should be considered as one component of a management strategy for cancer-related symptoms that may include a range of other interventions and education.
For those who are exercise naïve, commencing exercise may prove challenging. The health care team (GP, cancer care unit) should be ensuring exercise of a sufficient intensity is recommended to patients being treated or after treatment for cancer. The inclusion of an exercise physiologist to the patient’s team of health care professionals may assist in achieving this outcome.
NHMRC Level 1 evidence.
The Clinical Oncology Society of Australia’s position statement on exercise in cancer care recommends that exercise be embedded as part of standard practice in cancer care.
The Cancer Council of Western Australia has produced guidelines for implementing exercise programs for cancer patients.