Fatigue is one of the most common side effects of cancer, occurring during and years after treatment. An analysis of the research now concludes that exercise may help cancer survivors with fatigue during and after treatment, even more than pharmaceutical options.
The analysis, published in JAMA Oncology, focused on the four most commonly recommended treatments for cancer related fatigue: exercise, psychological, combined exercise and psychological, and medication.
Researchers looked at 113 studies that included 11,525 survivors. All studies were randomized clinical trials that tested one of the four interventions among adults with cancer and compared that to a control group. The study then analyzed all the differences reported from pre- to post-treatment between the groups.
While all four interventions led to some improvements in cancer fatigue, exercise alone showed the largest effect. The type of exercise didn’t matter, whether it was solely aerobic or resistance exercises or a combination. And it was most effective when prescribed for patients receiving primary treatment.
Psychological interventions and the combination of both exercise and psychological interventions ranked next, showing similar and strong improvements. The most effective type of psychological intervention seen was cognitive behavioral therapy, a common goal-oriented type of psychotherapy. This intervention was most effective when conducted among survivors after primary treatment.
Pharmaceutical interventions showed relatively small improvements.
Overall, the most effective interventions were group-based and in-person. Improvements occurred among survivors of all ages and with all types of cancer and fatigue reduction was not due to time, attention, or education.
There are several caveats to the analysis, such as that about half of the studies were conducted among women with breast cancer. There was also little long-term follow-up and some of the studies did not screen for a a certain level of fatigue as part of inclusion. More research is needed to better understand the combination of exercise and psychological treatments for fatigue, the authors also note.
The study was supported by grants from the National Cancer Institute.
Source: Karen M. Mustian et al. Comparison of Pharmaceutical, Psychological,and Exercise Treatments for Cancer-Related Fatigue A Meta-analysis. JAMA Oncol. Published online. March 2, 2017