Supportive Cancer Care by David Alberts Maria Lluria-Prevatt Stephanie Kha & Karen Weihs

Author:David Alberts, Maria Lluria-Prevatt, Stephanie Kha & Karen Weihs
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

10.3.2 Activity-Based and Psychological Interventions for CRF

10.3.2.1 Exercise

To date, the most convincing data of an effective intervention for CRF is that related to exercise. Exercise has been shown in multiple studies to improve patients’ level of fatigue [31–33]. In 2009 the American College of Sports Medicine (ACSM) convened a round table and, after an in-depth review of the literature, concluded that exercise training during and after adjuvant chemotherapy is safe and results in improvement in physical functioning, quality of life, and cancer-related fatigue in several groups of cancer survivors. ACMS recommended that cancer survivors avoid inactivity and follow the 2008 Physical Activity Guidelines for Americans with exercise adaptations based on disease and treatment-related adverse events [34]. These recommendations include aerobic exercise at least 150 min per week and strength training at least two days per week.

Exercise has been studied in a variety of patient populations and at various time points throughout the cancer experience. One prospective study explored whether the type of cancer affects exercise-mediated improvements in cardiorespiratory function and fatigue; 319 cancer survivors with 7 different types of cancer participated in fatigue inventories, cardiorespiratory function assessments, and an individualized, multimodal exercise intervention with cardiorespiratory, flexibility, balance, and muscular strength training 3 days per week for 3 months. Cancer types included breast cancer (BC, n = 170), prostate cancer and other male urogenital neoplasia (PC, n = 38), hematological malignancies (HM, n = 34), colorectal cancer (CC, n = 25), gynecological cancers (GC, n = 20), glandular and epithelial neoplasms (GEN, n = 20), and lung cancer (LC, n = 12). Trends toward improved cardiorespiratory function and fatigue reached statistical significance in some groups, and no significant differences were seen between cancer types, suggesting that these improvements are not dependent on specific cancer types. Mean fatigue indices decreased by at least 17% in all groups, with changes significant in BC, HM, CC, and GC groups. The authors concluded that it is appropriate to prescribe exercise interventions to cancer patients based on individual needs without emphasis on cancer type and recommend further research to investigate a relationship between cancer type and exercise-mediated rehabilitation [35].

One meta-analysis reviewed the effectiveness of exercise intervention on overall health-related quality of life (HRQOL) in cancer survivors who had completed primary treatment. The review included 40 trials with 3,694 participants exposed to exercise interventions. At 12 weeks, cancer survivors who participated in an exercise intervention had greater improvement in overall HRQOL including a significant reduction in fatigue [36].

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