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Exercise and psychological treatments cut cancer fatigue

Exercise and psychological interventions more effective than drug treatments

Louise Prime

Friday, 03 March 2017

Both exercise and psychological interventions, either separately or in combination, are effective in reducing the likelihood of suffering from cancer-related fatigue during and after cancer treatment, a large-scale review has concluded. Authors of the study,* published online first in JAMA Oncology, found that pharmaceutical treatments were not associated with the same degree of improvement in symptoms. They recommended that exercise and psychological interventions should be doctors’ first-line choice when prescribing treatment for patients with fatigue resulting from cancer.

A research team led from the University of Rochester (N.Y.) Medical Center pointed out that cancer-related fatigue (CRF) can not only undermine a patient’s quality of life, because it leaves them feeling less able to participate in their usual activities; it can also reduce their ability to complete medical treatments. They set out to see which of four treatments commonly recommended for CRF – exercise, psychological, the combination of both, or pharmaceutical – was the most effective.

The team conducted a meta-analysis of 113 randomised clinical trials, with a total of 11,525 participants, that had investigated the effect of exercise, psychological, exercise plus psychological, or pharmaceutical interventions on CRF severity in adults with cancer. Of these, 53 were studies of women with breast cancer.

They reported that exercise, psychological, and a combination of exercise plus psychological interventions all significantly improved CRF during and after primary treatment; this reduction in CRF was not explained by differences in time, attention, or education. In contrast, they found, pharmaceutical interventions did not produce the same magnitude of improvement in CRF reduction.

Their results also suggested that specific intervention modes might be more effective for treating CRF at different points in the cancer treatment trajectory. They said more research is needed to better understand the effectiveness of interventions that combine exercise and psychological treatments.

They concluded: “Exercise and psychological interventions are effective for reducing CRF during and after cancer treatment, and they are significantly better than the available pharmaceutical options. Clinicians should prescribe exercise or psychological interventions as first-line treatments for CRF.”

* Mustian KM, Alfano CM, Heckler C, et al. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol, published online: 2 March 2017. DOI:10.1001/jamaoncol.2016.6914.

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