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Effect of physical activity on fatigue in childhood cancer survivors: a systematic review

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Abstract

Purpose

Many children, adolescents, and young adult survivors of childhood cancer experience fatigue following cancer treatment. Physical activity has been shown to be effective in improving cancer-related fatigue in adult survivors, but there is a lack of evidence on its effect in childhood cancer survivors. In addition, there are no guidelines for treatment of fatigue in childhood cancer survivors. The purpose of this study was to examine the existing literature on the effect of physical activity on fatigue in children, adolescents, and young adult survivors of childhood cancer.

Methods

We conducted a systematic review to examine the effect of physical activity on fatigue in children, adolescents, and young adult survivors of childhood cancer.

Results

Nine studies were included. Most of the studies included reported an increase in physical activity and a decline in fatigue in the target patient population. Interpretation of these findings is limited due to small sample sizes, inadequate length of follow-up, and variability among reviewed studies. Quantitative analysis was not conducted due to significant variability in both the type of physical activity implemented and in the measurement of fatigue.

Conclusions

Further research, with a larger sample size and consistency in both physical activity interventions and measurement of fatigue, is needed to add greater precision and confidence in the effect of physical activity on fatigue in childhood cancer survivors. Results of this research will help guide future recommendations on physical activity for the treatment of cancer-related fatigue in children, adolescents, and young adult survivors of childhood cancer.

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References

  1. Hudson MM, Bhatia S, Casillas J, Landier W (2021) Long-term follow-up care for childhood, adolescent, and young adult cancer survivors. Pediatrics 148:e2021053127. https://doi.org/10.1542/peds.2021-053127

    Article  PubMed  Google Scholar 

  2. Armstrong GT, Kawashima T, Leisenring W, Stratton K, Stovall M, Hudson MM, Sklar CA, Robison LL, Oeffinger KC (2014) Aging and risk of severe, disabling, life-threatening, and fatal events in the childhood cancer survivor study. J Clin Oncol 32:1218–1227

    Article  Google Scholar 

  3. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582

    Article  CAS  Google Scholar 

  4. Children’s Oncology Group (2018) Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers, Version 5.0. http://www.survivorshipguidelines.org/. Accessed 10/27 2021

  5. van Deuren S, Boonstra A, van Dulmen-den Broeder E, Blijlevens N, Knoop H, Loonen J (2020) Severe fatigue after treatment for childhood cancer. Cochrane Database Syst Rev 3:CD012681

    PubMed  Google Scholar 

  6. Zeller B, Loge JH, Kanellopoulos A, Hamre H, Wyller VB, Ruud E (2014) Chronic fatigue in long-term survivors of childhood lymphomas and leukemia: persistence and associated clinical factors. J Pediatr Hematol Oncol 36:438–444

    Article  Google Scholar 

  7. Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L (2005) Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:5501–5510

    Article  Google Scholar 

  8. Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK, Robison LL, Mertens AC (2008) Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS). Sleep 31:271–281

    Article  Google Scholar 

  9. National Comprehensive Cancer Network (NCCN) Foundation (2020) NCCN guidelines for patients: survivorship care for cancer-related late and long-term effects. https://www.nccn.org/patients/guidelines/content/PDF/survivorship-crl-patient.pdf. Accessed 10/28 2021

  10. Oberoi S, Robinson PD, Cataudella D, Culos-Reed SN, Davis H, Duong N, Gibson F, Götte M, Hinds P, Nijhof SL (2018) Physical activity reduces fatigue in patients with cancer and hematopoietic stem cell transplant recipients: a systematic review and meta-analysis of randomized trials. Crit Rev Oncol 122:52–59

    Article  Google Scholar 

  11. van Dijk-Lokkart EM, Steur LMH, Braam KI, Veening MA, Huisman J, Takken T, Bierings M, Merks JH, den Heuvel-Eibrink Van, Kaspers GJK, Van Dulmen-den Broeder E, Van Litsenburg RRL (2019) Longitudinal development of cancer-related fatigue and physical activity in childhood cancer patients. Pediatr Blood Cancer 66:12

    Google Scholar 

  12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. 88:105906

  13. Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L (2020) Chapter 3: systematic reviews of effectiveness. In: Aromataris E, Munn Z (eds) JBI Manual for Evidence Synthesis. https://synthesismanual.jbi.global

  14. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Lisy K, Mu PF (2020) Chapter 7: systematic reviews of etiology and risk. In: Aromataris E, Munn Z (eds) JBI Manual for Evidence Synthesis. https://synthesismanual.jbi.global

  15. Devine KA, Viola A, Levonyan-Radloff K, Mackowski N, Bozzini B, Chandler A, Xu B, Ohman-Strickland P, Mayans S, Farrar-Anton A (2020) Feasibility of FitSurvivor: a technology-enhanced group-based fitness intervention for adolescent and young adult survivors of childhood cancer. Pediatr Blood Cancer 67:e28530

    Article  Google Scholar 

  16. Evans S, Seidman L, Sternlieb B, Casillas J, Zeltzer L, Tsao J (2017) Clinical case report: yoga for fatigue in five young adult survivors of childhood cancer. J Adolesc Young Adult Oncol 6:96–101

    Article  Google Scholar 

  17. Li WH, Ho K, Lam K, Lam H, Chui S, Chan GC, Cheung A, Ho L, Chung O (2018) Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors: a randomized controlled trial. Int J Nurs Stud 83:65–74

    Article  Google Scholar 

  18. Withycombe JS, Baek MJ, Jordan DH, Thomas NJ, Hale S (2018) Pilot study evaluating physical activity and fatigue in adolescent oncology patients and survivors during summer camp. J Adolesc Young Adult Oncol 7:254–257

    Article  Google Scholar 

  19. Ho KY, Li WH, Lam KWK, Wei X, Chiu S, Chan CG, Chung OKJ (2019) Relationships among fatigue, physical activity, depressive symptoms, and quality of life in Chinese children and adolescents surviving cancer. Eur J Oncol Nurs 38:21–27

    Article  Google Scholar 

  20. Macpherson CF, Hooke MC, Friedman DL, Campbell K, Withycombe J, Schwartz CL, Kelly K, Meza J (2015) Exercise and fatigue in adolescent and young adult survivors of Hodgkin lymphoma: a report from the children’s oncology group. Adolesc Young Adult Oncol 4:137–140

    Article  Google Scholar 

  21. Wright M, Bryans A, Gray K, Skinner L, Verhoeve A (2013) Physical activity in adolescents following treatment for cancer: influencing factors. Leuk Res Treatment 2013:592395

    PubMed  PubMed Central  Google Scholar 

  22. Wu WW, Jou ST, Liang SY, Tsai SY (2019) the mediating role of exercise on relationships between fatigue, sleep quality, and quality of life for adolescents with cancer. Cancer Nurs 42:E10–E19

    Article  Google Scholar 

  23. Li WH, Chung JO, Ho EK (2013) Effectiveness of an adventure-based training programme in promoting the psychological well-being of primary schoolchildren. Random Control Trial 18:1478–1492

    Google Scholar 

  24. Stout NL, Baima J, Swisher AK, Winters-Stone KM, Welsh J (2017) A systematic review of exercise systematic reviews in the cancer literature (2005-2017). PM R 9:S347–S384

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Funding

This work was supported by funding from the University of Nebraska Medical Center Department of Surgery (financial support for Libby Moberg, medical student summer research experience).

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Authors and Affiliations

  1. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Libby Moberg & Crystal Krause

  2. Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA

    Jordan Fritch & Melissa Acquazzino

  3. Department of Pediatrics, Children’s Hospital & Medical Center, Omaha, NE, USA

    Jordan Fritch & Melissa Acquazzino

  4. Leon S. McGoogan Health Sciences Library, University of Nebraska Medical Center, Omaha, NE, USA

    Danielle Westmark

  5. Department of Kinesiology and Physical Education, University of Toronto, Toronto, Canada

    Daniel Santa Mina

  6. College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA

    Laura Bilek

Authors
  1. Libby Moberg
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  2. Jordan Fritch
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  3. Danielle Westmark
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  4. Daniel Santa Mina
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  5. Crystal Krause
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  6. Laura Bilek
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  7. Melissa Acquazzino
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Contributions

Study conception and design were performed by Libby Moberg, Jordan Fritch, Danielle Westmark, Crystal Krause, Laura Bilek, and Melissa Acquazzino. Literature search, study selection, and data extraction were completed by Libby Moberg, Jordan Fritch, Danielle Westmark, Crystal Krause, and Melissa Acquazzino. Risk of bias assessment was completed by Daniel Santa Mina and Laura Bilek. The first draft of the manuscript was written by Libby Moberg. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Melissa Acquazzino.

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Moberg, L., Fritch, J., Westmark, D. et al. Effect of physical activity on fatigue in childhood cancer survivors: a systematic review. Support Care Cancer 30, 6441–6449 (2022). https://doi.org/10.1007/s00520-022-06960-4

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  • DOI: https://doi.org/10.1007/s00520-022-06960-4

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