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Exercise is more effective than health education in reducing fatigue in fatigued cancer survivors

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Abstract

Introduction

Cancer-related fatigue is a most debilitating side effect reported by survivors, often lasting years following treatment.

Purpose

To determine the effects of a 10-week exercise intervention compared with a health education intervention on fatigue, quality of life outcomes and functional fitness in cancer survivors with documented fatigue.

Methods

This quasi-experimental study allocated 37 post-treatment fatigued cancer survivors (33 female, 30 breast cancer, aged 55 ± 2 years, time since treatment 2.3 ± 0.3 years; mean ± SEM) to an exercise group (EX, n = 19) or health education comparison group (HE, n = 18). The EX intervention emphasised brisk walking with progressive increments, stretching, exercise education and self-efficacy enhancement. The HE intervention emphasised sleep management, nutrition and cognitive behavioural therapy. All participants were evaluated at pre- and post-intervention with EX followed up at 26 W.

Results

The intervention effect on fatigue (FACT-F) in EX was greater (p < 0.05) than that in HE, the difference being 4 times the recognised clinically important difference. The intervention also increased (p < 0.05) cognitive function, global quality of life and functional fitness scores. It reduced (p < 0.05) insomnia and fear of physical activity. All intervention effects were maintained to 26 W. The intervention effect on fatigue in EX was largely achieved by week 4. There was 100% retention rate at 10 W and no adverse events reported.

Conclusions

There is a reduction of considerable magnitude in cancer fatigue from group-based exercise training, that is sustainable and attributable to exercise per se.

Implications for cancer survivors

Exercise training is feasible for fatigued cancer survivors and should form part of tailored rehabilitation programmes.

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Acknowledgements

We are grateful to Dr. Miriam O’Connor, Dr. Anne Horgan, Dr. Paula Calvert and Dr. Brian Creedon, University Hospital Waterford, and to the Solas Cancer Support Centre, Waterford, for supporting this study and for their assistance with participant recruitment.

Funding

This study was funded under the 2014 Waterford Institute of Technology PhD Scholarship scheme.

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Authors and Affiliations

  1. Department of Sport and Exercise Science, Waterford Institute of Technology, Cork Road, Waterford, Ireland

    Patricia Sheehan, Niamh M. Murphy & Michael Harrison

  2. School of Humanities, Waterford Institute of Technology, Cork Road, Waterford, Ireland

    Suzanne Denieffe

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  1. Patricia Sheehan
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Correspondence to Michael Harrison.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals.

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Informed consent was obtained from all individual participants included in the study.

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Sheehan, P., Denieffe, S., Murphy, N.M. et al. Exercise is more effective than health education in reducing fatigue in fatigued cancer survivors. Support Care Cancer 28, 4953–4962 (2020). https://doi.org/10.1007/s00520-020-05328-w

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