Exercise and Cancer-related Fatigue

US Oncological Review, 2010;6(1):20-3


Cancer-related fatigue is the most common side effect reported by cancer patients during and after treatment. Cancer-related fatigue significantly interferes with a patient’s ability to perform activities of daily living and maintain functional independence and quality of life. Cancer-related fatigue can also interfere with a patient’s ability to complete treatments. The purpose of this article is to provide an overview of cancer-related fatigue, its pathopsychophysiology, and the role of exercise in the management of this side effect.
Keywords: Cancer, fatigue, exercise, symptoms
Disclosure: The authors have no conflicts of interest to declare.
Received: April 15, 2009 Accepted October 10, 2009 Citation US Oncological Review, 2010;6(1):20-3
Correspondence: Karen M Mustian, PhD, University of Rochester School of Medicine and Dentistry, James P Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642. E: karen_mustian@urmc.rochester.edu

Cancer and its treatments result in side effects that impair quality of life (QoL). The most common side effect reported by cancer patients is cancer-related fatigue (CRF).1–4 Cancer patients report that CRF begins with diagnosis and worsens during the course of treatment. It can persist for months, and years, after treatment is complete.1–4 CRF often continues even when the patient’s cancer is undetectable or in remission.1–4 Cancer patients report a prevalence of CRF ranging from 60 to 100%, with 41% or more indicating severe CRF during treatment.1–4 As many as 81% of patients report persistent CRF, with 17–38% indicating persistent severe CRF more than six months after completing treatment.1–4
CRF is a multidimensional, subjective, and objective physiological state that is characterized by a persistent, overwhelming exhaustion and a decreased capacity for physical and mental work.1–4 CRF is characteristically different from the fatigue experienced by healthy individuals in its severity, its impact on QoL, and its lack of alleviation by rest or sleep.1–4 CRF often requires that survivors depend on others for simple activities of daily living, such as transportation, preparing food, or bathing.1–4 These difficulties with daily activities lead to a lack of self-sufficiency and can be demoralizing and discouraging for patients. CRF is frequently reported by patients as more distressing and having a greater negative impact on their daily activities and QoL than other cancer-related side effects including vomiting, nausea, pain and depression.1–4 The purpose of this article is to provide an overview of CRF and its pathopsychophysiology and to summarize the evidence for exercise as an effective intervention for managing CRF.
Pathopsychophysiology of Cancer-related Fatigue
CRF and its underlying pathopsychophysiological mechanisms may derive from the cancer itself, the side-effects of cancer treatment and other co-morbid conditions.4,5
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Keywords: Cancer, fatigue, exercise, symptoms