Exercise For Cancer Patients

70% to 80% of cancer patients suffer from various kinds of fatigue.  The exact cause of cancer-related fatigue is uncertain; however, there are a few possible causes, which include the cancer treatment itself and the effects of the tumor. There are  comorbid medical conditions including anemia, hypothyroidism, cytokines, and sleep problems; psychological factors such as anxiety  and loss of functional status. A number of studies have  identified some benefits of physical activity on fatigue in cancer both during and after  treatment. A number of limitations in the original review show that an updated review is necessary.
The aim of this study  is to evaluate the effect of exercise on cancer-related fatigue both during and after cancer treatment.
 Aerobic exercise can help relieve fatigue related to breast and prostate cancer both during and after treatment, according to an updated review published on November 14, 2012 in the Cochrane Database of Systematic Reviews.
Fiona Cramp, PhD, from the Faculty of Health & Life Sciences, University of the West of England, and James Byron-Daniel, PhD, from the School of Psychology, University of West England, Bristol, United Kingdom state that the findings suggest that aerobic exercise should “be considered as one component of a management strategy for fatigue that may include  other interventions and education as well.”
Previously, patients with cancer were  encouraged to rest because of their  fatigue. However, now this approach is considered counterproductive because the patient’s inactivity can lead to muscle wasting as well as  a loss of cardiorespiratory fitness which can lead to increased fatigue.
Dr. Cramp and Dr. Byron-Daniel write that further research is necessary to determine the most effective parameters of exercise for fatigue management which should include  multi-modal exercise (a combination of resistance and aerobic), duration and frequency  of each exercise session, and the intensity of the exercise.
“It has yet to be determined whether the type of cancer treatment changes the  effects of exercise on cancer-related fatigue”, the doctors note.  Research is still needed to examine a broader range of cancer diagnoses, including patients that have an advanced form of the disease.
Most studies were from those with breast cancer although there were some with various cancer diagnoses. The exercises  occurred  during and after cancer treatment. The duration of the exercise intervention ranged from 3 weeks to 1 year and involved resistance training, aerobic activity  or flexibility exercises.
The exercise intervention varied widely, from home-based to supervised programs, and the intensity varied from self-administration to programs that involved heart monitoring  and oxygen uptake.
 Some sessions were conducted daily and some just 2 times a week; some sessions lasted 10 minutes and others lasted 120 minutes.
 Aerobic exercise like walking and cycling had a  significant benefit over no exercise.
The authors state that the  review should not be considered in isolation.  Nonpharmacologic interventions can also be considered  beneficial. Interventions that may be used together with an exercise program can include nutrition therapy, stress management  and sleep therapy.
Breast and prostate  are the two types of cancer where symptoms of fatigue can be reduced according to Dr. McNeely,  assistant professor in the Department of Physical Therapy at the University of Alberta and in the Department of Oncology and the Rehabilitation Medicine Department at the Cross Cancer Institute in Edmonton, Canada.
It is not clear yet if other forms of exercises such as weight training and yoga can provide the same benefits. More evaluation is needed, according to Dr. McNeely.
Even if formal exercising is not possible it is still imperative that cancer patients stay as active as possible. Staying active will help to prevent losses in muscular strength and overall fitness and will reduce fatigue.
Dr. McNeely states that more vigorous exercise after cancer treatments may be appropriate but should be administered by an exercise specialist.
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