Exercise and/or Psychological Interventions Best for Cancer-related Fatigue

Exercise is a successful means of combatting fatigue related to cancer treatment.
Exercise is a successful means of combatting fatigue related to cancer treatment.

Exercise and/or psychological interventions significantly reduce cancer-related fatigue during and after cancer treatment, and are more effective strategies than available pharmaceutical interventions, according to a study published in JAMA Oncology.1

Cancer-related fatigue is one of the most commonly occurring and troublesome adverse events experienced by patients with cancer both during and following treatment; however, the optimal approach for treating cancer-related fatigue remains unclear.

To establish the most effective treatment for cancer-related fatigue, investigators conducted a meta-analysis to compare the 4 most commonly recommended treatments, including exercise, psychological intervention, combined exercise and psychological intervention, and pharmaceutical options.

Investigators analyzed data from 113 randomized clinical trials published between 1999 and 2016, which included 11,525 adults with cancer. The researchers only included studies of good quality with no evidence of publication bias.

Results showed that exercise (P < .001), psychological (P < .001), and exercise plus psychological interventions (P < .001) significantly reduced the severity of cancer-related fatigue during and after primary treatment; however, the investigators found that pharmaceutical interventions did not improve cancer-related fatigue (P = .05).

The effectiveness of behavioral interventions like exercise and psychological interventions is not related to attention, education, or time, and certain interventions may be more effective at specific points of a patient's treatment trajectory.

The study further demonstrated that the effectiveness of cancer-related fatigue therapies correlated with cancer stage, baseline treatment status, experimental treatment format, experimental treatment delivery mode, psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures.

The findings suggest that clinicians should prescribe exercise and/or psychological interventions as first-line treatments for patients experiencing cancer-related fatigue.

Reference

1. Mustian KM, Alfano CM, Heckler C, et al. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue. JAMA Oncol. 2017 March 2. doi: 10.1001/jamaoncol.2016.6914 [Epub ahead of print]

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