Colorectal, breast and prostate cancer
John M. Saxton in Exercise and Chronic Disease, 2011
Cancer-related fatigue, defined as ‘a distressing, persistent, subjective sense of physical, emotional and/or cognitive tiredness or exhaustion related to cancer or cancer-related treatment that is not proportional to recent activity and interferes with usual functioning’ (Velthuis et al., 2010), is commonly reported by breast cancer survivors. The evidence for exercise as a therapy for combating fatigue in this patient group is currently equivocal. Supervised, combined aerobic and resistance exercise training for two (Campbell et al., 2005) or three times (Mutrie et al., 2007) per week has proved to have no significant effect on symptoms of fatigue in two previous RCTs. Conversely, trials that have used exercise prescriptions requiring moderate intensity walking exercise four to five (Mock et al., 1997) or five to six times per week (Mock et al., 2004) have reportedly been more successful in mitigating fatigue. Accordingly, this would suggest more frequent physical activity might evoke a greater improvement of symptoms. However, additional exercise studies are required to draw firmer conclusions.
Fatigue
Margaret O’Connor, Sanchia Aranda, Susie Wilkinson in Palliative Care Nursing, 2018
The problem of fatigue is prevalent in all chronic and life-limiting illness, and this symptom and the way it affects people’s wellbeing is therefore an important focus of palliative care. In particular, in people suffering from cancer, fatigue is the most prevalent symptom throughout the trajectory of the illness, and has been prominent in oncology nursing research and practice for many years (Mooney et al. 1991; Ropka et al. 2002; Stetz et al. 1995). To patients and their families, fatigue in the advanced stages of chronic illness can be an overwhelming symptom impairing quality of life through its impact on: ‘In palliative care, fatigue is the most prevalent symptom.’sense of wellbeing;daily performance;activities of daily living;relationships with family and friends;mood; andadherence to treatment.
Cancer and exercise
Adam P. Sharples, James P. Morton, Henning Wackerhage in Molecular Exercise Physiology, 2022
One of the most prevalent and troublesome side-effects from cancer, and different cancer treatment options, is cancer-related fatigue. This is described as a distressing, persistent, subjective sense of physical, emotional and/or cognitive tiredness or exhaustion. Although it is a transient phase for most cancer patients, it may persist for years post-treatment in some survivors and approximately 30% of breast cancer survivors (88), and lymphoma survivors (89) still report symptoms ten years post-diagnosis. Exercise has been shown to lessen the burden of cancer-related fatigue to some extent, as participants randomised to exercise groups typically report less symptoms and less distress compared to participants in the non-exercising control groups in randomised controlled trials undertaken during or shortly after treatment (90). It is, however, worth mentioning that only small to moderate effects sizes are reported in the meta-analysis. Furthermore, it is still unknown if exercise influences more the chronic phases of fatigue (i.e. if the condition persists for 6 months or longer following diagnosis) as very few trials have investigated this to date. In summary, it seems that exercise is one of few strategies that may help cancer patients cope with cancer-related fatigue, but whether these effects of exercise apply at later stages of cancer survivorship is largely unknown.
Fatigue with epidermal growth factor receptor tyrosine kinase inhibitors in cancer patients: A meta-analysis of randomized controlled trials
Published in Journal of Chemotherapy, 2018
Jing Li, Wenxia Sun
Cancer-related fatigue is perceived by patients as a chronic feeling of tiredness or general lack of energy not alleviated by rest. Nowadays, the exact mechanisms involved in cancer-related fatigue pathophysiology are poorly understood owing to its characteristics as a complex and multifactorial phenomenon which could be induced by a variety of causes and contributing factors. To describe fatigue, health professionals may use terms such as asthenia, lassitude, prostration, lack of energy, and weakness. Besides cancer treatments and the underlying cancer illness, fatigue can be caused or aggravated by a variety of factors, such as anemia, pain, depression, anxiety, sleep disorders, nutritional status, and medication side effects. In the case of persistent grade 3–4 fatigue, dose reduction or treatment suspension may be required. Moreover, fatigue may persist even after cessation of therapy. This renders it challenging to accurately quantify the incidence of fatigue in cancer patients. In our meta-analysis, all-grade and high-grade fatigue were reported in a substantial proportion of patients in the control arms of trials in our meta-analysis, which provides a benchmark for future studies attempting to mitigate cancer-related fatigue. Moreover, EGFR-TKIs can also cause nausea, vomiting and cardiac dysfunction, which may all result in fatigue.
Inpatient rehabilitation outcomes in neoplastic spinal cord compression vs. traumatic spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2022
Sevgi Ikbali Afsar, Sacide Nur Saraçgil Cosar, Oya Umit Yemişçi, Hüma Bölük
In a study by Santos et al., no significant correlation was found between the presence of medical comorbid disease and the functional gain of patients with metastatic spinal cord compression.19 Similarly, in the current study, no statistically significant correlation was found between the FIM and FAS scores and comorbid diseases of hypertension, diabetes mellitus and coronary artery disease in the traumatic and neoplastic groups. In addition to systemic comorbid diseases, it is important to distinguish medical comorbidities associated with cancer diagnosis. Cancer-related fatigue is the most prevalent symptom experienced by individuals with cancer. With evaluation and appropriate treatment of organic factors, such as anemia and infection, are often easily correctable. However, other causes of fatigue must be considered, such as depression, and sedation caused by centrally acting drugs and pain medications.16 These patients may require supportive care and modifications of the rehabilitation care plan.18
Can assessment of disease burden and quality of life based on mobility level in patients with end-stage cancer provide an insight into unmet needs? An exploratory cross-sectional study
Published in Physiotherapy Theory and Practice, 2023
Yeliz Bahar- Ozdemir, Sefik Kaya, Nalan Akgul- Babacan, Tugce Al, Ece Albayrak, Nilufer Coskun, Gulseren Akyuz
The etiology of cancer-related fatigue is complex and multidimensional and includes many potential contributing factors (Koornstra et al., 2014). Fatigue increases with the progression of the disease, and with the addition of other causes, such as anemia, side effects of the medical treatments, cognitive dysfunction and malnutrition (Koornstra et al., 2014). It becomes more evident in patients who are nearing death. In this study, the fact that severe fatigue levels observed in bedridden patients were not established in the patients who using MA or were ambulatory suggests that regardless of the stage of the disease, limited physical activity may increase fatigue level. Although Koornstra et al. (2014) suggested that a decrease in physical activity may cause fatigue, they did not provide precise data to explain this situation. Another cause of fatigue in this group is depression. In a study conducted by Huang, Blackwood, Godoshian, and Pfalzer (2018) levels of depression and anxiety were found to be lower in the patient group able to walk independently than in those who used MA or were bedridden.
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