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 Researchers examined data from 113 previously published studies
involving more than 11,500 cancer patients with fatigue. Patients
were randomly assigned to treat their exhaustion with exercise or
psychotherapy, or both, or with drugs.
Exercise and psychotherapy were associated with a 26 percent to 30
percent reduction in fatigue during and after cancer treatment, the
study found. Drugs, however, were tied to only a 9 percent decline
in fatigue.
“Patients need to try exercise or psychotherapy before they reach
for a pharmaceutical,” said lead study author Karen Mustian of the
University of Rochester Medical Center in Rochester, New York.
Cancer-related fatigue is common and may be tied to the effects of
tumors or treatments, researches note in JAMA Oncology. Unlike other
types of exhaustion, just getting more sleep or giving aching
muscles a break from strenuous activities can’t address fatigue
associated with tumors.
Fatigue tied to cancer can persist for years and may be worsened by
other cancer-related health problems like depression, anxiety, sleep
disturbance and pain.
It’s not clear why exercise and psychotherapy may be more effective
than drugs, Mustian said by email.
“We do not know for sure why exercise works, but some research is
beginning to suggest it is due to anti-inflammatory effects and also
improvements in physical function - cardiovascular, pulmonary and
muscular,” Mustian added. “In terms of psychotherapy, the most
beneficial form was group therapy that used a cognitive behavioral
approach to educate patients, help them to change the way they think
about fatigue and managing it, and adopting behaviors to help
alleviate it.”
Most participants in the studies were female, and almost half of the
studies involved women with breast cancer.
Age, gender, cancer type and forms of exercise didn’t appear to
influence how effective exercise or psychotherapy was relative to
medications, researchers found.
Overall, the analysis included 14 drug studies, mostly looking at
stimulants or drugs designed to promote wakefulness.
Among the 69 evaluations of exercise, most looked at aerobic
activity alone or in combination with other types of movement.
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Of the 34 psychological interventions tested in the studies, most
involved therapies focused on behavior and education.
One benefit of the current study is that researchers were able to
pool the data from several individual research efforts that were,
alone, too small to draw meaningful conclusions about the relative
advantages of different treatments, the authors note.
Limitations include the varied designs in the studies, which made it
difficult to assess how factors such as race, education, income or
other demographic differences might have impacted the results, the
researchers also point out.
Even so, the findings confirm previous research on interventions to
ease cancer-related fatigue, Dr. Jens Ulrich Rueffer, head of the
German Fatigue Society in Cologne, said by email.
“We already knew that exercise and/or psychological interventions
were beneficial for treating cancer-related fatigue,” said Kerry
Courneya, a researcher at the University of Alberta, in Edmonton,
Canada.
“What we learned from this new meta-analysis is that exercise and
psychological counseling are roughly equal in their benefits for
cancer-related fatigue,” Courneya, who wasn’t involved in the study,
added by email. “And both appear superior to current pharmaceutical
treatments.”
SOURCE: http://bit.ly/2mUd4Yv JAMA Oncology, online March 2, 2017.
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