We know that exercise is good for us all and it seems that aerobic exercise, including walking and cycling, may help people having treatment for cancer to beat fatigue. A Cochrane review on this topic has been updated this week and now brings together evidence from 56 randomised controlled trials involving over 4000 people. The trials explored a variety of exercise interventions and included people with different types of cancer, though half of them had breast cancer. Here’s what they found:
- When all exercise types were looked at together, people doing an exercise programme during or after cancer treatment showed statistically significant improvements in how tired they were, compared to those not doing an exercise programme
- These benefits were seen with aerobic exercise but not low-intensity mind-body interventions (including yoga and qigong) or resistance training
- Exercise helped tiredness in people with solid tumours such as cancer of the breast or prostate, but not those with leukaemia, myeloma or lymphoma
- There was a lot of variety in the type, timing and intensity of exercise, so there are unanswered questions about what might work best
- There is also a lack of evidence on the long-term effects of exercise
- Studies varied in quality and many were small
- There was some missing data, which can introduce bias and reduces confidence in the results
The authors concluded:
The findings of the updated review have enabled a more precise conclusion to be made in that aerobic exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post-cancer therapy, specifically those with solid tumours.
This is one of a suite of reviews on cancer-related fatigue, the others focusing on drug treatment and psychosocial interventions. Back in the summer I looked at two Cochrane reviews which suggested that exercise may improve quality of life for people during and after cancer treatment, with positive effects seen for tiredness, amongst other things, although the reviewers were cautious about their findings owing to the poor quality of the included studies.
It’s frustrating that problems with the way many trials are conducted or reported limit how confident we can be in the results, but it is encouraging that there seems to be a growing body of evidence suggesting that exercise can help people with cancer feel better. It’s what I hear from so many of you, whatever your age or state of health, that exercise makes you feel good. So if your get-up-and-go is missing, try going for a walk or a bike ride, or put on some loud music and have a bop around your house, and I really hope you might start to find it.
Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD006145. DOI: 10.1002/14651858.CD006145.pub3 Cochrane summary
Minton O, Richardson A, Sharpe M, Hotopf M, Stone P. Drug therapy for the management of cancer-related fatigue. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD006704. DOI: 10.1002/14651858.CD006704.pub3. Cochrane summary: http://summaries.cochrane.org/CD006704/drugs-for-cancer-related-fatigue
Goedendorp MM, Gielissen MFM, Verhagen CAHHVM, Bleijenberg G. Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD006953. DOI: 10.1002/14651858.CD006953.pub2. Cochrane summary: http://summaries.cochrane.org/CD006953/the-effect-of-psychosocial-interventions-on-fatigue-during-cancer-treatment-in-adults
Mishra SI, Scherer RW, Snyder C, Geigle PM, Berlanstein DR, Topaloglu O. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD008465. DOI: 10.1002/14651858.CD008465.pub2.
Cochrane Journal Club: http://www.cochranejournalclub.com/exercise-interventions-for-cancer-survivors-clinical/
Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, Snyder C. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD007566. DOI: 10.1002/14651858.CD007566.pub2.