Fatigue is a common symptom during cancer treatment. It may be caused by the cancer itself or as a side effect of cancer treatment. This fatigue may be treated with adjustments to treatment regimen, medication to address specific symptoms or causes, or alternative treatments. Often fatigue is temporary and will be relieved once treatment is completed, but sometimes the fatigue persists. Decline in physical conditioning (inactivity and loss of muscle mass/strength) and mental stress may contribute to this fatigue.
Researchers from the Netherlands investigated whether a mental or physical approach may be best for patients with cancer-related fatigue. The study, published in the Journal of the American Physical Therapy Association, found that physical training decreased in fatigue but cognitive behavioral therapy (type of mental health therapy) did not appear beneficial.
The randomized trial included 147 participants who had completed cancer treatments (81% for breast cancer) at least three months before the start of the trial but still had greater than normal fatigue. The participants were randomized to one of three treatment groups:
After 12 weeks, physical training alone was associated with significant reduction in general fatigue, physical fatigue, and mental fatigue scores compared to the waitlist group. Physical training plus cognitive behavioral therapy was only associated with a significant reduction in physical fatigue scores compared to the waitlist group. There was no significant difference between the treatment groups in fatigue scores.
Physical training appears to be beneficial for patients with post-cancer fatigue. Although the majority of participants in this trial had breast cancer, it is reasonable to assume that this may be beneficial for people with any type of cancer. Cancer treatment is often associated with loss of lean muscle mass, decreased activity, and mental stress and exercise is known to improve all of these factors. After getting consent from your doctor, gradually increase your activity level, including both strength and aerobic activities. Talk to an exercise specialist if you are concerned about limitations or concerns like lymphedema.
Fatigue can influence your quality life from work and/or school to personal relationships. Let your doctor know about your fatigue or any lingering symptoms from your cancer treatment. Your doctor may need to make adjustments to any medications you may still be on or may need to test for other health issues.
American Cancer Society
National Cancer Institute
van Weert E, May AM, Korstjens I, et al. Cancer-related fatigue and rehabilitation: a randomized controlled multicenter trial comparing physical training combined with cognitive-behavioral therapy with physical training only and with no intervention.Phys Ther. 2010 Oct;90(10):1413-1425.
Last reviewed April 2011 by Brian P. Randall, MD