Exercise is more effective than health education in reducing fatigue in fatigued cancer survivors

Introduction: Cancer-related fatigue is a most debilitating side effect reported by survivors, often lasting years following treatment. Purpose: To determine the effects of a 10-week exercise intervention compared with a health education intervention on fatigue, quality of life outcomes and functional fitness in cancer survivors with documented fatigue. Methods: This quasi-experimental study allocated 37 post-treatment fatigued cancer survivors (33 female, 30 breast cancer, aged 55 ± 2 years, time since treatment 2.3 ± 0.3 years; mean ± SEM) to an exercise group (EX, n = 19) or health education comparison group (HE, n = 18). The EX intervention emphasised brisk walking with progressive increments, stretching, exercise education and self-efficacy enhancement. The HE intervention emphasised sleep management, nutrition and cognitive behavioural therapy. All participants were evaluated at pre- and post-intervention with EX followed up at 26 W. Results: The intervention effect on fatigue (FACT-F) in EX was greater (p < 0.05) than that in HE, the difference being 4 times the recognised clinically important difference. The intervention also increased (p < 0.05) cognitive function, global quality of life and functional fitness scores. It reduced (p < 0.05) insomnia and fear of physical activity. All intervention effects were maintained to 26 W. The intervention effect on fatigue in EX was largely achieved by week 4. There was 100% retention rate at 10 W and no adverse events reported. Conclusions: There is a reduction of considerable magnitude in cancer fatigue from group-based exercise training, that is sustainable and attributable to exercise per se. Implications for cancer survivors: Exercise training is feasible for fatigued cancer survivors and should form part of tailored rehabilitation programmes.