|Key message:Aerobic exercise may help reduce cancer-related fatigue during and after Something done with the aim of improving health or relieving suffering. For example, medicines, surgery, psychological and physical therapies, diet and exercise changes. More for solid tumours.|
“Exercise is good for you” is a familiar mantra and now there is evidence that aerobic exercise, such as walking or cycling, may help relieve the tiredness experienced by people having treatment for cancer, particularly solid tumours. A Cochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. More published in 2008 has now been updated, with 28 additional Randomization is the process of randomly dividing into groups the people taking part in a trial. One group (the intervention group) will be given the intervention being tested (for example a drug, surgery, or exercise) and compared with a group which does not receive the intervention (the control group). More A trial in which a group (the ‘intervention group’) is given a intervention being tested (for example a drug, surgery, or exercise) is compared with a group which does not receive the intervention (the ‘control group’). More (RCTs) bringing the total to 56 RCTs with over 4000 people. Half the Clinical trials are research studies involving people who use healthcare services. They often compare a new or different treatment with the best treatment currently available. This is to test whether the new or different treatment is safe, effective and any better than what is currently used. No matter how promising a new treatment may appear during tests in a laboratory, it must go through clinical trials before its benefits and risks can really be known. More involved people with breast cancer. Exercise interventions varied between studies.
What did they find?
- Overall, people following an exercise programme either during or after cancer treatment showed a A statistically significant result is one which is unlikely to have happened by chance. This is not the same thing as clinical significance. More improvement in fatigue compared with those in control groups
- These benefits were seen after aerobic exercise programmes but not resistance training or low-intensity mind-body interventions
- Exercise helped fatigue in people with breast cancer and prostate cancer but not those with lymphoma, myeloma or leukaemia
How good is the evidence?
- An investigation of a healthcare problem. There are different types of studies used to answer research questions, for example randomised controlled trials or observational studies. More quality varied, with more recent studies generally being of better quality, and many were small
- Studies varied in the stage and types of cancer, the treatments being received by patients and the type, intensity and frequency of exercise
- Data is the information collected through research. More were not available for The use of statistical techniques in a systematic review to combine the results of included studies. Sometimes misused as a synonym for systematic reviews, where the review includes a meta-analysis. More (combining results from multiple studies) for all studies found to be suitable for the review
- The authors expressed a concern that failure to report data in full might have affected the results
- There is a lack of evidence on long-term benefits of exercise (or lack of them) and on how the frequency and type of exercise, and the type of cancer, might affect the results
This is one of three reviews on the treatment of cancer-related fatigue from the Cochrane Pain, Palliative and Supportive Care Group, with the other reviews focusing on drug therapy and on psychosocial interventions.
The The ability of an intervention (for example a drug, surgery, or exercise) to produce a desired effect, such as reduce symptoms. More of psychosocial interventions involving ‘trained helper’ support for improving quality of life and well-being in newly diagnosed cancer patients is explored in a new review, published today, from the Cochrane Gynaecological Cancer Group. Variation across studies in the participants, in the types of trained helper and in the content and delivery of the A treatment, procedure or programme of health care that has the potential to change the course of events of a healthcare condition. Examples include a drug, surgery, exercise or counselling. More made it difficult to be clear about how effective this approach might be for people with cancer, although nurse-led interventions look promising. The review authors point out that this is an area of considerable interest which is gaining increased support for research from funding bodies, and the review contains some helpful suggestions for those undertaking future research in this area.
The Gynaecological Cancer Group also published two new reviews earlier this year, which looked at the impact of exercise on quality of life during and after cancer treatment. The studies were judged to be at high A way of expressing the chance of an event taking place, expressed as the number of events divided by the total number of observations or people. It can be stated as ‘the chance of falling were one in four’ (1/4 = 25%). This measure is good no matter the incidence of events i.e. common or infrequent. More of Any factor, recognised or not, that distorts the findings of a study. For example, reporting bias is a type of bias that occurs when researchers, or others (e.g. drug companies) choose not report or publish the results of a study, or do not provide full information about a study. More, so the results need to be interpreted with caution, but their findings are of interest and again suggest that exercise can be beneficial. There are links below to all the reviews and Cochrane summaries and podcasts where available.
Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database of In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. More 2012, Issue 11. Art. No.: CD006145. DOI: 10.1002/14651858.CD006145.pub3
The 2012 update of this review was funded by the National Institute for Health Research (NIHR) (www.nihr.ac.uk) Health Technology Assessment Programme (https://www.nihr.ac.uk/funding-and-support/funding-for-research-studies/funding-programmes/health-technology-assessment/).
Wiley Press release: “Cancer: Exercise reduces tiredness”
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.
Galway K, Black A, Cantwell M, Cardwell CR, Mills M, Donnelly M. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD007064. DOI: 10.1002/14651858.CD007064.pub2.
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.