BALTIMORENew research indicates that exercise can play a significant
role in combating fatigue related to cancer treatment and the accompanying
loss of function fatigue brings, according to Victoria Mock, DNSc, RN. Dr.
Mock is the American Cancer Society Professor of Oncology Nursing at Johns
Hopkins School of Nursing and Director of Nursing Research Center at the
Sidney Kimmel Comprehensive Center at Johns Hopkins in Baltimore.
Fatigue is a major side effect of cancer treatment, contributing
significantly to decreases in activity that lower quality of life during
treatment and lead to long-term loss of function. Fatigue has, however,
received little research attention, Dr. Mock said, and practitioners have
traditionally just advised that patients rest when they complain of fatigue.
Exercisers Gained Function
In a study of 120 breast cancer patients, those who exercised regularly
suffered much less fatigue than those who didn’t and even gained rather
than lost functional ability, she reported. The descriptive, correlational
study was a substudy of a randomized clinical trial involving five academic
cancer centers and 35 nurses.
The patients, who were all receiving either radiation treatment or
adjuvant therapy, were divided into exercise and nonexercise groups. Those
in the exercise group received written prescriptions to walk for up to 30
minutes a day, 5 or 6 times a week. Women who already exercised regularly
and actively were not eligible for the study.
Each subject was evaluated at the beginning and end of the exercise study
for fatigue using the Piper Fatigue Scale, for self-assessed physical
functioning with the Medical Outcome Study Short Form 36 (MOS-SF 36)
Physical Functioning Subscale. Objective assessment of physical function
used the 12-Minute Walk Test.
‘‘At posttest, participants who were in the highest quintile of
fatigue scores had the lowest physical functioning scores and participants
in the quintile of lowest fatigues scores scored highest on physical
functioning even though physical functioning scores of two quintiles has
been similar at pretest.’’ The posttest also revealed a marked inverse
correlation between exercise and fatigue; exercisers had mild fatigue and
nonexercisers moderate fatigue. Seventy-two percent of the exercise group
had followed their prescriptions, averaging 29 minutes daily 4 days a week.
They also showed "significantly higher" physical functioning,
having gained 200 feet on the 12-Minute Walk Test, as compared to a 67-foot
loss for the nonexercisers, Dr. Mock noted.