Type of Exercise May Affect Fatigue in Patients Receiving Catabolic Steroids

PORTLAND, Oregon —Aerobic exercise may be more effective than resistance exercise in reducing cancer-related fatigue among patients taking catabolic steroids, according to a study presented at the Oncology Nursing Society’s 26th Annual Congress, held in San Diego.

Catabolic steroids are associated with muscle breakdown, leading to speculation that this process may contribute to fatigue. However, the effects of exercise among patients receiving these agents have not been fully explored.

Anna Schwartz, PhD, FNP, associate professor and research scientist at Oregon Health & Science University School of Nursing, conducted a 3-month study of the effects of different types of exercise on muscle strength, functional ability, and fatigue among patients receiving these agents. She reported her findings during a poster session at the meeting.

The study population included 42 newly diagnosed patients who had not yet started chemotherapy or radiotherapy. The mean age of the participants was 47 (range, 22 to 72), and most were women (37 women and 5 men). Thirty-two had breast cancer (stage II-IV), six had lymphoma (stage II-III), and four had leukemia.

Randomization

Patients were randomized to one of three groups: aerobic exercise, resistance exercise, or usual care.

• Patients in the aerobic group exercised at home 4 days a week for 15 to 30 minutes at varying intensities.

• The resistance exercisers worked out at home 4 days a week with Thera-Bands (four leg and four arm exercises at varying intensities).

• The usual care patients, who served as controls, were instructed to continue with usual activities and had no restrictions placed on exercise.

Fatigue was measured every month with the Schwartz Cancer Fatigue Scale and the Profile of Mood States (fatigue and vigor subscale). The investigators measured muscle strength after 3 months using a one repetition maximum test. Functional capacity was evaluated at 3 months using 12-minute walking distances.

At the end of 3 months, aerobic exercisers had significantly greater improvements in arm and leg strength than did resistance exercisers or patients in the usual care group.

Patients in the aerobic exercise group increased their functional ability by 12%, resistance exercisers improved by 8%, and the usual care group declined by 3%.

Both the aerobic exercisers and the resistance exercisers experienced significantly less fatigue at months 2 and 3 than did the usual care group. However, the improvements were greater among the aerobic exercise group.