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Moderate-to-vigorous intensity physical activity is associated with modified fatigue during and after cancer treatment

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Abstract

Purpose

The primary objective was to investigate the association between the amount of time spent in moderate-to-vigorous intensity physical activity (MVPA) and cancer-related fatigue (CRF) before, during, and 2 years after start of treatment.

Methods

The results of the present study are based on data from the study “Early rehabilitation of cancer patients.” Two hundred and forty patients (109 females) with one of the following cancer types were included: breast, colorectal, prostate and testicular cancer, and lymphoma. Chalder’s fatigue questionnaire (FQ) was used to map CRF at baseline, 4, 8, 12, and 24 months post-inclusion. Baseline was at the time of diagnosis, before treatment start. Physical activity was recorded using SenseWear armband (SWA) at baseline, 4 and 24 months post-inclusion.

Results

One hour increased MVPA daily at baseline was associated with lower fatigue with − 0.8 at 4 months’ follow-up (p < 0.001), − 0.7 at 8 months’ follow-up (p = 0.001), − 0.6 at 12 months’ follow-up (p = 0.008), and − 0.5 at 24 months’ follow-up (p < 0.043). The participants maintained and improved PA level at the two follow-up points.

Conclusion

The results imply that the amount of time spent in moderate to vigorous intensity physical activity at baseline can modify cancer related fatigue during and after cancer treatment. The participants managed to maintain and improve their activity level at the two follow-up points. Future research should map fatigue and measure activity, with objective measurement units, at several measurement points to map activity level over time and to substantiate these results.

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References

  1. Cramp F, Byron-Daniel J (2012) Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 11:97

    Google Scholar 

  2. Bower JE (2014) Cancer-related fatigue--mechanisms, risk factors, and treatments. Nat Rev Clin Oncol 11(10):597–609

    Article  CAS  Google Scholar 

  3. Al-Majid S et al (2015) Effects of exercise on biobehavioral outcomes of fatigue during cancer treatment: results of a feasibility study. Biol Res Nurs 17(1):40–48

    Article  Google Scholar 

  4. Travier N et al (2015) Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial. BMC Med 13:121

    Article  Google Scholar 

  5. Tomlinson D et al (2014) Effect of exercise on cancer-related fatigue: a meta-analysis. Am J Phys Med Rehabil 93(8):675–686

    Article  Google Scholar 

  6. Scott K, Posmontier B (2017) Exercise interventions to reduce cancer-related fatigue and improve health-related quality of life in cancer patients. Holist Nurs Pract 31(2):66–79

    Article  Google Scholar 

  7. Minton O, Jo F, Jane M (2015) The role of behavioural modification and exercise in the management of cancer-related fatigue to reduce its impact during and after cancer treatment. Acta Oncol 54(5):581–586

    Article  Google Scholar 

  8. Velthuis MJ et al (2010) The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. Clin Oncol (R Coll Radiol) 22(3):208–221

    Article  CAS  Google Scholar 

  9. Hilfiker R et al (2018) Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med 52(10):651–658

    Article  Google Scholar 

  10. Mustian KM, Alfano CM, Heckler C, Kleckner AS, Kleckner IR, Leach CR, Mohr D, Palesh OG, Peppone LJ, Piper BF, Scarpato J, Smith T, Sprod LK, Miller SM (2017) Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol 3(7):961–968

    Article  Google Scholar 

  11. National Comprehensive Cancer Network, NCCN clinical practice guidelines in oncology (NCCN guidelines) cancer-related fatigue. 2018.

    Google Scholar 

  12. Mishra SI et al (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 8:379

    Google Scholar 

  13. Arving C et al (2018) Early rehabilitation of cancer patients-an individual randomized stepped-care stress-management intervention. Psychooncology

  14. Arving C et al (2013) Early rehabilitation of cancer patients - a randomized controlled intervention study. BMC Cancer 13:9

    Article  Google Scholar 

  15. Chalder T et al (1993) Development of a fatigue scale. Journal of Psychomatic Research:147–153

    Article  CAS  Google Scholar 

  16. Loge JH, Ekeberg Ø, Kaasa S (1998) Fatigue in the general norwegian population: normative data and assoiations. J Psychosom Res 45:53–65

    Article  CAS  Google Scholar 

  17. Minton O, Stone P (2009) A systematic review of the scales used for the measurement of cancer-related fatigue (CRF). Ann Oncol 20(1):17–25

    Article  CAS  Google Scholar 

  18. Neuberger GB (2003) Measures of fatigue; the fatigue questionnaire, fatigue severity scale, multidimensional assessment of fatigue scale, and short form-36 vitality (energy/fatigue) subscale of the short form health survey. Arthritis & Rheumatism (Arthritis Care & Research) 49(5S):9

    Google Scholar 

  19. St-Onge M et al (2007) Evaluation of a portable device to measure daily energy expenditure in free-living adults. Am J Clin Nutr 85(3):742–749

    Article  CAS  Google Scholar 

  20. Cereda E, Turrini M, Ciapanna D, Marbello L, Pietrobelli A, Corradi E (2007) Assessing energy expenditure in cancer patients: a pilot validation of a new wearable device. JPEN J Parenter Enteral Nutr 31(6):502–507

    Article  Google Scholar 

  21. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports Medicine (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43(7):1334–1359

    Article  Google Scholar 

  22. R Core Team, R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria, 2016.

  23. Pinheiro, J., et al., nlme: linear and nonlinear mixed effects models. R package version 3.1-127. 2016.

  24. Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E (2015) Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer 121(22):4044–4052

    Article  Google Scholar 

  25. Truong PT, Gaul CA, McDonald R, Petersen RB, Jones SO, Alexander AS, Lim JT, Ludgate C (2011) Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy. Am J Clin Oncol 34(4):350–355

    Article  Google Scholar 

  26. Steindorf K, Schmidt ME, Klassen O, Ulrich CM, Oelmann J, Habermann N, Beckhove P, Owen R, Debus J, Wiskemann J, Potthoff K (2014) Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 25(11):2237–2243

    Article  CAS  Google Scholar 

  27. van Waart H et al (2015) Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol 33(17):1918–1927

    Article  Google Scholar 

  28. Juvet LK et al (2017) The effect of exercise on fatigue and physical functioning in breast cancer patients during and after treatment and at 6 months follow-up: a meta-analysis. Breast 33:166–177

    Article  CAS  Google Scholar 

  29. Lipsett A, Barrett S, Haruna F, Mustian K, O'Donovan A (2017) The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: a systematic review and meta-analysis. Breast 32:144–155

    Article  Google Scholar 

  30. Mishra SI et al (2012) Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 8:460

    Google Scholar 

  31. Brown JC et al (2011) Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomark Prev 20(1):123–133

    Article  Google Scholar 

  32. Ryan JL et al (2007) Mechanisms of cancer-related fatigue. Oncologist 12(Suppl 1):22–34

    Article  CAS  Google Scholar 

  33. Segal RJ et al (2009) Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 27(3):344–351

    Article  Google Scholar 

  34. Buffart LM, Galvão DA, Chinapaw MJ, Brug J, Taaffe DR, Spry N, Joseph D, Newton RU (2014) Mediators of the resistance and aerobic exercise intervention effect on physical and general health in men undergoing androgen deprivation therapy for prostate cancer. Cancer 120(2):294–301

    Article  Google Scholar 

  35. Gardner JR, Livingston PM, Fraser SF (2014) Effects of exercise on treatment-related adverse effects for patients with prostate cancer receiving androgen-deprivation therapy: a systematic review. J Clin Oncol 32(4):335–346

    Article  Google Scholar 

  36. Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4(2):87–100

    Article  Google Scholar 

  37. Bower JE (2007) Cancer-related fatigue: links with inflammation in cancer patients and survivors. Brain Behav Immun 21(7):863–871

    Article  CAS  Google Scholar 

  38. Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR (2000) Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 18(4):743–753

    Article  CAS  Google Scholar 

  39. Schmidt ME et al (2015) Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer 137(2):471–480

    Article  CAS  Google Scholar 

  40. Berntsen S, Hageberg R, Aandstad A, Mowinckel P, Anderssen SA, Carlsen KH, Andersen LB (2010) Validity of physical activity monitors in adults participating in free-living activities. Br J Sports Med 44(9):657–664

    Article  CAS  Google Scholar 

  41. McCambridge J, Witton J, Elbourne DR (2013) Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol 67:267–277

    Article  Google Scholar 

Download references

Acknowledgments

We thank all participants and professional staff of participating institutes. The study is ethically approved, and founded by charity awards from the Grieg foundation as well as the Norwegian Cancer Society.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

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Authors and Affiliations

  1. Cancer Centre for Education and Rehabilitation, Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway

    Mona Nilsson, Cecilia Arving & Inger Thormodsen

  2. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

    Cecilia Arving, Sveinung Berntsen & Karin Nordin

  3. Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway

    Jörg Assmus

  4. Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway

    Sveinung Berntsen

Authors
  1. Mona Nilsson
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  2. Cecilia Arving
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Correspondence to Mona Nilsson.

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Informed consent was obtained from all individual participants included in the study.

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Nilsson, M., Arving, C., Thormodsen, I. et al. Moderate-to-vigorous intensity physical activity is associated with modified fatigue during and after cancer treatment. Support Care Cancer 28, 3343–3350 (2020). https://doi.org/10.1007/s00520-019-05176-3

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