Physical exercise for cytotoxic drug-induced fatigue

Cancer-related fatigue (CRF) is frequently reported by cancer patients receiving cytotoxic drugs. The specific mechanism of CRF in cancer patients is not completely known. In recent years, convincing evidence supports the management of fatigue with physical exercise. This study investigated a recommendation that physical activity, eg, a 30-minute daily walk, would decrease fatigue in cancer patients receiving cytotoxic drugs at an outpatient ward.

In total, 89 patients were interviewed about their fatigue and were asked to complete a questionnaire, the Fatigue Symptom Inventory (FSI), once a week over several treatment cycles of cytotoxic drugs. On inclusion, all patients received similar information about fatigue. After randomization, information about the positive effects of exercise was given to half of the patients after one cycle of cytotoxic drugs, and to the remaining patients after two cycles of cytotoxic drugs.

A total of 74 patients completed the study and returned useable questionnaires. The fatigue prevalence was 89% after one cytotoxic drug cycle. According to the FSI ratings, the group who received information about physical exercise after one cycle scored significantly lower ratings than the other group throughout the study (P = 0.034). The patient interviews confirmed that physical activity helped them to better battle fatigue. Intensity of other symptoms and side effects from cytotoxic drugs closely paralleled the fatigue ratings.

Fatigue was commonly found in the study population. Though small improvements followed physical exercise, results pointed towards the fact that information and exercise may support patients to combat fatigue. Early and frequent information would probably support patients to better combat fatigue by physical exercise.