The best option for cancer fatigue isn’t a pill

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Exercise and/or psychological therapy work better than medications to reduce cancer-related fatigue and should be recommended first to patients, say researchers.

“If a cancer patient is having trouble with fatigue, rather than looking for extra cups of coffee, a nap, or a pharmaceutical solution, consider a 15-minute walk,” says Karen Mustian, associate professor at the University of Rochester Medical Center department of surgery’s Cancer Control Program.

“It’s a really simple concept but it’s very hard for patients and the medical community to wrap their heads around it because these interventions have not been front-and-center in the. Our research gives clinicians a valuable asset to alleviate cancer-related fatigue.”

For the study, published in JAMA Oncology, scientists analyzed the outcomes of 113 studies that tested various treatments for cancer-related fatigue in more than 11,000 patients. Nearly half were women with breast cancer; 10 studies focused on other types of cancer and enrolled only men.

Data show that exercise alone—whether aerobic or anaerobic—reduces cancer-related fatigue most significantly. Psychological interventions, such as therapy designed to provide education, change personal behavior, and adapt the way a person thinks about his or her circumstances, similarly improved fatigue.

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A combination of exercise and psychological therapy has mixed results and researchers cannot say for sure what the best method is for combining treatments to make them effective.

Finally, the study shows that drugs tested for treating cancer-related fatigue—including stimulants like modafinil, which can be used for narcolepsy, and Ritalin, which treats ADHD were not as effective.

“The literature bears out that these drugs don’t work very well although they are continually prescribed,” Mustian says. “Cancer patients already take a lot of medications and they all come with risks and side effects. So any time you can subtract a pharmaceutical from the picture it usually benefits patients.”

All of the participants in the analyzed studies suffered cancer-related fatigue, the most common side effect during and after cancer treatment. This type of fatigue is different from being chronically tired: It’s a crushing sensation that’s not relieved by rest or sleep, and can persist for months or years.

Researchers believe cancer-related fatigue might be the result of a chronic state of inflammation induced by the disease or its treatment. Most concerning, is that fatigue can decrease a patient’s chances of survival because it lessens the likelihood of completing medical treatments.

The National Cancer Institute funded the research.

Source: University of Rochester