Exercise for the management of cancer-related fatigue in adults.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 23152233 · doi:10.1002/14651858.CD006145.pub3
What was done
This Cochrane systematic review and meta-analysis evaluated the effect of exercise interventions on cancer-related fatigue in adults during and after cancer treatment. The authors searched multiple biomedical databases through March 2011 for randomized controlled trials (RCTs) comparing exercise to control interventions. Two reviewers independently extracted data and assessed risk of bias. Meta-analyses were conducted using a random-effects model for fatigue outcomes.
What was found
A total of 56 RCTs (4,068 participants) were included, with 28 studies conducted in breast cancer. A meta-analysis of 38 comparisons (1,461 exercise participants vs. 1,187 control participants) demonstrated that exercise significantly reduced fatigue compared to control at the end of the intervention period (SMD -0.27, 95% CI -0.37 to -0.17). Significant fatigue reduction occurred during and post-adjuvant therapy, and for breast and prostate cancer, but not for hematological malignancies. Aerobic exercise significantly reduced fatigue, whereas resistance training and alternative forms of exercise did not reach statistical significance.
Why it matters
This review establishes that aerobic exercise is an effective intervention for reducing cancer-related fatigue during and after treatment, particularly in solid tumors such as breast and prostate cancer.
Limits
Half of all included studies were in breast cancer, limiting generalizability to other cancer types. Exercise did not show a statistically significant benefit in hematological malignancies, nor did resistance training or alternative exercise modalities reach significance. The abstract does not define the optimal exercise intensity, frequency, or long-term durability of effects.
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