Cancer-related Fatigue Research Articles

Effectiveness of supervised combined aerobic and resistance exercise in fatigue of prostate cancer survivors under androgen deprivation therapy: a systematic review and meta-analysis

Abstract Objectives Cancer-related fatigue is prevalent in prostate cancer patients. This symptom can negatively affect patients’ performance and emotional well-being, but there is no consensus on the best therapeutic approach. Despite the growing evidence on the management of fatigue with exercise, there are recognised limitations in its use when considering the different cancer patients. Specifically, prostate cancer patients under androgen deprivation therapy present several contributors to fatigue, emotional distress, inactivity, and deconditioning. The aim of this research was to describe the current literature on the effects of supervised combined aerobic and resistance training on fatigue in patients under androgen deprivation therapy. Methods We conducted a literature search in PubMed, Scopus, and Web of Science. The GRADE and the Cochrane tools were used to assess the quality and risk of bias of the selected studies. Only randomised controlled trials in which combined aerobic and resistance training was used with prostate cancer patients under androgen deprivation therapy were included. A cancer-related fatigue meta-analysis was performed. Results Nine studies with a low risk of bias were included in the review. Regarding cancer-related fatigue, significant results that cannot be attributed to chance were found in favour of combined exercise (MD=0.71; 95 %; CI=0.05, 1.37; p=0.03; I2=91 %). The GRADE system showed a moderate recommendation. Conclusions Supervised combined aerobic and resistance training was proven to significantly improve fatigue in patients with prostate cancer under androgen deprivation therapy. These findings could provide clinicians with more information on the management of cancer patients under androgen deprivation therapy.

Study protocol of an exercise and nutrition intervention for ovarian cancer patients during and after first-line chemotherapy (BENITA) - a randomized controlled trial

Abstract Background In ovarian cancer frequently reported side effects are muscle wasting and malnutrition, leading to frailty, decreased health-related quality of life (HRQoL), and cancer-related fatigue (CRF). Both often begin during first-line chemotherapy and develop progressively into a refractory state, if left untreated. Method Primary objective is to evaluate effectiveness of a newly developed app-based exercise and nutrition program under non-standardized conditions of clinical routine. We hypothize that patients who receive an individually tailored exercise and nutrition program for six months will have improved physical performance compared to patients who receive usual care. This is a multicenter randomized controlled open-label trial comparing an intervention group receiving a six-month exercise and nutrition intervention and a control group receiving usual care. Primary endpoint is the change in 6-Minute Walk Test (6MWT) from baseline to T2 (26 weeks after baseline) as a measure of physical functioning. Secondary endpoints include patients’ utilization and adherence to the nutrition program (MEDAS), their malnutrition risk (NRS2002), as well as patients’ HRQoL (see Table 1). Using the two-sample t-test with a two-sided type I error of 5% and 80% power, a medium effect size of Cohen’s d = 0.50 can be demonstrated with a minimum of 128 participants (64 per group). With a conservatively estimated dropout rate of 30%, 182 patients will be recruited. Patients who are included must be over 18 years of age, be diagnosed with ovarian cancer, cancer of fallopian tubes, or peritoneal cancer, FIGO stages II-IV, receive surgery and chemotherapy (adjuvant or neoadjuvant). Exclusion criteria are an ECOG status greater than 2, inadequate proficiency in German, or physical or mental impairments hindering the implementation of the program or execution of study procedures. Discussion In case of success, the project contributes in the long term to (i) improving medical care (diagnosis, psychoeducation, patient orientation, and empowerment), (ii) reducing the burden of disease and promoting physical autonomy for patients, and (iii) being incorporated into relevant guidelines. Trial registration The study was registered at ClinicalTrials.gov (NCT06250686).

Systematic review of Buzhong Yiqi method in alleviating cancer-related fatigue: a meta-analysis and exploratory network pharmacology approach

ObjectivesCancer-related fatigue (CRF) is a prevalent and distressing symptom experienced by many cancer patients, necessitating effective treatments. This study utilizes meta-analysis and network pharmacology to comprehensively assess the efficacy of the Buzhong Yiqi prescription in alleviating cancer-related fatigue and to preliminarily explore the mechanism of its core drugs.MethodsWe included randomized controlled trials (RCTs) in cancer patients. The inclusion criteria encompassed a diagnosis of cancer-related fatigue, without limitation on cancer type, the experimental group receiving Buzhong Yiqi prescription, the control group receiving conventional treatment, patients awaiting treatment, and articles published in either English or Chinese. We conducted a search through 29 February 2024, across PubMed, Cochrane Database of Systematic Reviews, Cochrane Controlled Clinical Trials (CENTRAL), China Biomedical Literature Service (CBM), China National Knowledge Infrastructure (CNKI), WANFANG Database, and Weipu Database (VIP). Journal articles that met the inclusion criteria were selected for inclusion. Two independent investigators evaluated the quality of the included studies. A meta-analysis was performed utilizing the Stata 12.0 software package, where estimates of cancer-related fatigue were aggregated through the application of a random-effects model. We employed the Cochrane Risk of Bias Tool to evaluate potential biases in RCTs. The primary outcome measures utilized to assess the efficacy and safety of CRF treatment comprised the Revised Piper Fatigue Scale (PFS-R) and the Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). The secondary outcomes encompassed the KPS score, the effective rate, the TCM syndrome score, and an evaluation of adverse reactions. The Traditional Chinese Medicine Systems Pharmacology (TCMSP) was utilized to identify the active ingredients and targets of BZD. Additionally, the Drug bank, Therapeutic Target Database (TTD), DiaGeNET, and GeneCards databases were utilized to retrieve relevant targets for CRC. The Venn diagram was employed to identify overlapping targets. Cytoscape software was utilized to construct a network of “herb-ingredient-target” and identify core targets. GO and KEGG pathway enrichment analyses were performed using R language software.ResultsIn comparison to the control group, patients with CRF who received BZYQ prescription exhibited marked improvements in KPS score, QLQ-C30 quality of life score, and effective rate. Conversely, PFS, TCM syndrome score, and adverse reaction assessments significantly decreased. The primary active ingredients in its core drugs may exert a positive therapeutic effect on CRF by targeting molecules such as AKT1, IL6, IL1B, PTGS2, CASP3, ESR1, and BCL2, as well as through signaling pathways including TNF, IL17, TLR, NF-κB, and C-type lectin receptor.ConclusionBZYQ demonstrates significant efficacy in treating CRF with minimal adverse reactions. It can serve as a fundamental treatment for CRF in clinical practice, and the medication can be tailored to individual patients for personalized therapy. The potential pharmacological mechanism of BZYQ in treating CRF, as predicted by network pharmacology, offers a molecular foundation for clinical CRF treatment.Systematic Review Registration:https://inplasy.com, identifier INPLASY202430025

Application of fine nursing mode in nursing management of blood oncology department

Objective: To explore the effect of fine nursing on cancer-related fatigue (CRF), anxiety, and depression in patients with hematological tumors undergoing chemotherapy, and to provide a feasible intervention plan for clinical management of these symptoms. Methods: A quasi-experimental study was conducted on patients with hematological tumors undergoing chemotherapy, admitted to our hospital from June 2018 to November 2021. A total of 84 eligible patients were randomly divided into two groups: 44 in the experimental group and 40 in the control group. The control group received routine nursing care, including psychological support, diet guidance, catheter care, bleeding prevention, and chemotherapy guidance. The experimental group received an additional 4 weeks of intensive nursing care on top of the routine care. Results: Three patients withdrew from the study, leaving 42 in the experimental group and 40 in the control group. No significant differences were observed between the two groups in terms of demographic and clinical baseline characteristics. Before the intervention, there were no significant differences in CRF, anxiety, and depression scores between the groups. After the intervention, the experimental group showed significantly lower scores in CRF, anxiety, and depression compared to the control group and their own baseline scores. Conclusion: Fine nursing can effectively reduce cancer-related fatigue, anxiety, and depression in patients with hematological tumors undergoing chemotherapy.

A holistic intervention for alleviating anxiety, depression, and fatigue in cervical cancer

ObjectiveEvaluate how well an intervention program reduces anxiety, depression, and fatigue. MethodsThe study was carried out at the Postgraduate Institute of Medical Education in a hospital in Lebanon. A randomized controlled trial (RCT) was conducted with 30 patients undergoing radiotherapy or chemotherapy. Participants were randomized into two groups of 15 each using an approach for comprehensive enumeration sampling. The Zung Anxiety Scale, Beck Depression Inventory, and Fatigue Scale were among the research instruments. The study approach involved counseling, home care, and the Progressive Muscle Relaxation technique. ResultsBoth groups had comparable sociodemographic and clinical profiles. The study comprised 30 participants, averaging 32 years in the experimental group and 28 years in the control group. Most of the participants were married (74 % experimental, 60 % control), with a significant proportion identified as housewives (87 % control, 60 % experimental). In addition, many had limited education, with 74 % of the experimental group and 67 % of the control group below the primary level. The intervention group, which received counseling, home care and Progressive Muscle Relaxation, experienced significantly greater reductions in anxiety, depression, and fatigue, with p-values below 0.001 for all variables. Statistical analyzes, including paired and independent t-tests, confirmed these findings. ConclusionsThe therapeutic program significantly reduced anxiety, depression, and fatigue in patients undergoing cancer treatment, with p-values less than 0.001. These findings highlight the importance of tailored support, suggesting that integrating such interventions into standard care can improve patients’ mental and emotional well-being

Prevalence of cancer-related fatigue, associated factors and adult cancer patients’ experiences at Hawassa University Comprehensive Specialized Hospital in Ethiopia: a mixed methods study

Prevalence of cancer-related fatigue, associated factors and adult cancer patients’ experiences at Hawassa University Comprehensive Specialized Hospital in Ethiopia: a mixed methods study

Exercise benefits following breast cancer surgery – a narrative review

One of the most common cancer diseases among women is breast cancer. Treatment following breast cancer surgery leads to many complications. Exercises play an important role from the immediate post operative period which could help in preventing post-surgical complications. Prevention of complications improves the quality of life of women. Though women feel that performing exercises following treatment are difficult there are many positive effects of exercises. This current study was done with an objective to analyse the various effects of exercises especially on the resisted exercises in preventing Secondary lymphedema (SL) and to focus light on the benefits of the exercises during and after chemotherapy. Literature search of PubMed, Clinical Key and Google scholar was performed. For women recovering from breast cancer surgery, resisted exercises, either by themselves or in combination with aerobic exercises, were safe and effective. These exercises improved upper body strength, increased endurance, decreased adipose tissue, decreased waist and hip circumferences, increased lean body mass, improved cardiovascular fitness, improved self-esteem, and decreased depression. Women with breast cancer related lymphedema had a considerable improvement in pain after performing deep breathing exercises combined with upper limb movements. Exercise can help mitigate the negative effects of chemotherapy and helps to overcome cancer related fatigue. Along with conventional exercises including range of motion exercises and aerobic exercises, moderate-intensity upper body resistance exercises are recommended to be a part of exercise protocol prescribed and educated to the women following breast cancer surgery for them to lead a better quality of life.

Lifestyle factors before and after colorectal cancer treatment and their association with fatigue

Abstract Background As colorectal cancer (CRC) survivorship increases, so does the challenge of managing cancer-related fatigue, a prevalent condition that severely impacts survivors’ ability to work and overall quality of life. This study delves into the relationship between lifestyle behaviors, assessed using the HEALTHY lifestyle score, and its influence on fatigue among CRC patients. Methods Data was derived from MIRANDA, a multicenter cohort study that enrolls adult CRC patients during a 3-week in-patient rehab within a year after primary CRC treatment. Up to date, n = 438 participants provided information on lifestyle factors at the rehabilitation start (baseline) and then every three months for the first year. The predictors were the HEALTHY lifestyle score and its components (diet, alcohol consumption, physical activity, BMI, and smoking status) calculated at three time points: before surgery, after surgery, and 12 months following rehabilitation. The outcome was fatigue, assessed using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F-FS) scale. Results Participants with a higher HEALTHY lifestyle score after CRC surgery had statistically significantly lower fatigue levels. The components that contributed most to this finding were smoking and physical activity. Participants who engaged in exercise post-surgery or did not smoke before their cancer diagnosis experienced lower fatigue levels during rehabilitation. Conclusions Lifestyle modifications, such as increasing physical activity and smoking cessation, are crucial in preventing or reducing fatigue among CRC patients. Tailored public health initiatives that advocate for these lifestyle adjustments and their incorporation into CRC rehabilitation protocols could significantly advance survivor care, ultimately leading to better health outcomes. Key messages • The HEALTHY score is associated with fatigue of CRC patients during rehabilitation, highlighting the crucial role of lifestyle changes after CRC treatment. • Smoking cessation and physical activity programs may be the most effective measures for decreasing the fatigue burden of these patients.

Constructing a picture of fatigue in the context of cancer: assessment of construct overlap in common fatigue scales.

Individuals diagnosed with cancer experience multiple inter-related short- and long-term side effects. Chief among such symptomology is cancer-related fatigue (CRF), which, if left unmanaged, can become chronic and result in increased disability and healthcare utilization. A growing number of self-report scales have been developed to measure CRF symptoms based on various theoretical conceptualizations with the aim of promoting targeted assessment and intervention efforts. It may be, however, unwise to assume that the various measures are conceptually similar (i.e., that they assess for the same constructs). Accordingly, we aimed to characterize item content among nine self-report scales, using a Jaccard index to quantify content overlap among scales. We characterized construct assessment among nine self-report scales recommended to assess CRF by a recent clinical practice guideline, and used a Jaccard index to quantify content overlap among scales. Analysis of 208 items across nine rating scales resulted in 20 distinct symptoms of CRF assessed. The most common symptoms were energy level (captured in all nine scales), cognitive function, impaired task performance (in eight scales), sleepiness, and physical function (in seven scales). Mean overlap among all scales was low (Jaccard index = 0.455). Only one construct (duration of fatigue; 5.0%) was captured by a single scale, and one symptom (energy level; 5.0%) was common across all scales. The PFS, MFSI, and BFI each captured at least one symptom from each of the NCCN domains of CRF. CRF scales are heterogeneousin the content they measure, critically impairing integration of knowledge across studies using disparate scales. Future work is urgently needed to build more integrated theoretical and/or computational models of CRF based on relevant mechanisms.

Effectiveness of an Exercise and Educational-Based Prehabilitation Program in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy (PREOptimize) on Functional Outcomes: A Randomized Controlled Trial.

The study objective was to determine the effectiveness of a prehabilitation program to decrease postoperative musculoskeletal impairments in patients who have breast cancer and are receiving neoadjuvant therapy (NAT). Patients who had breast cancer and were receiving NAT before surgery were invited to participate in this randomized controlled trial. Patients randomized to the intervention group participated in a group-based prehabilitation program consisting of Nordic walking, resistance training, and therapeutic education from month 4 of NAT until before surgery. Patients in the control group received usual care (no prehabilitation). The main outcome was arm function measured with the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire 1month after surgery. Other measures included pain, range of motion, functional capacity, cancer-related fatigue, handgrip strength, physical activity, and arm circumferences. A total of 64 patients were randomized during the study period, and 61 completed all assessments. A significant difference in the main outcome (short version of the Disabilities of the Arm, Shoulder and Hand questionnaire) was found before surgery as patients in the control group experienced worsening in arm function (mean difference = -9.84, 95% CI = -17.7 to -2). In addition, they also showed increased symptom frequency/severity according to the combined scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) (mean difference = +6.7 points, 95% CI = 13.4 to 0.1) compared to the intervention group. Prehabilitation also improved functional capacity (mean difference = 67.6m, 95% CI = 37.4 to 97.7) and physical activity levels and decreased cancer-related fatigue (mean difference = -1.3, 95% CI = -0.29 to -2.4) compared to the control group but had no effect on other secondary outcomes. After surgery, patients receiving prehabilitation also exhibited greater functional capacity at both 1 and 3months. No other difference was observed. A prehabilitation program was able to maintain arm function and increase functional capacity while decreasing fatigue in patients with breast cancer receiving NAT. Prehabilitation programs should be offered to patients with breast cancer to maintain functionality and enhance physical performance before surgery. An exercise program combined with therapeutic education in patients with breast cancer who receive neoadjuvant therapy before surgery can improve functional capacity and prevent declines of arm mobility and function.

"Such a different type of tiredness": people with brain tumour, their caregivers', and healthcare professionals' qualitative perceptions of cancer-related fatigue.

Cancer-related fatigue (CRF) is one of the most common symptoms reported by people with primary brain tumour (BT). Previous research predominantly examined CRF using quantitative assessments, failing to capture the rich insight garnered from exploring individuals' lived experiences. We addressed this gap by qualitatively exploring people with BTs' experiences of CRF. Semi-structured interviews were conducted with people with BT, their caregivers, and healthcare professionals (HCPs) who care for them. Interviews explored the experience, impact, and management of CRF, including types of support provided by HCPs. Data were analysed using reflexive thematic analysis. Forty participants were interviewed (24 people with BT, 5 caregivers, 11 HCPs). Qualitative analysis identified four themes: pervasiveness of CRF; impacts of CRF; advice and support; and self-management strategies. CRF was described as an almost universal symptom with physical, emotional, and cognitive aspects and profound psychosocial and functional impacts. HCPs reported assessing fatigue and providing management support. Yet, people with BT and caregivers reported CRF assessment and support were rarely received. Consequently, people with BT developed their own management strategies. All participants identified a lack of CRF information resources and interventions specific to people with BT. Our findings provide rich insight into the pervasive, debilitating impact of CRF in people with BT and highlight the lack of BT-specific CRF support and information available. There is a critical need for evidence-based fatigue interventions and information resources tailored to the needs of people with BT.

Impact of resistance training on fatigue among breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis.

The effects of aerobic exercise interventions for reducing fatigue after cancer treatment are well-established, and the effect of resistance training remains uncertain. Therefore, this systematic review and meta-analysis aim to analyze the effect of resistance training and combined resistance and endurance training on cancer-related fatigue (CRF) in breast cancer patients. A systematic search for randomized controlled trials (RCTs) was conducted on the PubMed, SPORTDiscus, Embase, and Cochrane databases, focusing on the effect of supervised resistance training and combined supervised resistance and endurance training on CRF. Random-effect models were employed for calculating the standardized mean difference (SMD). Risk of bias was assessed with risk of bias 2 (RoB2), and certainty of evidence was judged according to the GRADE approach. A total of 9 RCTs with 1512 participants were included, and data from 866 participants in 8 RCTs were used for the meta-analysis. The risk of bias was deemed low in seven studies, while one study exhibited attrition bias, and one showed possible selection bias. Resistance training probably reduce the total fatigue (SMD= -0.30, 95% CI -0.52, -0.08, p=0.008), with individual studies showing small effects on physical and emotional CRF. A combined resistance and endurance training reduce total fatigue (SMD= -0.34, 95% CI -0.51, -0.17, p= 0.0001), with individual studies indicating moderate effects on physical fatigue, in daily life fatigue, and small effects on emotional and cognitive CRF. Both supervised resistance training and combined resistance and endurance training have a small effect on total CRF. There is a trend towards an influence of intensity, with higher intensity potentially resulting in lower total CRF.

Women's Experience and Management of Cancer-Related Fatigue and Psychological Distress During Treatment for Gynaecological Cancer: A Qualitative Study.

To explore women's experience and management of cancer-related fatigue and psychological distress during treatment for gynaecological cancer. Qualitative descriptive study. Face-to-face semistructured individual interviews were conducted with 23 women in mainland China undergoing treatment for gynaecological cancer between July and October 2023. Data were analysed using content analysis. Three categories were identified: overwhelming experience of cancer-related fatigue, diverse experiences of psychological distress and strategies for managing cancer-related fatigue and psychological distress. Participants reported physical exhaustion and emotional fatigue, disrupting their normal lives. Psychological distress included distress due to cancer treatment, psychological burden associated with social relationships, frustration with being ill and worries about disease progression and recurrence. Strategies for managing symptoms were mainly nonpharmacological, with some unable to find suitable methods. This study found that participants had a complex experience of cancer-related fatigue and psychological distress, influenced by social expectations regarding women's roles and treatment impacts on reproductive health and femininity. These findings underscore the need for comprehensive interventions involving family members or fellow patients to reduce both symptoms. Nurses should focus on addressing cancer-related fatigue and psychological distress in women receiving treatment for gynaecological cancer, particularly in adolescents and young adults. It is essential to provide comprehensive care to improve their physical and psychological well-being. This study explored how women with gynaecological cancer experience and manage cancer-related fatigue and psychological distress. The findings highlight the need for holistic care that addresses physical and psychological symptoms. Nurses should consider the impact of reproductive health and femininity on symptom experiences and management. Furthermore, the findings could inform the development of evidence-based interventions to improve the physical and psychological well-being of women with gynaecological cancer. Standards for Reporting Qualitative Research checklist. No patient or public contribution.

Complementary and integrative medicine in cancer-related fatigue

The majority of cancer patients experience fatigue during the course of their illness. Fatigue should not be seen as an inevitable consequence of cancer and its treatment. Cancer-related fatigue (CRF) is amultidimensional symptom complex that is influenced by avariety of factors. Complementary medicine approaches offer potentially promising strategies to address this fatigue and can therefore be avaluable addition to conventional therapies.In this narrative review, complementary medicine treatment approaches for tumor-associated fatigue are presented according to the historical development and current scientific evidence. The focus is on methods with the highest current evidence based on the recommendations of national and international guidelines. Therapeutic approaches from mind-body medicine, such as mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), yoga, tai chi, and qigong, as well as acupuncture, acupressure, moxibustion, and phytotherapeutic treatment approaches are presented.In Germany, the complementary therapies listed here are not generally covered by health insurances. However, afew clinics have developed comprehensive programs in mind-body medicine, for which cost coverage has already been obtained. As aresult, complementary medical treatments for cancer-related fatigue that adhere to national and international guidelines are typically available only as private services or within the framework of study participation.

The effect of YOCAS©® yoga on cancer-related fatigue and quality of life in older (60+) vs. younger (≤ 59) cancer survivors: Secondary analysis of a nationwide, multicenter, phase 3 randomized controlled trial

IntroductionOlder cancer survivors consistently express the need for interventions to reduce cancer-related fatigue (CRF) and maintain quality of life (QOL). Yoga is a promising treatment to address CRF and QOL. However, research comparing the efficacy of yoga for improving fatigue and QOL in older survivors (60+) vs. younger adult survivors (≤59)is limited. Our objective was to examine the effects of yoga on CRF and QOL in older survivors vs. younger survivors. Materials and MethodsWe conducted a secondary analysis of a nationwide, multicenter, phase 3 randomized controlled trial. For this study, participants who provided evaluable pre- and post-intervention data on the Functional Assessment for Chronic Illness Therapy-Fatigue (FACIT-F) and the Functional Assessment for Cancer Therapy-General (FACT-G) were eligible. The yoga intervention comprises gentle Hatha and Restorative Yoga and includes breathing exercises, physical alignment postures, and mindfulness. ResultsOf the 177 participants included in the study, 30.1 % were aged 60+ and 69.9 % were aged ≤59. More younger participants had breast cancer (82.0 % vs. 59.2 %. p = 0.009), surgery (98.9 % vs. 77.8 %, p < 0.001), and chemotherapy (80.5 % vs. 55.6 %, p = 0.001). There were no differences in the cancer stage (66.1 % stage I or II). There were statistically significant and clinically meaningful within-group improvements from baseline to post-intervention in CRF for participants aged ≤59 and participants aged 60+ (4.0 ± 0.7, p < 0.001 vs. 3.1 ± 1.0, p = 0.003). Both age groups also demonstrated improvements in QOL (3.2 ± 0.8, p < 0.001 vs. 2.1 ± 1.2, p = 0.078), physical (1.6 ± 0.3, p < 0.001 vs. 0.8 ± 0.5, p = 0.084), functional (0.7 ± 0.3, p = 0.048 vs. 1.0 ± 0.5, p = 0.037), and emotional well-being. There were no significant between-group differences between the age groups. Most younger and older participants reported that yoga helped improve their sleep quality (92.8 % vs 88.5 %) and they would recommend it to other survivors (98.2 % vs 90.4 %). DiscussionOlder cancer survivors who undergo gentle Hatha and restorative yoga performed two to three times per week for four weeks at a low to moderate level of intensity have similar improvements in CRF and QOL compared to participants aged ≤59. For older survivors experiencing these toxicities, it is reasonable for clinicians to prescribe yoga.ClinicalTrials.govidentifier: NCT00397930

Effects of mindfulness-based stress reduction on cancer-related fatigue in patients with breast cancer: a meta-analysis of randomized controlled trials.

Mindfulness-based stress reduction (MBSR) has been widely used for improving psychological symptoms and sleep quality in breast cancer patients and has a positive impact on posttraumatic growth and immunology. Moreover, MBSR is increasingly being used in cancer-related fatigue (CRF) intervention studies for breast cancer patients, but conflicting results also exist. This study aimed to evaluate the effect of MBSR on CRF in patients with breast cancer. A comprehensive computer search of the Pubmed, Cochrane Library, Embase, Web of Science, China Biomedical Document Service System, China Knowledge Infrastructure Engineering, Wanfang Data Knowledge Service Platform, and VIP databases was performed. Randomized controlled trials (RCTs) published before April 10, 2023, were identified. The primary outcome was cancer-related fatigue associated with breast cancer. Two researchers independently screened the studies, extracted the data, and evaluated the methodological quality of the studies according to the inclusion and exclusion criteria. The Meta-analysis of the outcome indicators was performed using STATA 16.0 software. A total of 13 studies were included, including 1992 patients (997 patients in the MBSR group and 1015 patients in the control group). Compared with conventional care, MBSR significantly alleviated the symptoms of CRF in breast cancer patients (SMD=-0.32, 95% CI [-0.42, -0.22], z=6.54, p<.01). Under the supervision of experts, the 8-week MBSR had a great influence on CRF, especially in the Asian population. MBSR is effective in the treatment of CRF induced by breast cancer, and no obvious adverse effects occur; thus, MBSR can be recommended as a beneficial adjuvant therapy for treating CRF in breast cancer patients. https://www.crd.york.ac.uk/prospero/, identifier CRD42021245365.

Network Analyses Applied to the Dimensions of Cancer-Related Fatigue in Women With Breast Cancer.

Understanding cancer symptom cluster through network analyses is a new approach in oncology, revealing interconnected and influential relationships among reported symptoms. We aimed to assess these relationships using network analysis in posttreatment breast cancer patients, focusing on the five dimensions of cancer-related fatigue (CRF), and on other common difficulties encountered by oncological patients (i.e., pain, anxiety, depression, sleep difficulties, cognitive impairments, and emotion regulation and mental adaptation difficulties). This study involved a complementary analysis of data from two interventional studies. Participants completed questionnaires before and after the intervention, with baseline scores being used in this article. Partial correlation network analysis modeled the relationships between symptoms in five distinct networks, each of them including one specific dimension of CRF. The core symptom in each network was identified based on the highest centrality indices. Depression emerged as the core symptom in all networks, strongly associated with all fatigue dimensions (partial correlations ranging from 0.183 to 0.269) except mental fatigue. These findings indicate robust connections between symptoms, as variations in depression scores directly or indirectly influence fatigue and other symptoms within the cluster. Our results support the multidimensional aspect of CRF, and its links with other common symptoms. To effectively reduce patient CRF, interventions should address not only fatigue but also the closely related symptoms from the cluster, such as depression, given its centrality in the cluster. ClinicalTrials.gov (NCT03144154 and NCT04873661). Retrospectively registered on May 1, 2017 and April 29, 2021, respectively.

Most Common Symptomatic Adverse Reactions of Cancer Treatments From US Drug Labels (2015-2021) to Inform Selection of Patient-Reported Outcomes

ObjectivesIncorporating patient-reported outcomes (PROs) to assess symptomatic adverse events (AEs) in cancer clinical trials (CTs) is important to characterize treatment tolerability. Cancer therapies approved over the past decade have expanded the types of expected toxicities. To inform future symptomatic AE PRO item selection, we identified the most common symptomatic adverse reactions from recently approved products. MethodsWe reviewed approvals from 2015 to 2021 for lung, breast, and hematologic cancer indications. Using United States Prescribing Information safety data, we recorded symptomatic adverse reactions reported in ≥20% of patients in the experimental arm of CTs supporting approvals. We calculated the proportion of arms reporting each symptomatic adverse reaction. ResultsIn total, 130 experimental arms were included (lung = 30, breast = 10, hematologic = 90). For all cancer types, fatigue and diarrhea were reported in >50% of the arms. Nausea was reported in ≥50% of the arms for all except lung. Vomiting, decreased appetite, and alopecia, were reported in ≥50% of breast cancer arms. Rash, musculoskeletal pain, and cough were reported in >50% of leukemia/lymphoma arms. Cough was common (50%) in multiple myeloma arms. ConclusionsHeterogeneity in symptomatic adverse reactions across CTs supports the use of item libraries when building a PRO strategy to assess tolerability. Fatigue, diarrhea, and nausea were the most frequent symptomatic adverse reactions reported in contemporary cancer CTs and could provide a starting point when selecting PRO symptomatic AE items. Additional symptomatic AE PRO items should be selected based on the mechanism of action, early clinical data, published literature, and patient and clinician input.

The Effects of Home-Based Walking on Cancer-Related Fatigue in Patients with Breast Cancer: A Systematic Review

Objective: Home-based walking programs can be a good option for breast cancer patients with fatigue. However, studies on the effectiveness of home-based walking exercise programs have not fully defined proper exercise prescriptions that may be safe and beneficial for breast cancer patients, and their effects on fatigue are still controversial. This systematic review aimed to evaluate the effect of home-based walking on fatigue management in patients with breast cancer. Method: In this study, electronic databases such as Scopus, Pubmed, Web of Science, Medline, Science Direct, and Ebsco Ultimate were searched. The randomized controlled studies published between January 2002 and February 2022 were included in the study. The data were summarized narratively. Results: Patients in the studies consisted of young individuals. The majority of their cancer stages ranged from I to III. A significant part of them received chemotherapy. Home-based walking was found to have positive effects on cancer-related fatigue in women with breast cancer. Home-based walking prescriptions were provided to patients through face-to-face or telephone counseling or printed learning materials. It was determined that the exercise frequency, duration and intensity of home-based walking programs varied in the studies. Conclusion: Home-based walking was found to have positive effects on cancer-related fatigue in women with breast cancer. Therefore, home-based walking can be a simple, cost-effective and safe approach to women with breast cancer. The heterogeneity in reporting procedures suggests that further high-quality and uniform studies should be conducted to reach a stronger consensus on the effects of home-based walking program on fatigue.

Effects of exercise interventions on cancer-related fatigue in children with cancer: A meta-analysis.

Cancer-related fatigue (CRF) emerges as a common symptom in pediatric cancer patients during treatment. Exercise interventions are increasingly being used as CRF interventions to improve CRF in children with cancer. The objective of this meta-analysis was to synthesize the best available evidence concerning the effectiveness of exercise interventions for cancer-related fatigue in children with cancer. Six databases were extensively searched from inception to December 2023 to identify relevant randomized controlled trials. The risk of bias and methodological quality were assessed using the Cochrane appraisal tool. Pooled effects were calculated using a random-effects model. Heterogeneity was assessed using the I2 test. Eight trials (n = 465) were finally included. Exercise was statistically more effective than conventional care in improving CRF in children with cancer (SMD = -0.62, 95% CI [-1.21, -0.03]) with high statistical heterogeneity (p = .004; I2 = 86%). The results of the subgroup analysis showed that intervention duration <12 weeks (p < .05), exercise frequency ≥ 3 times/week (p < .05), and exercise duration <45 min/time (p < .05) were more effective in improving CRF in children with cancer. Our results suggest that exercise interventions are effective in reducing CRF in children with cancer. We recommend exercise frequency ≥ 3 times/week, exercise duration <45 min/time, and intervention duration <12 weeks.