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Cancer-related fatigue and exercise

Fatigue is one of the most common and debilitating symptoms experienced by patients with cancer. Cancer-related fatigue (CRF) is characterized by feelings of tiredness, weakness, and lack of energy, and is distinct from the “normal” drowsiness experienced by healthy individuals in that it is not relieved by rest or sleep. It occurs both as a consequence of the cancer itself and as a side effect of cancer treatment, although the precise underlying pathophysiology is largely unknown. Virtually all patients expect fatigue from cancer therapy. Up to 90% of patients treated with radiation and up to 80% of those treated with chemotherapy experience fatigue. CRF continues for months and even years following completion of treatment in approximately one third of the patients with cancer.

If cancer-related fatigue continues even after treatment, what then is a person to do to defeat fatigue? A not so popular but very well researched treatment is exercise. Exercise has been proven to help people with fatigue. Here are some positive findings about exercise and how it affects fatigue:

1.    Research has found no harmful effects on patients with cancer from moderate exercise and, in fact, has demonstrated that those who exercised regularly had 40% to 50% less fatigue, the primary complaint during treatment.

2.    Increases muscle strength, joint flexibility and general conditioning, all of which may be impaired by surgery and some therapies. Exercise is known to improve cardiovascular function and to protect bones. It also elevates mood, offering drug-free relief for the feelings of depression that may accompany a cancer diagnosis.

3.    Increases blood flow systemically which increases oxygen, this can help decrease tumor growth as tumors tend to be hypoxic

4.    Helps control weight -- a crucial factor, as studies have shown that gaining weight during and after treatment raises the risk of a cancer recurrence, particularly for breast, colon and prostate cancers.

5.    Helps keep chemo-therapy treatments on track

6.    Reduces inflammation

The next question is, how much exercise is enough? The American Heart Association recommends 30 minutes of exercise 5 days per week. It is unknown what combination of exercise is right for cancer patients. Here are some exercises that are safe: walking, biking, lifting light weights, and swimming. If you haven't exercised in a long time the advice is to take it slow and do not increase your fatigue symptoms. You should feel good after you perform the exercise. Some fatigue after exercise is normal but should not last longer than a few hours.

If you have questions about how much exercise is appropriate schedule an appointment with your physician to be cleared of any underlying pathologies and then ask for a referral to a physical therapist. They can help figure out your exercise plan that is geared to you. Not everyone exercises the same, it's important to find something that is fun at the same time. If the exercise is forced the likelihood of sticking with it is minimal.

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