Reduced fatigue and improved quality of life could revise standard of care
Three studies at Oregon Health & Science University explore the theory that exercise helps combat fatigue caused by chemotherapy and improves the quality of life of cancer patients. The premise challenges traditional medical advice that cancer patients who suffer fatigue should rest, and results could improve the current standard of care for cancer patients.
People with cancer may have more exercise capability than medical experts thought, according to the investigator. "Patients who exercise feel better and are happier than those who do not exercise," said Anna Schwartz, Ph.D., c-F.N.P., scientist in the OHSU School of Nursing, and lead researcher of the three exercise studies. "Cancer patients experience a 20 - 25 percent loss of physical ability within eight weeks after beginning chemotherapy, the risk for osteoporosis is severely magnified, and they are three times more likely to die from heart disease," said Schwartz. Exercise appears to improve body composition and increase bone density, which decreases the risk for osteoporosis and heart disease. "We are learning just how debilitated cancer patients get," said Schwartz. "They need to be active."
The studies look at whether exercise affects different types of cancer patients at different stages of diagnosis and treatment.
• The first study enrolls male and female patients recently diagnosed with cancer that has not metastasized. The study looks at the effects of resistance training and aerobic exercise on fatigue, body composition, bone density and quality of life. Seventy-two patients are enrolled and 29 more patients are needed. The patient must be enrolled for one year and five hospital visits are required. The study is funded by the National Institutes of Health.
• The second study enrolls male and female patients receiving Interferon for malignant melanoma, chronic myelogenous leukemia and renal cell carcinoma. The study looks at the effects of aerobic exercise and the drugs Ritalin and Effexor on seratonin levels and fatigue. Twelve patients are enrolled and 58 more patients are needed. The patient must be enrolled for four months and three hospital visits are required. The study is funded by the Oncology Nursing Foundation.
• The third study enrolls postmenopausal breast cancer survivors who received chemotherapy. The study looks at the effects of exercise and Evista on reducing the risks for osteoporosis and heart disease and improving quality of life. Fifteen patients are enrolled and 225 more patients are needed. The patient must be enrolled for two year and nine hospital visits are required. The study is funded by the National Cancer Institute.
Patients come from all over the Northwest. The studies require an initial one-on-one exercise session and specific follow-up schedule. For most patients the exercises are home-based to reduce the stress of having to go somewhere to exercise. "Cancer patients are often overwhelmed with managing the fatigue associated with cancer, juggling children and work, plus they are always at the hospital for treatment. It is easier for them to exercise at home," said Schwartz.
Schwartz said an exercise routine gives cancer patients a new sense of control and improved body image. "The women in the breast cancer studies want to make a difference for other women, and improve their chance of being fully functional and healthy," said Schwartz.