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Cancer – Improves cancer-related fatigue

Improves cancer-related fatigue

Evidence summary

During treatment

Systematic reviews and meta-analysis have demonstrated either a control in fatigue or small reductions in fatigue.[7] This has been demonstrated in both exercise programmes during chemotherapy or radiotherapy, and has been seen in breast cancer, prostate cancer; during androgen therapy and radiotherapy; haematological malignancies, and head and neck cancers.[4-6, 8, 9]

Quality of evidence

Moderate quality – good overall quality of studies demonstrating either control or small reduction in fatigue during chemotherapy or radiotherapy.

Strength of recommendation



Promising meta-analyses for fatigue reduction for all cancer types and breast cancer. Otherwise a reduction in fatigue is demonstrated with physical activity.


1.Van Moll, C.C., et al., The effect of training during treatment with chemotherapy on muscle strength and endurance capacity: A systematic review. Acta Oncol, 2016. 55(5): p. 539-46.

2.Stene, G.B., et al., Effect of physical exercise on muscle mass and strength in cancer patients during treatment–a systematic review. Crit Rev Oncol Hematol, 2013. 88(3): p. 573-93.

3.Buffart, L.M., et al., Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev, 2017. 52: p. 91-104.

4.Furmaniak, A.C., M. Menig, and M.H. Markes, Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev, 2016. 9: p. CD005001.

5.Baumann, F.T., E.M. Zopf, and W. Bloch, Clinical exercise interventions in prostate cancer patients–a systematic review of randomized controlled trials. Support Care Cancer, 2012. 20(2): p. 221-33.

6.Gardner, J.R., P.M. Livingston, and S.F. Fraser, Effects of exercise on treatment-related adverse effects for patients with prostate cancer receiving androgen-deprivation therapy: a systematic review. J Clin Oncol, 2014. 32(4): p. 335-46.

7.Cramp, F. and J. Byron-Daniel, Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev, 2012. 11: p. CD006145.

8.Capozzi, L.C., et al., The impact of physical activity on health-related fitness and quality of life for patients with head and neck cancer: a systematic review. Br J Sports Med, 2016. 50(6): p. 325-38.

9.van Haren, I.E., et al., Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials. Phys Ther, 2013. 93(4): p. 514-28.

Post treatment

Meta-analyses for all cancers and breast cancers has shown moderate sized reduction in fatigue.[1, 2] No such change in fatigue levels were reported in a meta-analyses for colorectal cancer, which involved aerobic exercise.[3, 4]

Quality of evidence

Moderate quality – heterogenous study designs,  however there overall appears to be reduction in fatigue levels.

Strength of recommendation

Weak – one meta-analyses showed improved levels of fatigue in direction proportional to the intensity of resistance exercise.


1.Cramp, F. and J. Byron-Daniel, Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev, 2012. 11: p. CD006145.

2.Brown, J.C., et al., Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev, 2011. 20(1): p. 123-33.

3.Cramer, H., et al., A systematic review and meta-analysis of exercise interventions for colorectal cancer patients. Eur J Cancer Care (Engl), 2014. 23(1): p. 3-14.

4.Fong, D.Y., et al., Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ, 2012. 344: p. e70.