An exercise trial to reduce cancer related fatigue in African American breast cancer patients undergoing radiation therapy: Design, rationale, and methods

An 8-week exercise study to improve cancer treatment related fatigue and QOL among African American breast cancer patients undergoing radiation treatment: A pilot randomized clinical trial

BACKGROUND

Cancer treatment related fatigue (CTRF) is one of the most debilitating side effects of adjuvant radiation therapy (RT). Several studies have found that physical activity (PA) may be an effective intervention to decrease fatigue and enhance QOL in cancer survivors. The primary objective of the PEDLAR study is to test the feasibility of an easily administered 8-week structured moderate-intensity PA intervention, delivered concurrently with RT, in reducing CTRF and improving health-related QOL among African-American breast cancer patients. This study is also designed to provide pilot data on the acceptability and adherence of PA interventions in African-American women with breast cancer.

METHODS

It is a prospective, 2-arm, 8-week feasibility trial. Participants are randomized to either a structured, moderate-intensity aerobic training exercise regimen concurrent with radiotherapy or a control group.

RESULTS

Participants in intervention group reported high satisfaction with exercise and adherence was >75% for exercise sessions.

CONCLUSIONS

African-American breast cancer patients in a moderate-intensity 75 min/wk aerobic exercise intervention had marginally lower fatigue at 8-wk follow-up compared to baseline. The control group participants had marginally higher fatigue at 8-wk follow-up compared to baseline. Participants in the intervention group reported slightly better quality of life at 8-wk follow-up compared to baseline (P = 0.06).

Application of the Multidimensional Fatigue Inventory to Ethiopian Cancer Patients

Objectives: Fatigue is a frequent debilitating symptom associated with cancer. However, scientific data on cancer-related fatigue is scarce in developing nations. This work examines psychometric properties of the multidimensional fatigue inventory (MFI-20) and analyzes the level of fatigue among Ethiopian patients with cancer in comparison with data from Germany.

Methods: A sample of 256 patients with cancer drawn from a hospital in Ethiopia was examined with the MFI-20 and the European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30). A comparative sample of 780 German patients with cancer served as the control.

Results: The MFI-20 scales and total score showed acceptable reliability (α = 0.60–0.93) with a considerable convergent validity between MFI-20 and the EORTC QLQ-C30 fatigue scale (r = 0.67–0.75). The Ethiopian patients with cancer reported higher levels of fatigue than the German patients. Analyses of variance showed that Ethiopian patients with cancer who were illiterate, having advanced cancer, and those who did not receive either surgery or chemotherapy reported especially high levels of fatigue.

Conclusion: The MFI-20 is a fairly reliable and valid instrument to be used with Amharic speaking patients with cancer. The high level of fatigue in these patients implies that appropriate cancer care is needed in developing countries.

Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients

Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk^-1). Each session included a combined progressive training of cardiorespiratory, resistance, flexibility and postural education exercises. Self-efficacy and fatigue were measured with the Regulatory Emotional Self-Efficacy scale and 0-10 rating scale, respectively. Physical fitness was assessed with the body mass index, lower back flexibility, static balance, muscle strength and functional mobility. Results: Adherence to exercise was high (91.2% ± 4.8%) and no major health problems were noted in the patients over the intervention period. At baseline, significant differences were found between Hodgkin's lymphoma and non-Hodgkin's lymphoma patients by age and all dependent measures (p < 0.05). Fatigue significantly decreased and the perceived capability to regulate negative affect and to express positive emotions improved after exercise (p < 0.001). Significant improvements were found for body mass index, trunk lateral flexibility, monopodalic balance, isometric handgrip force and functional mobility (p < 0.001). Fatigue was significantly correlated with handgrip force (r = -0.56, p < 0.001) and functional mobility (r = -0.69, p < 0.001). Conclusions: The supervised exercise program improved psychological and physical fitness without causing adverse effects and health problems. Therefore, exercise to improve fitness levels and reduce perceived fatigue should be considered in the management of lymphoma patients.