Fitness: Dutch study shows exercise can ease cancer-related fatigue

Pulling on sports shoes might not seem the most obvious solution, but a study found participants had more energy, even four years later.

Twelve years ago I profiled Ann Roberts-Tellier, who used exercise to battled the fatigue from cancer treatments with exercise. Now retired, the former schoolteacher kicked cancer to the curb, but hung on to her exercise habit.

“The year before my diagnosis, during treatment and the years following treatment — I was in the best shape of my life,” said Roberts-Tellier.

Despite feeling fit, she also remembers feeling like she was carrying around a bag of bricks in the days following radiation treatments. Yet somehow she still found the motivation to exercise.

“It’s one of the few things you have control over during a time when you have very little control over everything else in your life,” she said.

Exhaustion is common among cancer patients undergoing treatment, with many claiming it’s one of the worst side effects of fighting the disease. Yet even with cancer in remission fatigue continues — sometimes for years after treatment ends.

It’s only recently that cancer patients have been advised to fight fatigue with exercise. Over the last several years, a number of research teams have conducted studies designed to learn more about how physical activity fits into a treatment plan. In almost all cases exercise proved to be an effective antidote for the exhaustion that follows chemotherapy and radiation. Researchers from the Netherlands published one such study but took it a step further, checking in with their original group of subjects several years later to see if they had maintained their exercise habit and whether they were experiencing any lingering fatigue.

“Since fatigue is known to be a long-lasting side effect of cancer treatment, it is important to develop interventions that reduce fatigue both in the short and long term,” said the researchers.

In the initial study, the exercise group (119 people with either breast or colon cancer) participated in an 18-week supervised exercise program featuring both aerobic and muscular conditioning. Twice a week they met with a trained professional. Three additional times a week they were expected to exercise for a minimum of 30 minutes without supervision. A control group (118 people) was also part of the study, but they were given no specific exercise goals or supervised workout sessions.

At the end of the 18 weeks, the exercisers reported less fatigue than the non-exercisers. After 36 weeks, a check-in showed the difference in fatigue levels between the exercise and non-exercise group had diminished but still held. Four years later, the exercise group still reported less fatigue and higher levels of physical activity than the non-exercise group. In particular the exercisers were more likely to engage in moderate to vigorous intensity exercise than those who didn’t exercise during treatment. But more than just reaping the physical benefits of being active, the survivors who stayed active benefited from a better quality of life and lower levels of depression.

“Results of these studies suggest that for both breast and colon cancer survivors, engaging in exercise during chemotherapy and maintaining a physically active lifestyle into survivorship might be important for enhanced well-being in the long term,” said the researchers.

The researchers also believe that the exercise habit acquired during the study four years earlier was most likely maintained, hence the comfort with more vigorous exercise and the lack of chronic lethargy.

It’s worth nothing that the exercise subjects in the Dutch study benefitted from working with a team of experts to design a workout plan and that their progress was encouraged and monitored. They were also expected to work out on their own several times a week, a conscious decision on the part of the research team to develop the intrinsic motivation to be active.

For anyone out their on their own trying to battle through the fatigue of cancer treatments, pulling on a pair of running shoes doesn’t seem the most obvious or easiest of solutions. Yet, there are more and more options geared for individuals looking to add exercise to their treatment plan.

Most hospitals can refer you to support networks designed to provide the right mix of exercise and motivation on days when you feel like “you’re carrying a load of bricks.” Working with professionals who understand the side effects of cancer and the value of exercise increases your chance of success. That said, there’s something liberating about getting out there on your own with nothing more than your favourite playlist for motivation.

There’s no doubt that battling back against cancer takes every bit of energy you’ve got. And even those up for the fight may need help on days when it feels like the cancer is winning, which is why exercise is an ally worth having in your corner.