Mind/Body Workout Fights Chemo Fatigue

Oct. 13, 2009 -- Cancer patients undergoing chemotherapy feel less exhausted if they enroll in an intense program that exercises the mind as well as the body, a Danish study finds.

Fatigue is one of the most troubling side effects of cancer chemotherapy. Patients don't feel like doing anything, either physically or mentally. And the less they do, the weaker and more depression-prone they become.

Earlier studies showed that moderate exercise can help. So can psychosocial programs. Could both kinds of programs be combined -- and intensified -- for greater impact?

To find out, Lis Adamsen, PhD, and colleagues at Copenhagen University Hospital, Denmark, asked 269 adult cancer patients to enroll in a nine-hours-a-week exercise program for six weeks. Half the volunteers were randomly assigned to a control group and were asked to wait six weeks to join the program.

Although the program was designed to appeal to men and women, women were much more likely to volunteer. In the end, 196 women and 73 men volunteered for the study; 235 of them completed the program.

The program included:

• Monday, Wednesday, and Friday: High-intensity physical training (30 minutes of warmup, 45 minutes resistance training, and 15 minutes of cardiovascular training).
• Tuesdays: 90 minutes of body-awareness training ( stretching on week 1, yoga breathing on weeks 2-3, and Pilates movement on weeks 4-6).
• Monday, Tuesday, Wednesday, and Friday: 30 minutes of relaxation training to follow physical training or body-awareness training.
• Monday and Friday: 30 minutes of massage

Patients weren't allowed to pick and choose -- they had to show up for the entire program, regardless of how they felt after their chemo treatments.

One patient with a brain tumor had a seizure after cardio training, so Adamsen and colleagues warn brain cancer patients not to try this kind of exercise. Ill effects were not seen in other patients.

Instead, those completing the program felt better. Although improvements were small to medium in size, the exercise program significantly reduced fatigue and increased patients' sense of vitality. They felt fewer limits in their daily activities than did patients who did not exercise.

"The range of exercise components used ... has been shown to be feasible, safe, and beneficial to various patients with cancer during chemotherapy -- even patients with advanced disease," Adamsen and colleagues conclude.

They note, however, that a program with more appeal to men needs to be developed.

The findings appear in the Online First edition of BMJ.