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Am Fam Physician. 1999;60(3):988

Fatigue and somatic complaints are frequent in patients undergoing cancer therapy. Fatigue, in particular, occurs in up to 70 percent of patients undergoing cancer therapy. In many patients with cancer, fatigue is severe and significantly limits daily activities and reduces work capacity. It can also affect the course of chemotherapy treatment in some patients. Aerobic exercise has been shown to improve physical performance in patients with cancer and can provide a broad range of other benefits. Dimeo and colleagues studied the impact of aerobic exercise in patients undergoing high-dose chemotherapy.

Sixty-three successive patients who were scheduled to receive high-dose chemotherapy were enrolled in this controlled study. One week before starting chemotherapy, patients were evaluated with resting and stress electrocardiograms and echocardiograms. Their psychologic status was evaluated with the short version of the Profile and Mood Status and the Symptom Check List. One patient found to have cardiac disease was excluded from the study. The remaining patients were assigned to an exercise group (29 patients) or a nonexercise group (33 patients).

The exercise group used a bed ergometer to “bike” in bed for 30 minutes a day with an intensity level high enough to achieve at least 50 percent of their cardiac reserve. Administration of the questionnaires was repeated after the completion of the chemotherapy regimen.

At the beginning of the study, there were no differences in baseline characteristics between the two groups. Patients in the exercise group were able to train 82 percent of the time. This group showed significant improvement in obsessive-compulsive traits, anxiety, interpersonal sensitivity and phobic anxieties. They also showed a reduction in psychologic stress compared with the nonexercise group. During chemotherapy, patients in the exercise group did not have any change in fatigue level, while the nonexercise group showed a significant increase in fatigue. The nonexercise group also had less vigor and higher somatization scores.

Fatigue is a problem for patients undergoing cancer treatment, and it can last for months after completion of the treatment. Fatigue can have a significant impact on a patient's ability to function. The authors conclude that aerobic exercise reduces fatigue related to cancer treatment and can improve the psychiatric state of these patients.

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