Simply walking for 90 minutes on three or more days per week has been shown to significantly reduce fatigue and emotional distress, while increasing the functional ability and quality of life (QOL) of women undergoing breast cancer treatment, according to a study published in the May 23 issue of Cancer Practice (Vol. 9, No. 3: 119-127).

"Exercise should be part of the counseling that every woman receives when coming into breast cancer treatment," says Victoria Mock, DNSc, AOCN, associate professor at the Johns Hopkins University School of Nursing, and principal investigator of the study. "For a long time, we have been recommending rest for patients with fatigue who were undergoing cancer treatment. There is mounting evidence now that exercise will help reduce fatigue if people begin an exercise program before treatment or early on in their treatment," notes Mock.

She explains that fatigue is the most common unmanaged symptom of cancer patients undergoing radiation therapy, chemotherapy, and biotherapies. It often leads to a decrease in activity, which reduces one’s tolerance for exercise. The person’s quality of life (QOL) erodes, as one becomes too tired to participate in the activities that make life meaningful.

Exercise is known to reduce fatigue and improve activity tolerance in healthy individuals. Mock and her colleagues decided to see if it had a similar effect on patients undergoing cancer therapy.

Their study involved 48 women undergoing post-surgical radiation therapy or chemotherapy for breast cancer at five different institutions. Half of the women were given no instructions to exercise. The others received individualized exercise prescriptions for a moderate walk, up to 30 minutes a day, at least three days per week, while they were in treatment. The participants recorded their experiences in a journal.

Their journal entries revealed that taking a 20- to 30-minute walk a few times a week reduced their fatigue and anxiety, made them feel stronger and more capable, reduced sleeping problems, and improved the overall quality of their lives.

The study also found that women who exercised for only six weeks had almost equally benefical outcomes as those who exercised for longer periods of time. "At around three to four weeks, you experience reduction of symptoms that lasts throughout the exercise period," says Mock.

Mock’s conclusions, derived from only 48 patients, are preliminary. What is safe and effective for women with breast cancer may not hold for patients with other forms of cancer. Mock says she recently completed a four-year clinical trial on exercise and QOL considerations involving 120 patients with various cancers. The findings of that study might give people with cancer and clinicians a better sense of the benefits from various levels of exercise, but the results are yet to be published.

"Physical activity and cancer survivorship is a very new area of research," says Colleen Doyle, nutrition and physical activity director for the American Cancer Society. "There’s a big gap in research that is beginning to be filled with studies like this one, which show that people with cancer who are active have less fatigue, lower levels of anxiety, and tend to have a stronger sense of self control — at a time when so many things are out of their control," she explains.

But you have to be sensible, advises Doyle, "A moderate, gradual approach to increased activity, under supervision, will help cancer patients with fatigue, just as it does in the general population."