Exercise for the Management of Cancer Related Fatigue in Adults
Table of Contents
Understanding Cancer-Related Fatigue (CRF)
Definition and Symptoms
Cancer-related fatigue (CRF) is a persistent, overwhelming sense of tiredness that is not relieved by rest. It is one of the most common and distressing symptoms experienced by cancer patients, often affecting daily activities, mental well-being, and overall quality of life. Symptoms of CRF include:
• Extreme exhaustion
• Weakness and lack of energy
• Difficulty concentrating
• Reduced motivation
Causes of Cancer-Related Fatigue
CRF can be caused by various factors, including:
• Cancer treatments such as chemotherapy, radiation, and immunotherapy
• The body’s immune response to cancer
• Nutritional deficiencies
• Sleep disturbances
• Emotional distress and anxiety
Importance of CRF Management in Adults
Managing CRF is crucial to improving a patient’s physical function, emotional health, and ability to participate in daily life. Effective management strategies include lifestyle modifications, psychological support, and, increasingly, structured exercise programs.
What I’ve Seen Firsthand at ICON Cancer Rehab
During my time at ICON Cancer Centre in Canberra, I worked directly with individuals undergoing chemotherapy, radiation, and hormone therapy—most of them experiencing cancer-related fatigue (CRF) as their number one barrier to daily function.
What I saw consistently: CRF doesn’t improve with rest alone. In fact, inactivity often made it worse. What did work—every time—was structured, low-to-moderate intensity exercise tailored to their energy levels.
What I Delivered at ICON
• Tailored fatigue management sessions, starting as low as 10–15 minutes and progressing based on response
• Education on energy conservation vs. deconditioning
• Collaborative care with oncologists and nurses to ensure safety
The Role of Exercise in Cancer Care
Benefits of Physical Activity
Exercise has been shown to help reduce CRF by:
• Improving cardiovascular health and endurance
• Enhancing muscle strength and physical function
• Reducing stress and anxiety
• Regulating sleep patterns
• Boosting mood and overall well-being
Types of Exercise Recommended
Aerobic Exercise
Low-to-moderate intensity aerobic activities, such as walking, cycling, or swimming, help improve stamina and reduce fatigue. The goal is to engage in at least 150 minutes of moderate aerobic exercise per week.
Resistance Training
Strength-based exercises, such as bodyweight movements, resistance bands, or light weights, help combat muscle weakness caused by cancer treatments. Resistance training should be done two to three times per week, focusing on major muscle groups.
Flexibility and Balance Exercises
Yoga, stretching, and tai chi improve flexibility, balance, and relaxation, reducing stress and enhancing mobility. These exercises can be practiced daily for gentle movement and relaxation benefits.
Evidence Supporting Exercise for CRF
Research Studies and Findings
Multiple studies highlight that structured exercise programs significantly reduce CRF. Research suggests that regular physical activity can reduce fatigue levels by up to 40% in cancer patients and survivors.
Meta-Analyses Overview
Systematic reviews and meta-analyses confirm that both aerobic and resistance training are effective in improving energy levels, reducing fatigue, and enhancing quality of life in cancer patients.
Guidelines for Incorporating Exercise
Developing an Exercise Plan
Exercise plans should be tailored to an individual’s fitness level, cancer type, and treatment phase. A gradual increase in intensity and duration is recommended.
Individualised Approaches
Each cancer patient responds differently to exercise, so it is essential to consider their personal energy levels, symptoms, and medical history when designing an exercise program.
Frequency and Duration Recommendations
• Aerobic Exercise: 20-30 minutes, 3-5 times per week
• Resistance Training: 2-3 times per week, with light to moderate resistance
• Flexibility & Balance Training: Daily, as tolerated
Safety Considerations
When to Avoid Exercise
• If experiencing extreme fatigue, dizziness, or severe pain
• If blood counts (such as white blood cells or platelets) are critically low
• If advised by a healthcare professional to rest
Precautions for Cancer Patients
• Start with light exercises and gradually increase intensity
• Stay hydrated and listen to the body’s signals
• Seek guidance from an exercise physiologist or physiotherapist
A Word of Encouragement
Cancer patients should feel empowered to incorporate movement into their routine, even in small amounts. Exercise is not about pushing limits but about enhancing quality of life and regaining strength. Consulting with healthcare professionals can help create a safe and effective exercise plan.
