Muscling Through Cancer-Related Fatigue

Cancer related fatigue higher in patients with lower muscle mass

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(RxWiki News) The end of the battle against cancer can be difficult to witness,  with the wasting away of the human body and the whittling away of energy. The strength to carry on, it turns out, comes from within the body.

Individuals who have more muscle mass and strength are typically less affected by cachexia - a condition also known as body-wasting - that's seen in people with advanced cancer.

The condition causes significant weight loss, extraordinary fatigue and poor quality of life.

"Stay strong, eat healthy and enjoy each day."

Researchers at Concordia University and the McGill University Health Centre (MUHC) have discovered that people who suffer the most from debilitating cancer fatigue tend to have less muscle mass and strength than patients who are stronger.

“It is surprising that a strong relationship between cancer-related fatigue and muscle mass and strength hasn’t been previously studied,” says first author Robert Kilgour, professor and chair of Concordia’s Department of Exercise Science.

The study, which is the first to identify this association, involved 84 patients who had recently been diagnosed with inoperable lung or gastrointestinal cancer.

Researchers measured fatigue level, muscle mass and strength using several tools. These measurements were then compared with what they called "a brief fatigue inventory," which has been shown to indicate physical and emotional factors, including depression.

Patients who had higher levels of cancer-related fatigue, had lower levels of muscle mass.

Kilgour hopes this study can be used to encourage hospitals and cancer centers to provide strength and training programs that can improve patients' muscle mass, along with the quality of life.

Acknowledging that many advanced cancer patients are receiving comfort (palliative) care, “we want to maintain their quality of life as much as possible,” says co-author Antonio Vigano, a palliative care physician at the MUHC. This type of activity, he says, “gives patients control over their situation — control they feel they’ve lost. In addition we know there are other positive benefits to exercise, such as increased appetite.”

Physical therapist and dailyRx Contributing Expert, Diane Shiao, P.T., M.S.P.T., D.P.T., knows this to be true. "Generally, fatigue and muscle atrophy are common during advanced stages of cancer," she said.

"In terms of prescribing an exercise regime to reduce these debilitating symptoms, the cancer patient should be assessed on a case by case basis with an individualized exercise program, Shiao recommends.

"I have kept a stage four small cell carcinoma patient at a high performance level for over six months, but there was also a sudden drop in endurance that required the patient to seek home care assistance," Shiao recalls.

"During the entire bout of physical therapy, muscle wasting and weight loss were apparent, but strength and energy levels were good up until the end."

Shiao says, "There are "special" patients out there who do not fit the norm and individuals are better off with comprehensive exercise programs that are prescribed to their needs."

This study was published in the Journal of Cachexia, Sarcopenia and Muscle.

The research was supported by the Canada Foundation for Innovation, the Canadian Institutes of Health Research, the Research Institute of the MUHC, the Fonds de recherche du Québec - Santé, and the Canadian Hypertension Society.

Last Updated:
February 18, 2012