# Exercise as it relates to Disease/reducing the effects of Cancer related Fatigue through Exercise

As technology and treatments improve, so does the survival rate of patients suffering various diseases consequently leaving the patient to manage any long-term side effects of the treatment and disease. Despite these advancements allowing sufferers to live longer, the treatments themselves can reduce the patients quality of life not only during, but post-treatment. Cancer related fatigue (CRF) is commonly reported amongst patients who have and are undergoing cancer treatments; 91% of these patients reported that CRF hindered their ability to live a 'normal life'. According to the National Cancer Institute (NCI) moderate to severe Cancer related fatigue can occur for years after the cancer has been treated.

## Background
### Cancer Related Fatigue

Cancer related fatigue is an unpleasant subjective experience of exhaustion and tiredness that is disproportional to an individuals current exertion- unlike fatigue, CRF sufferers will not improve after sleeping. CRF is often characterized by symptoms of weakness, tiredness and a general lack of energy. It is reportedly perceived by the patient as more distressing than other symptoms associated with cancer and cancer treatment, affecting approximately one third of sufferers for years after the treatment was completed. One study assessed the impact of CRF on sufferers daily life, it was reported that 88% of patients had to alter their daily routine due to fatigue, while (of the sufferers that had jobs) 75% had to change their employment state. While CRF affects a huge aspect of the patients life, it can also impact the caregiver, not only emotionally but in their workplace; on average the caregivers took one day off (mean=4.5 days) per month in order to provide support.

#### Cancer Treatments

* Chemotherapy
* Radiation therapy
* Biologic Therapy
* Surgery

### Cause

The cause of cancer related fatigue is still unclear as patients who aren't undergoing the harsh therapies are also subject to this commonly reported symptom. More research is necessary to determine what the root cause of CRF is; however for now doctors have suggested that it is caused by a combination of factors including:-
* infection,
* Pain,
* Stress,
* weight loss/Muscle loss,
* dehydration,
* Chemotherapy/Radiotherapy/Biologic Therapy,
* being less active

## Benefits of exercise

On a general scale, regular exercise is typically associated with good health. However specifically to cancer patients, many studies have revealed evidence that exercise can ease a lot of the symptoms cancer patients have to manage such as an improved aerobic capacity, decreased feelings of nausea, a decreased amount of time spent in hospitals, reduced pain, stimulated blood counts and overall an improved immune system.
studies that have used tested exercise as a method have found in comparison to control groups, the patients undergoing exercise have experienced positive impacts, reducing the severity of CRF. The research did not test whether the quality of life had improved for cancer patients suffering from CRF. It is unclear why exercise appeared to have a positive affect on the participants, however it may be related to general benefits such as an improved cardiovascular system and blood flow return, strengthening and conditioning their muscles, or even the release of endorphins.
Sleep plays a role in managing Cancer related fatigue as it is important to try maintain a normal sleeping pattern. People that exercise regularly report better sleeping habits and patterns. Though a lose connection it is possible that exercise may encourage a better sleeping pattern, which can reduce depressive symptoms and allow the body to recover.

## Conclusion

only recently Cancer related fatigue was recognised as a symptom resulting from cancer and its treatment. Previously cancer patients were encouraged to rest if they felt fatigued, despite being effective for people suffering from regular fatigue, Cancer patients would still feel exhausted and as though they had no energy. More research is necessary in order to determine a solution to stop and prevent this debilitating symptom, however patients that have attempted to reduce the severity through exercise have mostly been effective. Further research is required to understand what benefits are actually reducing CRF and to determine what causes it.

## Further reading

The impact of CRF CRF and exercise

## References

* ↑ Cramp.F. & Daniel. J., (2008), Exercise for the management of cancer-related fatigue in adults (review), The Cochrane Collaboration, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006145.pub2/pdf/standard
* ↑ Curt.g., Breitbart. W.,Cella. D., Groopman. J.,Horning. S.,Itri.L., Johnson. D., Miaskowski. C., Scherr.S., Portenoy., R. & Vogelzang. N., (2000) Impact of Cancer-Related Fatigue on the Lives of Patients: New Findings From the Fatigue Coalition, The Oncologist, 5(5):353-360
* ↑ Escalante. C. (2014), Cancer-related fatigue: Prevalence, screening and clinical assessment, Wolters Kluwer health,http://www.uptodate.com/contents/cancer-related-fatigue-prevalence-screening-and-clinical-assessment
* ↑ Hofman. M., Ryan. J., Figeuroa-Moseley.C., Jean-Pierre. P. & Morrow. G., (2007), Cancer-Related Fatigue: The Scale of the Problem, The Oncologist, 12(1):4-10
* ↑ Hofman. M., Ryan. J., Figeuroa-Moseley.C., Jean-Pierre. P. & Morrow. G., (2007), Cancer-Related Fatigue: The Scale of the Problem, The Oncologist, 12(1):4-10
* ↑ Curt.g., Breitbart. W.,Cella. D., Groopman. J.,Horning. S.,Itri.L., Johnson. D., Miaskowski. C., Scherr.S., Portenoy., R. & Vogelzang. N., (2000) Impact of Cancer-Related Fatigue on the Lives of Patients: New Findings From the Fatigue Coalition, The Oncologist, 5(5):353-360
* ↑ Curt.g., Breitbart. W.,Cella. D., Groopman. J.,Horning. S.,Itri.L., Johnson. D., Miaskowski. C., Scherr.S., Portenoy., R. & Vogelzang. N., (2000) Impact of Cancer-Related Fatigue on the Lives of Patients: New Findings From the Fatigue Coalition, The Oncologist, 5(5):353-360
* ↑ National Cancer Institute, (2014), Fatigue (PDQ®), National Institues of Health, http://www.cancer.gov/cancertopics/pdq/supportivecare/fatigue/Patient/page2#Keypoint4
* ↑ Keenan, M. P. Cancer Related Fatigue and Exercise. Weight Loss Fitness And Personal Trainers. http://www.pdf177.com/pdf/weight-loss-fitness-and-personal-trainers-in-charlotte-26593.pdf#page=501
* ↑ Cramp.F. & Daniel. J., (2008), Exercise for the management of cancer-related fatigue in adults (review), The Cochrane Collaboration, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006145.pub2/pdf/standard
* ↑ Brand, S., Gerber, M., Beck, J., Hatzinger, M., Pühse, U., & Holsboer-Trachsler, E. (2010). High exercise levels are related to favorable sleep patterns and psychological functioning in adolescents: a comparison of athletes and controls. Journal of Adolescent Health, 46(2), 133-141.