There are over 12 million cancer survivors in the United States. Nearly all of them have experienced physical, emotional, and psychological symptoms including fatigue, insomnia, and depression. This can contribute to the erosion of overall quality of life. While exercise is commonly prescribed to mitigate these symptoms, the optimal dose and characteristics of its prescription require further investigation. PURPOSE: To evaluate the effect of structured exercise on fatigue, insomnia, and depression in cancer survivors. METHODS: We enrolled 157 cancer survivors in a 10-week exercise intervention that included aerobic, resistance, and flexibility training. At baseline, patients completed the Fatigue Symptom Index, Athens Insomnia Instrument, and Zung-Self Rating Depression Scale to assess fatigue, insomnia, and depression respectively. Upon conclusion of the program, follow-up data were collected. Paired-samples t tests were conducted on patients who completed the intervention. Logistic regression tested the effect of fatigue, insomnia, and depression on odds of completion. Linear regression evaluated predictors of fatigue, insomnia, and depression. RESULTS: Among patients who completed the intervention (n=58), fatigue decreased (p<0.001); insomnia (p=0.673) and depression (p=0.675) were unchanged. Fatigue (p=0.432), insomnia (p=0.759), and depression (p=0.932) did not predict program completion. Patients who were more fatigued at baseline experienced greater reductions in fatigue at follow-up, assessed by score (r= -0.677; p<0.001) and category (r=-0.685; p<0.001). Patients with worse insomnia at baseline reported greater improvements at follow-up (r=-0.761; p=0.079); elevated depression did not facilitate greater improvement (p=0.228). CONCLUSIONS: Fatigue, insomnia, and depression are often indissoluble from the daily experience of a cancer survivor. A biweekly exercise intervention improved fatigue and insomnia after 10 weeks, with greater improvements among the more severely affected; however, we did not find significant alleviation of depression symptoms. These findings suggest exercise is a safe, effective strategy to relieve some symptoms associated with cancer. Further research is required to address potential bias owing to the high rate of attrition in our study.
Available at: http://works.bepress.com/courtney-jensen/81/