By Jolinta Lin, MD, Emory University School of Medicine
Fatigue is a common and well-documented side effect of cancer treatment. Many cancer survivors consider cancer-related fatigue “to be the most distressing symptom of cancer and its treatment” and its effects can continue to linger after treatment.1
Exercise and mind-body therapies are effective strategies to decrease cancer-related fatigue. Despite national organizations’ recommendations of three to five hours of moderate exercise per week to reduce fatigue, many breast cancer patients have barriers in engaging in consistent exercise routines during cancer treatment.1 With the known and established benefits of exercise, how do we get patients to exercise more often and more regularly during treatment so that they can overcome their fatigue? New and effective strategies to encourage increased physical activity during breast cancer treatment are needed.
Virtual exercise programs may motivate and offer additional options to cancer patients so that they can exercise in the convenience of their own homes or their preferred locations. On October 1, 2024, Erin Gillespie, MD, MPH, and colleagues presented abstract #62180, “Effect of a virtual integrative medicine program during radiation for breast cancer: Results from a randomized controlled basket trial.”
The prospective, randomized clinical trial recruited cancer patients who reported moderate or greater fatigue during active cancer therapy. For breast cancer patients, participants were enrolled during or immediately after radiation therapy. Participants were randomized in a 1:1 fashion to a virtual mind-body and fitness program, IM@Home, or enhanced usual care with access to pre-recorded meditation resources. Fatigue as well as other patient-reported outcomes were tracked over 12 weeks using validated measurement tools. Participants could register to join virtual classes from a series of weekly live, mind-body and fitness classes via Zoom. These 30-60-minute sessions were led by certified fitness trainers, yoga instructors, mindfulness instructors, and licensed music therapists who have expertise in teaching classes for patients with cancer.
Among the 73 randomized participants with breast cancer, the group assigned to the IM@Home program had significantly less average fatigue at 12 weeks compared to the group with enhanced usual care, 2.06 vs. 2.79, respectively (p=0.009). Other reductions in patient reported outcomes among the IM@Home group included less insomnia (p=0.005), symptom distress (p=0.013), and depression (p=0.04). Classes for yoga, cardio fitness and tai chi were particularly popular, with more than 55% of participants enrolling in those classes.
The study demonstrates a significant decrease in cancer-related fatigue among breast cancer patients who participated in virtual exercise programs while undergoing radiation therapy compared to those who were randomized to enhanced usual care. Virtual exercise classes, including mind-body therapies, may offer patients more flexibility and convenient options to engage in physical activity during cancer treatment while also having guidance and encouragement from expert fitness instructors. “Due to the basket trial design, we were somewhat surprised to find significant improvements in multiple symptoms within the breast radiation cohort alone. We are excited to potentially explore further the benefits of this program among patients of different backgrounds seeking radiation treatment in other clinical settings,” says Dr. Gillespie. Encouraging exercise through virtual classes may help patients become more empowered and better equipped to navigate through cancer-related fatigue and other associated side effects.
Abstract 278, A Virtual Program for Fatigue among Women Undergoing Radiation Treatment: Results from a Randomized Controlled Basket Trial, was presented during the SS 31 - Breast Cancer 3: Toxicity session of ASTRO’s 66th Annual Meeting.
