Lecture 11 - Fatigue, Depression, & Anxiety Flashcards
Lecture 11:
What impact does fatigue have on cancer patients & who is affected?
- causes large quality of life issue in cancer survivors
- results from chemo & radiation therapy
Lecture 11:
How does PA influence fatigue?
Many studies show improvements in fatigue after physical activity performance
Lecture 11:
How are rest & fatigue related?
Cancer patients often told to rest however, rest can actually make fatigue worse & is not relieved by rest
Lecture 11:
Of the 18 systemic reviews of PA & cancer from 2013-2018, which cancer sites shower PA to have a positive effect on fatigue?
Mixed cancer sites (mostly breast cancer) & breast cancer patients showed positive effect of PA on fatigue
Lecture 11:
Of the 18 systemic reviews of PA & cancer from 2013-2018, which cancer sites showed PA to have no effect on fatigue?
Colorectal & prostate (unless PA 6+months) showed no effect
Lecture 11:
What type of physical activity had the most influence on fatigue levels?
Aerobic or combined aerobic & resistance had the greatest benefit on improving fatigue after physical
- resistance on own = no effect
- Type of aerobic activity = didn’t matter
Lecture 11:
What dose of PA had the most effect on fatigue levels?
Lower intensity or moderate intensity PA is best
- optimal duration = 50mins
Lecture 11:
What is the most effective timing for PA in cancer patients & improving fatigue levels?
Most effective is PA after the conclusion of cancer treatment
Lecture 11:
What does HSCT stand for?
Hematopoietic Stem-Cell Transplant
Lecture 11:
What is HSCT used for?
A curative treatment for hematologic malignancies & bone marrow failure syndromes
Lecture 11:
What does HSCT often result in?
Debilitating, severe fatigue
Lecture 11:
What is Autologous HSCT ?
Donating own stem cells to self by taking stem cells from body first, then treatment & then re-inject with own stem cells
Lecture 11:
When discussing biological mechanisms of the relationship b/w PA & Cardiorespiratory fitness, what happens with inflammation?
- tumour & treatment increase pro-inflammatory cytokines
- inflammation influences CNS signalling which leads to fatigue
**PA decreases inflammatory response
Lecture 11:
When discussing biological mechanisms of the relationship b/w PA & Cardiorespiratory fitness, what happens with HPA & Sleep?
Disruption of Hypothalamic-Pituitary-Adrenal Axis (HPA) may cause persistent fatigue & Circadian Rhythm Dysregulation
PA normalizes HPA axis in breast cancer survivors & helps limit the impact of fatigue
Lecture 11:
When discussing biological mechanisms of the relationship b/w PA & Cardiorespiratory fitness, what happens with Serotonin Dysregulation?
- increase in pro-inflammatory cytokines
- leads to increases levels of serotonin (5-HT) which causes fatigue sensations
- PA leads to increase 5-HT but possible long-term exercise normals the serotonin metabolism
Lecture 11:
When discussing biological mechanisms of the relationship b/w PA & Cardiorespiratory fitness, what happens with ATP & Muscle Metabolism?
Peripheral muscle metabolism & function may lead to persistent fatigue in cancer survivors
- PA can increase muscle strength & function so fatigue may be improved
Lecture 11:
How does PA impact depression & anxiety in the normal population?
Depression & anxiety can by improved with regular PA & generally takes weeks for PA to be effective
Lecture 11:
What is the prevalence of depression in Cancer patients?
- % with minor vs major
- one of the most common psychological condition in cancer survivors
~ 5-26% with major depression & 7-26% with minor - have such high risk of depression due to closer to death, overthinking, lots of time alone, hospital stays, etc
Lecture 11:
What is the prevalence of Anxiety in cancer & how does it impact someone?
Anxiety is a common psychological problem in cancer patients with symptoms of worry, restlessness, & insomnia
- 12 month prevalence = 15.8% & lifetime prevalence = 24.1%
*more anxiety in cancer patients that general population
Lecture 11:
What has been studied more; depression or anxiety?
More studies done on depression than anxiety
Lecture 11:
In a study with 25 randomized control trials (RCT’s), studying 1931 adults cancer patients, how was depression & aerobic PA correlated?
Aerobic PA was linked to decreased depression across all 25 studies with PA ultimately resulting in modest short-term & long-term reductions in depression
lecture 10:
In a study of 15 RCTs with 2756 breast cancer survivors, how many were analyzed for depression & how many for anxiety?
2082 studied for depression & 513 for anxiety
Lecture 10:
In the study of 2756 breast cancer survivors, what were the resulting impacts of PA?
PA significantly reduced depression & anxiety
- greatest reduction of anxiety when aerobic & resistance training were combined
Lecture 11:
What type of PA showed greatest reduction of anxiety?
Combination of resistance and aerobic training
Lecture 11:
in a study of breast cancer survivors, what were the results of the BEAT group?
*BEAT = 12 exercise sessions over 6 weeks & then more home-based programming
Fatigue, anxiety, & depression were significantly reduced at the 3month & 6month check ins
- all of the following had small to medium effect size interventions; fatigue intensity, fatigue interference, depressive symptomatology, & anxiety
Lecture 11:
Ultimately, how does exercise improve anxiety & depression?
1.) increases certain neurotransmitters (eg; serotonin) & regulates them better
2.) Sleep is better to bring more energy
3.) tension is relieved
4.) cortisol levels reduced
