Physical Activity & Cancer Rehabilitation: Fatigue, Depression and Anxiety Flashcards
What is Fatigue in relation to cancer survivors?
A widespread quality of life issue in cancer survivors
What causes fatigue in cancer survivors?
Often results from chemotherapy and radiation therapy. The tumour itself can also cause fatigue
What improves fatigue?
Many studies show PA improves fatigue
What used to be encouraged, but makes fatigue worse?
Rest!! Fatigue is not relieved by rest. Any movement is better than nothing
What types of cancer did PA have a positive effect on their fatigue?
- Mixed cancer types
- Breast cancer most effective
- Prostate cancer (after 6+ months)
What types of cancer had no significant change to fatigue when being physically active?
- Colorectal cancer
What types of cancer had mixed results of fatigue changes due to PA?
- Gynecological and Hematological cancers
(some fatigue improved, some had no change in fatigue)
What types of PA improve fatigue?
- Aerobic (walking, cycling)
- Combined Aerobic and resistance exercise
What types of PA had no effect on fatigue?
- Resistance training alone
- The type of Aerobic exercise did not matter
What dose of PA is effective for improving fatigue?
Low-moderate intensity is superior (no high intensity, vigorous activity!!)
Optimal duration: 50 minutes
What is the best timing to begin PA in cancer survivors to improve fatigue?
Most effective for improving fatigue: PA after the conclusion of cancer treatment
What is Hematopoietic Stem-Cell transplant? HSCT
A curative treatment for hematological malignancies and bone marrow failure syndrome
What does HSCT often result in?
Debilitating, severe fatigue
What research was done on HSCT patients and fatigue levels?
HSCT in 33 leukemia/lymphoma/
myeloma survivors prior to transplant, during chemo. Cycle ergometer 2x per day improved fatigue levels
How is inflammation caused and what does it do to the body?
Tumour and treatment increases pro-inflammatory cytokines, influencing CNS signalling. This can lead to fatigue
How does PA help with inflammation?
Decreases inflammatory response
How does Hypothalamic-Pituitary-Adrenal Axis (HPA Axis) and Circadian Rhythm Dysregulation (sleep cycle) affect the body?
Disruption of the HPA axis may play a role in causing persistent fatigue
How can PA help with HPA axis?
In breast cancer survivors specifically, PA has been found to normalize HPA axis function
How can Serotonin dysregulation affect the body?
Increases activity of pro-inflammatory cytokines leading to increased levels of 5-HT (serotonin) which results in sensation of fatigue
How can PA help serotonin dysregulation?
Exercise increases 5-HT but long term exercise normalizes serotonin metabolism
How does alterations in ATP and Muscle metabolism affect the body?
Impairment of peripheral muscle metabolism and function may lead to persistent fatigue in cancer survivors
How can PA help alterations in ATP and muscle metabolism?
PA can result in greater muscular strength and function, overall improving fatigue
What can help depression and anxiety in general populations?
Regular physical activity
How long does it take for PA to be effective in improving depression and anxiety levels?
Generally takes weeks to be effective
Depression in cancer survivors is…
One of the most common psychological conditions present
Major depression in cancer survivors?
5-26%
Minor depression in cancer survivors?
7-26%
Why do cancer survivors have such high rates of depression?
- closer to death
- Staying in the hospital for long periods of time
- Sleep disruptions
- Relationship issues
- Fatigue
- Serotonin dysregulation
What is anxiety in cancer survivors?
A common psychological problem
What are anxiety symptoms cancer survivors experience?
Excessive worry, restlessness, insomnia
What is 12-month anxiety prevalence rates?
15.8%
What is lifetime prevalence rates?
24.1%
What area is more researched depression or anxiety?
Depression because it’s more common
What can help with depression?
Aerobic capacity was found to decrease depression across all 25 studies
PA resulted in modest short term and long term reductions in depression
What produces the greatest reduction in anxiety?
When Aerobic and resistance exercise is combined
How can depression and anxiety be assessed?
Through questionnaires
How does exercise improve depression and anxiety?
- Increase certain neurotransmitters (serotonin)
- Sleep better
- Relieves tension
- Reduces cortisol levels
