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Exercise Plus Mindfulness Training May Ease Fatigue in Breast Cancer Survivors, Small Study Suggests

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A combination of exercise and mindfulness training seems better at easing fatigue in breast cancer survivors than either technique alone, according to a small study.

The research was published online on Oct. 3, 2020, by the journal Psycho-Oncology. Read the abstract of “Acute effects of aerobic exercise and relaxation training on fatigue in breast cancer survivors: A feasibility trial.”

Fatigue and breast cancer treatment

Fatigue is hard to describe. You feel like you don't have any energy and are tired all the time. But there's not a specific cause, such as doing errands all day, working out, or other activities that use up your energy. When you're tired from daily activities, if you get enough sleep that night, you usually feel better the next day. With fatigue, you feel generally tired all the time and lose interest in people and the things you normally like to do.

Fatigue is the most common side effect of breast cancer treatment. Some doctors estimate that 9 out of 10 people have some fatigue during treatment. Fatigue from treatment can appear suddenly and can be overwhelming. Rest doesn't ease fatigue, and it can last for months after treatment ends.

Symptoms of fatigue include:

  • lack of energy
  • sleeping more
  • not wanting to do normal activities or being unable to do them
  • paying less attention to personal appearance
  • feeling tired even after sleeping
  • trouble thinking or concentrating
  • trouble finding words or speaking

Almost every treatment for breast cancer can cause fatigue, and many pain medicines, such as codeine and morphine, also can cause fatigue.

About the study

While a number of studies have looked at only exercise or only relaxation/mindfulness training to ease fatigue, very few studies have looked at the two techniques in combination.

This 7-day study included 40 women from central Illinois who had been treated for breast cancer within the past 5 years. At the beginning of the study, the women were asked to fill out an online questionnaire about their fatigue levels. Women who regularly exercised 150 minutes or more per week were excluded from the study.

The women were then divided into three groups:

  • The aerobic exercise-only group did three 20-minute exercise sessions that were led by a research assistant. Sessions were done at least 24 hours apart. Each session included 20 minutes of riding a stationary bike at moderate intensity, as well as 20 minutes of quiet, seated rest.
  • The relaxation-only group did three 20-minute sessions of guided mindfulness-based stress reduction using a biofeedback headset that recorded activity through seven sensors. Spoken cues instructed the women to focus on their breathing cycle by counting up to 10 and then restarting. The women also had a 20-minute period of quiet, seated rest.
  • The combination exercise and relaxation group did the same three 20-minute exercise sessions as the aerobic-exercise-only group, as well as 20 minutes of the guided mindfulness-based stress reduction.

After the women completed all their sessions, they again filled out an online questionnaire about their fatigue levels.

"We found that initially all the participants had a moderate level of self-reported mental fatigue," Jason Cohen, a former graduate student in the University of Illinois Urbana-Champaign Exercise, Technology, and Cognition Laboratory, said in a statement. "Over the course of the week, the groups that took part in a combination of exercise and mindfulness training reported a drop in fatigue levels from moderate to mild. The other groups did not show a comparable degree of improvement."

What this means for you

If you’re having fatigue from breast cancer treatment, you may want to talk to your doctor about this study.

For the exercise part, ask your doctor how much and how often you can exercise, as well as if there are types of exercise you should avoid. If you’ve never exercised before, it can help to think of exercise as another important part of your overall treatment plan that helps you recover and stay healthy. You also can ask around and see if any breast cancer support groups near you have organized exercise classes. If you can't find an exercise class through a breast cancer group, consider joining another exercise class or start walking with a friend. There's a good chance that exercising with other people will give you the motivation and support to make regular exercise part of your recovery. Find the right exercise routine for you, and then do your best to stick with it! It can make a difference, today and tomorrow.

For the mindfulness relaxation part, ask someone on your medical team what’s available at your hospital or treatment center. You also may want to look at some online videos by Jon Kabat-Zinn, an internationally known meditation teacher and professor of medicine emeritus at the University of Massachusetts Medical School.

For more information, visit the Breastcancer.org pages on Exercise and Meditation.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser


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