Physical Activity & Cancer Rehabilitation: Fatigue, Depression and Anxiety

Question 1

What is Fatigue in relation to cancer survivors?

Answer 1

A widespread quality of life issue in cancer survivors

Question 2

What causes fatigue in cancer survivors?

Answer 2

Often results from chemotherapy and radiation therapy. The tumour itself can also cause fatigue

Question 3

What improves fatigue?

Answer 3

Many studies show PA improves fatigue

Question 4

What used to be encouraged, but makes fatigue worse?

Answer 4

Rest!! Fatigue is not relieved by rest. Any movement is better than nothing

Question 5

What types of cancer did PA have a positive effect on their fatigue?

Answer 5

• Mixed cancer types
• Breast cancer most effective
• Prostate cancer (after 6+ months)

Question 6

What types of cancer had no significant change to fatigue when being physically active?

Answer 6

• Colorectal cancer

Question 7

What types of cancer had mixed results of fatigue changes due to PA?

Answer 7

• Gynecological and Hematological cancers
  (some fatigue improved, some had no change in fatigue)

Question 8

What types of PA improve fatigue?

Answer 8

• Aerobic (walking, cycling)
• Combined Aerobic and resistance exercise

Question 9

What types of PA had no effect on fatigue?

Answer 9

• Resistance training alone
• The type of Aerobic exercise did not matter

Question 10

What dose of PA is effective for improving fatigue?

Answer 10

Low-moderate intensity is superior (no high intensity, vigorous activity!!)
Optimal duration: 50 minutes

Question 11

What is the best timing to begin PA in cancer survivors to improve fatigue?

Answer 11

Most effective for improving fatigue: PA after the conclusion of cancer treatment

Question 12

What is Hematopoietic Stem-Cell transplant? HSCT

Answer 12

A curative treatment for hematological malignancies and bone marrow failure syndrome

Question 13

What does HSCT often result in?

Answer 13

Debilitating, severe fatigue

Question 14

What research was done on HSCT patients and fatigue levels?

Answer 14

HSCT in 33 leukemia/lymphoma/
myeloma survivors prior to transplant, during chemo. Cycle ergometer 2x per day improved fatigue levels

Question 15

How is inflammation caused and what does it do to the body?

Answer 15

Tumour and treatment increases pro-inflammatory cytokines, influencing CNS signalling. This can lead to fatigue

Question 16

How does PA help with inflammation?

Answer 16

Decreases inflammatory response

Question 17

How does Hypothalamic-Pituitary-Adrenal Axis (HPA Axis) and Circadian Rhythm Dysregulation (sleep cycle) affect the body?

Answer 17

Disruption of the HPA axis may play a role in causing persistent fatigue

Question 18

How can PA help with HPA axis?

Answer 18

In breast cancer survivors specifically, PA has been found to normalize HPA axis function

Question 19

How can Serotonin dysregulation affect the body?

Answer 19

Increases activity of pro-inflammatory cytokines leading to increased levels of 5-HT (serotonin) which results in sensation of fatigue

Question 20

How can PA help serotonin dysregulation?

Answer 20

Exercise increases 5-HT but long term exercise normalizes serotonin metabolism

Question 21

How does alterations in ATP and Muscle metabolism affect the body?

Answer 21

Impairment of peripheral muscle metabolism and function may lead to persistent fatigue in cancer survivors

Question 22

How can PA help alterations in ATP and muscle metabolism?

Answer 22

PA can result in greater muscular strength and function, overall improving fatigue

Question 23

What can help depression and anxiety in general populations?

Answer 23

Regular physical activity

Question 24

How long does it take for PA to be effective in improving depression and anxiety levels?

Answer 24

Generally takes weeks to be effective

Question 25

Depression in cancer survivors is...

Answer 25

One of the most common psychological conditions present

Question 26

Major depression in cancer survivors?

Answer 26

5-26%

Question 27

Minor depression in cancer survivors?

Answer 27

7-26%

Question 28

Why do cancer survivors have such high rates of depression?

Answer 28

- closer to death - Staying in the hospital for long periods of time - Sleep disruptions - Relationship issues - Fatigue - Serotonin dysregulation

Question 29

What is anxiety in cancer survivors?

Answer 29

A common psychological problem

Question 30

What are anxiety symptoms cancer survivors experience?

Answer 30

Excessive worry, restlessness, insomnia

Question 31

What is 12-month anxiety prevalence rates?

Answer 31

15.8%

Question 32

What is lifetime prevalence rates?

Answer 32

24.1%

Question 33

What area is more researched depression or anxiety?

Answer 33

Depression because it's more common

Question 34

What can help with depression?

Answer 34

Aerobic capacity was found to decrease depression across all 25 studies PA resulted in modest short term and long term reductions in depression

Question 35

What produces the greatest reduction in anxiety?

Answer 35

When Aerobic and resistance exercise is combined

Question 36

How can depression and anxiety be assessed?

Answer 36

Through questionnaires

Question 37

How does exercise improve depression and anxiety?

Answer 37

- Increase certain neurotransmitters (serotonin) - Sleep better - Relieves tension - Reduces cortisol levels