Daily fatigue patterns and effect of exercise in women with breast cancer

Objectives: Cancer treatment-related fatigue is a common and disruptive side effect of chemotherapy. Exercise is an intervention proposed to reduce fatigue in cancer patients. The purpose of this study was to describe the patterns of daily fatigue in women with breast cancer who did and did not exercise while receiving the first three cycles of adjuvant chemotherapy. Materials and Methods: Women received instruction to follow an 8-week home- based exercise program and to maintain daily exercise and fatigue diaries. Functional ability (12-minute walk) was measured pretest and post-test. Results: Several distinct patterns of fatigue emerged. The most common pattern of fatigue after chemotherapy demonstrated a sharp rise in fatigue. However, several women demonstrated a chaotic pattern with erratic and wide swings in their fatigue throughout the entire study period. Women who adopted exercise experienced fewer days of high fatigue levels and more days of lower fatigue for both average and worst levels of fatigue. Women who did not exercise experienced more bad days (high fatigue) and fewer good days (low fatigue). Conclusions: Exercise appears to reduce the levels of average and worst fatigue and may help women recognize their pattern of fatigue. Exercise may reduce the intensity of fatigue by reorganizing women's interpretation of fatigue. Routine clinical assessment and education about fatigue by health professionals can help patients to understand their pattern of fatigue and may help them to manage the symptom.