Beneficial Exercises for Cancer-Related Fatigue among Women with Breast Cancer: A Systematic Review and Network Meta-Analysis

Abstract

Context: Cancer-related fatigue (CRF) is the most common cause of physical powerlessness in women with breast cancer (BC). The practice of continuous effective exercise is beneficial with respect to reducing CRF. Objective: To explore exercise efficacy and respective ranks with respect to reducing CRF in women with BC within the inter-treatment and post-treatment periods. Methods: Throughout this systematic review and network meta-analysis, articles published from 2000 to March 2022 were included. Article searches were conducted on the MEDLINE, Embase, CINAHL, and CENTRAL databases. Adult women with BC and different exercise programs were compared with those involved in regular care as a control during or after treatment. In addition, randomized controlled trials (RCT) were also included. A risk-of-bias assessment, with the revised Cochrane risk-of-bias tool regarding RCT and probability-based ranking, was established based on the surface under the cumulative rank (SUCRA) method via network meta-analysis. Results: a total of 5747 women with BC followed seven exercise interventions. Yoga (SMD = −0.54, 95% CI [−0.86, −0.22]) was ranked first (94.5%), with significant effects in respect of mitigating CRF, followed by resistance exercise (66.2%), and aerobic resistance (63.3%), while Qigong ranked last (22.2%) among the 36 RCT in inter-treatment. Aerobic resistance exercise (SMD = −0.52, 95% CI [−0.98, −0.07]) induced significant effects in respect of mitigating CRF in the 38 RCTs in the post-treatment period. Yoga, aerobic yoga, and aerobic resistance exercise ranked as the top three (75.5%, 75.0%, and 72.4%, respectively), whereas relaxation ranked last (38.8%) in the post-treatment period. Conclusion: Yoga, aerobic resistance, and aerobic yoga are recommended for the purposes of inter- and post-treatment exercise to reduce CRF in women with BC by enhancing their physical resilience and long-term quality of life.

Improved awareness of physical activities is associated with a gain of fitness and a stable body weight in breast cancer patients during the first year of antineoplastic therapy: the BEGYN-1 study

“…Even though, none of the BEGYN-1 study patients showed any sign of overexertion or other negative side effects of too much physical activity, further research is needed to individualize recommendations for the level of physical activity to aim for (50, 51). The increased physical activity and fitness achieved in the BEGYN-1 study might have multiple other consequences that are known to be associated with increased physical activity in breast cancer patients, e.g., increased bone health (52), reduced cancer related fatigue (53), and reduced cancer related cognitive impairment (54). Strengths of our study are the high number of patients, the inclusion prior to therapy induction, the dual assessment of physical activities by using a fitness tracker and a diary, and the long follow up period of one year.…”

The Interplay between Microbiota and Chemotherapy-Derived Metabolites in Breast Cancer

“…For cancer-related fatigue in women with BC, yoga, aerobic resistance, and aerobic yoga are recommended as inter- and post-treatment exercises to improve their physical resilience and quality of life in the long run [ 172 ].…”

Various interventions for cancer-related fatigue in patients with breast cancer: a systematic review and network meta-analysis

“…Network meta-analysis (NMA), also called meta-analysis of mixed treatment comparisons or multiple treatment comparisons (20), offers a method to compare the size of the impact of various intervention types on CRF in patients with breast cancer by estimating direct and indirect comparisons. Although two previously published NMA studies were identified (21,22), the study only reported on the effects of various exercise interventions, and no further studies were conducted on other intervention types. Consequently, this study aims to conduct an NMA on relevant randomized controlled trials (RCTs) to compare the effects of various interventions on CRF in patients with breast cancer.…”