Cancer patients may ease fatigue more effectively with exercise and psychotherapy than with medication, a recent study suggests. Researchers examined data from 113 previously published studies involving more than 11,500 cancer patients with fatigue. Patients were randomly assigned to treat their exhaustion with exercise or psychotherapy, or both, or with drugs. Exercise and psychotherapy were associated with a 26 percent to 30 percent reduction in fatigue during and after cancer treatment, the study found. Drugs, however, were tied to only a nine percent decline in fatigue. “Patients need to try exercise or psychotherapy before they reach for a pharmaceutical,” said lead study author Karen Mustian of the University of Rochester Medical Center in Rochester, New York.

Cancer-related fatigue is common and may be tied to the effects of tumors or treatments, researches note in JAMA Oncology. Unlike other types of exhaustion, just getting more sleep or giving aching muscles a break from strenuous activities can’t address fatigue associated with tumors. Fatigue tied to cancer can persist for years and may be worsened by other cancer-related health problems like depression, anxiety, sleep disturbance and pain. It’s not clear why exercise and psychotherapy may be more effective than drugs, Mustian said by email. “We do not know for sure why exercise works, but some research is beginning to suggest it is due to anti-inflammatory effects and also improvements in physical function – cardiovascular, pulmonary and muscular,” Mustian added. “In terms of psychotherapy, the most beneficial form was group therapy that used a cognitive behavioral approach to educate patients, help them to change the way they think about fatigue and managing it, and adopting behaviors to help alleviate it.” Most participants in the studies were female, and almost half of the studies involved women with breast cancer.