Purpose: The following paper presents a case of a 56-year-old female who presented to physical therapy following adjuvant treatment for breast cancer. This paper provides an evidence-based analysis to answer the following PICO question: Is exercise an effective intervention for reducing cancer-related fatigue in individuals diagnosed with cancer, receiving adjuvant treatment for cancer, or are successfully in remission?
Background: Fatigue is one of the most common effects of cancer and its various treatments. This condition affects 60% to 90% of cancer patients, who describe feeling weak, listless, paralyzed, and too exhausted to perform basic activities such as eating, toileting, or general movement19. The condition may persist for months or years following completion of treatment9, and is not relieved by rest or sleep. As a result, many patients find cancer-related fatigue to be more distressing than more visible cancer therapy sequelae. This is especially concerning because moderate to severe distress can play a role in the development or recurrence of cancer5.
Case Description: The patient in this case was a 56-year-old female who was referred to outpatient physical therapy for generalized weakness following a recent battle against stage IIIA breast cancer. Following successful treatment, the patient was still experiencing persistent cancer-related fatigue that limited her ability to participate in most activities. She also experienced global muscle wasting, weakness, and significant scar tissue formation that limited her right neck and shoulder mobility.
Outcomes: There is a growing body of research aimed at determining the effects of exercise and different exercise parameters on cancer-related fatigue. An in-depth analysis of 8 articles selected from current available research demonstrated that exercise can improve cancer-related fatigue as well as quality of life, activity avoidance, strength, aerobic capacity and general physical function in many different cancer populations. There is still conflicting evidence regarding how statistically and clinically significant these exercise-induced changes are, but there is an overall trend towards the positive nonetheless.
Discussion: Though the author did not observe the full treatment of the patient presented in this case study, the initiation of an individualized exercise program supported by research showed promising progress that supported the use of exercise to improve cancer-related fatigue.
Doctor of Physical Therapy (DPT)
Pfaff, Andrea Kerstin. "Exercise and Cancer Related Fatigue: An Evidence-Based Analysis." (2017). https://digitalrepository.unm.edu/dpt/129