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Non-pharmacological interventions for cancer related fatigue. A network meta-analysis

Young cancer woman wearing scarf after chemotherapy

Fatigue is one of the most common and distressing symptoms of cancer and cancer treatment. Fatigue can be prevalent before cancer treatment onset but usually increases during cancer therapy and may persist for a long.

In a large project including researchers from the School of Health Sciences HES-SO Valais-Wallis and the School of Health Sciences Fribourg, Bern University of Applied Sciences, the Zurich University of Applied Sciences and researchers from the University Hospitals Bern and Zürich, evidence for the effects of different non-pharmacological interventions to tackle cancer related fatigue was searched in electronic databases and in reference lists of publications. After screening 1902 abstracts of trials and reading 573 full text articles, they could extract relevant data from 245 randomised controlled trials. They applied state of the art statistical analyses to estimate the effects of all comparisons between treatments.

Results: Evidence from this indirect-comparisons meta-analysis indicated that during cancer treatment, relaxation, massage, cognitive behavioural therapy (CBT) combined with physical activity, aerobic and resistance training (alone or combined), as well as Yoga, all showed similar moderate to large effect sizes. After cancer treatment, the importance of relaxation seems to decrease while Yoga might be the best option. Combined aerobic and resistance training, CBT, combined CBT and Tai-Chi showed all moderate effect sizes. This enables the patient and the health care professional to choose out of a variety of evidence based alternatives according to patients’ preference and abilities in order to tackle cancer related fatigue.

This project underlines the importance of increasing educational offers for non-pharmacological strategies to reduce cancer related fatigue.

The full text of the article can be found here (free):  http://bjsm.bmj.com/content/early/2017/05/13/bjsports-2016-096422.full