Excellent palliative care provided to patients with end-stage cancer includes improving quality of life, which entails the management of fatigue, defined as a "constant, subjective sensation of exhaustion associated with cancer or its treatment that impedes normal functioning and that is out of proportion to recent activity." About 60% to 90% of such patients experience cancer-related fatigue. Physical activity has been documented as effective in the management of fatigue in the early stages of cancer, and a recent review focuses on the evidence of its benefit in patients with end-stage cancer receiving palliative care. Included were patients 18 years old or older with any type of cancer, the treatment of which included physical activity defined as "any bodily movement produced by the skeletal muscles that resulted in a substantial increase in energy expenditure over resting levels." Among the six studies that met the inclusion criteria, three involved aerobic exercise and three involved a mixture of aerobic and resistance-training components. All the studies represented pilot research, but they did document that the majority of the 84 end-stage palliative care participants were able to tolerate physical activity; the one randomized, controlled trial documented "a statistically significant slower rate of decline in total well-being, as well as a statistically significant slower rate of increase in total fatigue."

The crux of the matter. The results of the studies reviewed suggest that physical activity interventions can benefit patients with cancer throughout the entire course of the disease. Further research to substantiate that finding is necessary.

MM