What is the effect of implementing non-pharmacological interventions on CRF in adult cancer patients during and after their treatment? An adapted systematic review.

Abstract

Abstract Background: Cancer is a major healthcare organisational concern, especially with the high increase in rates over the last decade. Despite advanced technology to treat cancer, the side effects of these treatments are not fully acknowledged. Cancer-related fatigue, for example, is the most unrated symptom that is faced by many cancer patients and survivors. Although non-pharmacological interventions are suggested to manage this symptom, little is known regarding their effect on different cancer patients and survivors. Objective: This review aims to critically examine the effectiveness of non-pharmacological interventions (exercise and yoga) at managing cancer-related fatigue among adult patients living with and beyond cancer. Method: Databases, including PubMed, MEDLINE, CINHAL Plus, AMED, Embase and CENTRAL, were searched comprehensively between August and October 2021, based on PRISMA 2020 guidelines. All databases have systematically searched the literature from the most recent studies regarding cancer fatigue, limited to adults (as age group), English language, with the timeframe of 2015 and 2021. The CASP tool was used for critical appraisal. Results:1,522 studies were identified, of which eight randomised control trials were reviewed. Of the studies that met the eligibility criteria, four focused on physical exercise, three on yoga, and one evaluated the benefits of combining physical exercise with yoga, suggesting a significant reduction of CRF, except in advanced lung cancer patients. Different effects on CRF-related outcomes were found. The long-term effects were not maintained in all studies and were not consistent across all studies. Sources of potential bias included a lack of description of blinding, favouring the female gender, and small study sizes. No serious adverse events were reported in any studies. Conclusion: Low to medium intensity yoga and physical activity can effectively reduce cancer- related fatigue in adults who are experiencing fatigue during or after their treatment journey. Further research, with a large sample, RCT phase III and better methodology quality is required.