Tuesday, November 3, 2009
Exercise may reduce chemo-related fatigue.
THE QUESTION Fatigue is a frequent complaint of people getting chemotherapy for cancer. Might exercise change that?
THIS STUDY involved 269 adults (average age, 47) who, as a group, had 21 cancer diagnoses; all were undergoing chemotherapy. All got standard medical care for cancer; some were assigned to supplement that care with nine hours of supervised exercise. The exercise included high-intensity cardiovascular and resistance training and low-intensity relaxation and body awareness techniques; massages also were given. After six weeks, people in the exercise group reported less fatigue and greater vitality and emotional well-being than the non-exercisers. They also were found to have improved aerobic capacity, muscular strength and overall physical functioning.
WHO MAY BE AFFECTED? People being treated for cancer with chemotherapy, which uses drugs to kill cancer cells. But the drugs' effect on healthy cells produces a range of side effects, including fatigue. The disease itself also can make people feel unusually tired.
CAVEATS No one with cancer should begin an exercise regimen without first consulting with a doctor. If approval is given, supervision might be suggested; for safety, study participants were closely monitored during all exercise. Exercise regimens that differ from that used in the study might yield different results. Some data came from the participants' responses on questionnaires. Though fatigue was lessened, it remained greater, on average, than in the general population.
FIND THIS STUDY Oct. 13 online issue of BMJ.
Mixed results seen from laparoscopic surgery.
THE QUESTION For some diseases, minimally invasive surgery has been shown to have advantages over traditional, open surgery. Might that be the case when the prostate gland needs to be removed?
THIS STUDY analyzed data on 8,837 men, 65 and older, who had a radical prostatectomy; 22 percent had minimally invasive laparoscopic surgery, with or without robotic assistance, and the others had open surgery, with the gland removed through an incision in the abdomen (retropubic prostatectomy). Men who had laparoscopic surgery stayed in the hospital an average of two rather than three days, got fewer blood transfusions and had fewer respiratory and other postoperative complications than those who had open surgery. However, they had double the rate of genital and urinary-tract complications and were more likely to have incontinence or erectile dysfunction 18 months later. There was little difference between the groups in the need for additional cancer treatment.
WHO MAY BE AFFECTED? Men who are having their prostate gland removed because of cancer. In the United States, men have about a 1-in-6 chance of developing prostate cancer. However, the survival rate at five years is nearly 100 percent, it is greater than 90 percent at 10 years, and the outlook continues to improve with earlier detection and improved treatment methods.
CAVEATS The study did not include men who had perineal prostatectomy (where the incision is between the scrotum and anus); their results could be different. Procedures performed by less experienced surgeons also might yield different results. Because the data came from Medicare forms, complications such as erectile dysfunction, which do not necessarily require medical attention, could have been underreported. The study did not compare either type of surgery with other treatment options, such as radiation or monitoring the prostate for changes (called watchful waiting).
FIND THIS STUDY Oct. 14 issue of the Journal of the American Medical Association.
-- Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.