A study in cancer patients with radiotherapy assessing effectiveness of nutritional supplement and ambulation in improving fatigue and physical activity

Pallela Narayana Someshwara Rao, Anil Vince Vincent, Helen Mabel


Background: Patients receiving radiation therapy suffer from ill effects of cancer as well as the side effects of radiation therapy. In this study, we prepared a nutritional supplement therapy and ambulation plan for the patients and assessed the improvement in physical activity and decrease in fatigue.

Methods: The patients who had completed at least 3 sittings of radiotherapy in the oncology ward were selected by non-probability purposive sampling method. 60 patients were divided equally into experimental and control group. In the experiment group patients were given porridge three times a day and made to walk after drinking the porridge every day for 25 days. In both groups, post test was conducted. The data obtained was analyzed using descriptive and inferential statistics.

Results: All the patients in both the groups had fatigue before the intervention. After the intervention on 30th day, 7 (23.3%) patients had mild fatigue, 23 (76.70%) had moderate fatigue and there was none with severe fatigue in the experimental group. In the control group, fatigue level became severe in 3 (10.00%) patients and remained same in others. In the experimental group, significant improvement was shown in performing physical activities after the intervention. 9 (30%) showed good physical activity, 12 (40.00%) showed moderate activity after the intervention in the experimental group.

Conclusions: As there was a significant reduction in the level of fatigue and improvement in the level of physical activity in the experimental group after the intervention which could be attributed to the effect of nutritional supplement therapy and ambulation.



Cancer related fatigue, Fatigue, Nutrition, Physical activity, Radiotherapy

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Mock V, Atkinson A, Barsevick AM, Berger AM, Cimprich B, Eisenberger MA, et al. Cancer-Related Fatigue. J Natl Compr Canc Netw. 2010;(8)8:904-31.

Stone PC, Minton O. Cancer-related fatigue. Eur J Cancer. 2008;(44)8:1097-1104.

Mock V. NCCN Practice Guidelines for Cancer-Related Fatigue. Oncology (Williston Park). 2000;11(14):151-61.

Howell D, Keller-Olaman S, Oliver TK, Hack TF, Broadfield L, Biggs K, et al. A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue. Curr Oncol. 2013;(20)3:e233-46.

Zick SM, Sen A, Han-Markey TL, Harris RE. Examination of the association of diet and persistent cancer-related fatigue: a pilot study. Oncol Nurs Forum. 2013;(40)1:E41-9.

McCallum PD, Polisena C. Nutrition concerns with the radiation therapy patient. In: he clinical guide to oncology nutrition. The American Dietetic Association: Chicago, Illinois; 2000:11-23.

Polisena CG, Wade VR. Cancer patients need referrals to dietitians. J Am Diet Assoc. 1993;93:975-6.

Mustian KM, Morrow GR, Carroll JK, Figueroa-Moseley CD, Jean-Pierre P, Williams GC. Integrative non pharmological behavioral interventions in cancer related fatigue. Oncologist. 2007;12(1):52-67.

Morrow GR. Cancer related fatigue. Oncologist. 2007;12(1):1-3.

Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12(1):4-10.

Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR. Mechanisms of cancer related fatigue. Oncologist. 2007;12(1):22-34.

Bellizzi KM, Mustian KM, Bowen DJ. Aging in the context of cancer prevention and control. Cancer. 2008;113:3479-83.

Mendoza TR, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK, et al. The Rapid Assessment of Fatigue Severity in Cancer Patients: Use of the Brief Fatigue Inventory. Cancer. 1999;85(5):1186-96.

Bellizzi KM, Mustian KM, Palesh OG, Diefenbach M. Cancer survivorship and aging: moving the science forward. Cancer. 2008;113(12):3530-9.

Rogers LQ, Courneya KS, Robbins KT, Malone J, Seiz A, Koch L, et al. Physical activity and quality of life in head and neck cancer survivors. Support Care Cancer. 2006;14(10):1012-9.

O'Neill M, Heron DE, Flickinger JC, Smith R, Ferris RL, Gibson M. Post treatment quality-of-life assessment in patients with head and neck cancer treated with intensity-modulated radiation therapy. Am J Clin Oncol. 2011;34(5):478-82.

Lenk K, Schuler G, Adams V. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training. J Cachexia Sarcopenia Muscle. 2010;1(1):9-21.

Gustafsson M, Edvardsson T, Ahlstrom G. The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Cancer. 2006;14(12):1205-12.

Taylor JC, Terrell JE, Ronis DL, Fowler KE, Bishop C, Lambert MT, et al. Disability in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2004;130(6):764-9.

Silver HJ, Dietrich MS, Murphy BA. Changes in body mass, energy balance, physical function, and inflammatory state in patients with locally advanced head and neck cancer treated with concurrent chemoradiation after low-dose induction chemotherapy. Head Neck. 2007;29(10):893-900.

Kroenke CH, Fung TT, Hu FB, Holmes MD. Dietary patterns and survival after breast cancer diagnosis. J Clin Oncol. 2005;23:9295-303.

Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, et al. American cancer society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. CA: Cancer J Clin. 2012;62:30-67.

Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev. 2012;8:CD007566.

Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. J Cancer Surv. 2010;4:87-100.

Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ, et al. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomark Prev. 2008;17:379-86.

Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, et al. Influence of pre- and post-diagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study. J Clin Oncol. 2008;26:3958-64.

Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol. 2011;29:726-32.

Meyerhardt JA, Giovannucci EL, Holmes MD, Chan AT, Chan JA, Colditz GA, et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol. 2006;24:3527-34.