Interferon-induced fatigue in patients with melanoma: a pilot study of exercise and methylphenidate.
OBJECTIVE
To examine the effect of exercise and methylphenidate on fatigue, functional ability, and cognitive function in patients with melanoma.


METHODS
Pilot study with comparison to historic controls.


METHODS
University-based cancer center.


METHODS
12 patients with melanoma entered and completed the study. The mean age was 44 years.


METHODS
Eligible patients were recruited before their first dose of interferon-a (IFN-a). Patients were instructed to take 20 mg sustained-release methylphenidate every morning and follow an aerobic exercise program four days a week for 15-30 minutes. Measures included a 12-minute walk, the Schwartz Cancer Fatigue Scale, Trail Maker Forms A and B, Medical Outcomes Study 36 Short Form, body weight, and daily logs. Fatigue scores were compared to usual care historical controls with melanoma receiving only IFN-a.


METHODS
Fatigue, functional ability, and cognitive function.


RESULTS
66% adhered to exercise and methylphenidate; all adhered to exercise. Fatigue was lower for the exercise and methylphenidate group than historic controls. Functional ability increased 6% for all patients and 9% for the exercise and methylphenidate group. Cognitive function was stable for the exercise and methylphenidate group. The exercise-only group showed marked cognitive slowing.


CONCLUSIONS
The combination of aerobic exercise and methylphenidate may have a positive effect on fatigue, cognitive function, and functional ability. A larger sample size and randomized trial is needed to more rigorously evaluate the results of exercise and methylphenidate alone or in combination.


CONCLUSIONS
Although further study is needed, a combination of exercise and methylphenidate may be a practical intervention for patients receiving IFN-a for melanoma.
Department of Primary Care, School of Nursing, Oregon Health and Science University, Portland, OR, USA. schwarta@ohsu.edu
Anna L
AL
Schwartz
John A
JA
Thompson
Nehal
N
Masood
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002173:Cancer Care Facilities; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D003071:Cognition / Q000187:drug effects; D015444:Exercise; D005221:Fatigue / Q000139:chemically induced / Q000451:nursing*; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000451:nursing*; D008774:Methylphenidate / Q000008:administration & dosage*; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D000697:Central Nervous System Stimulants; D016898:Interferon-alpha; D008774:Methylphenidate