title: Evidence-based practice for fatigue management in adults with cancer: exercise as an intervention.
abstract: OBJECTIVE
  To review and summarize the current state of the evidence for exercise as an intervention for cancer-related fatigue and to facilitate application to clinical practice.
  
  
  METHODS
  Articles, abstracts, and practice guidelines published through October 2003.
  
  
  RESULTS
  The strength of the evidence of effectiveness of exercise in managing cancer-related fatigue is growing.
  
  
  CONCLUSIONS
  All patients with cancer should be encouraged to maintain an optimum level of physical activity during and following cancer treatment. Patients with breast cancer and other selected patients should receive recommendations for moderate exercise programs. Referrals to physical therapy and/or rehabilitation may benefit certain patients, including those with comorbidities or deconditioning. Published multidisciplinary evidence-based guidelines for exercise programs involving patients with cancer are needed.
  
  
  CONCLUSIONS
  Nurses may participate in implementing exercise interventions with patients with cancer in various roles depending on skill and knowledge--from encouraging physical activity to referring patients to physical therapy and/or rehabilitation programs to prescribing and monitoring exercise in certain patient populations.
authors.affiliation: University of Pennsylvania Medical Center, Philadelphia, PA, USA. carrie.stricker@uphs.upenn.edu
authors.forename: Carrie Tompkins
authors.initials: CT
authors.lastname: Stricker
authors.forename: Diane
authors.initials: D
authors.lastname: Drake
authors.forename: Kyle-Anne
authors.initials: KA
authors.lastname: Hoyer
authors.forename: Victoria
authors.initials: V
authors.lastname: Mock
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005221:Fatigue / Q000139:chemically induced / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D005260:Female; D006801:Humans; D007372:Interferons / Q000009:adverse effects; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000451:nursing / Q000523:psychology / Q000628:therapy; D009859:Oncology Nursing / Q000193:education; D010166:Palliative Care; D036102:Peripheral Blood Stem Cell Transplantation / Q000523:psychology; D010865:Pilot Projects; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D007372:Interferons