Cancer-Related Fatigue

Jeremy McGuire et al. (2026) · Journal of the National Comprehensive Cancer Network : JNCCN

This three-arm randomized pilot trial with 87 adults explored whether Reiki, a biofield therapy in which a practitioner rests or holds hands lightly near the body to work with the body's energy field, could ease cancer-related fatigue as well as therapeutic massage does. Cancer-related fatigue is a persistent, rest-resistant exhaustion driven by cancer treatment itself — it affects roughly 6 in 10 people on aromatase-inhibitor therapy for breast cancer and about 4 in 10 on long-term androgen-deprivation therapy (ADT) for prostate cancer, and unlike ordinary tiredness it does not improve with sleep. Because many patients cannot manage the exercise-based therapies oncology guidelines usually recommend, the study looked at two passive, low-effort alternatives instead. Participants — 57 with breast cancer on aromatase inhibitors and 30 with prostate cancer on ADT — were randomly assigned to two Swedish-massage sessions, two Reiki sessions, or four Reiki sessions, each delivered by licensed practitioners in up to 75-minute visits over one to two weeks. Fatigue was tracked with the well-validated 9-item Brief Fatigue Inventory at baseline, weekly through six weeks, and again at a one-month follow-up. All three groups reported real, clinically meaningful drops in fatigue by week six, with benefits still holding a month later. Statistically, the massage and Reiki groups did not differ from each other, but Reiki's improvements were consistently larger and grew with more sessions: on the total fatigue score, the effect size (Cohen's d, where 0.8 is considered large) was 0.57 for massage, 0.87 for two Reiki sessions, and 1.16 for four Reiki sessions — with a similar pattern for the "worst fatigue" and "fatigue interference" measures. Looked at by cancer type, both therapies helped breast-cancer patients across the board, but for prostate-cancer patients only Reiki improved every fatigue measure, while massage helped only the single worst-fatigue item. No one in either therapy arm reported a treatment-related adverse event. These results position Reiki as a safe, well-tolerated option that may match or exceed massage for cancer-related fatigue, particularly for men on ADT, and hint that four sessions work better than two. As a small pilot without a placebo or "sham Reiki" comparison arm, it cannot rule out expectancy or attention effects, and its per-group sizes (26-30 people) are too small to draw firm conclusions — the authors call for larger, sham-controlled trials next.

Georgios Mavropalias et al. (2022) · Breast cancer (Tokyo, Japan)

This randomized trial with 106 women getting radiation therapy for breast cancer tested whether a 12-week program of home-based exercise -- with no gym or supervision required -- could reduce cancer-related fatigue and improve quality of life during and after treatment. Cancer-related fatigue is an overwhelming tiredness affecting most breast cancer patients undergoing radiotherapy, and unlike ordinary tiredness, it does not resolve with rest alone. Conducted in Australia, the trial split participants into an exercise group, who received a one-on-one session with an exercise specialist plus biweekly phone check-ins, a resistance band, a pedometer, and an exercise guide, or a usual-care group with no exercise support. Eighty-nine women (43 exercise, 46 usual care) completed the full study. Fatigue was tracked weekly during the 6-week radiation course and at several points afterward using validated fatigue and quality-of-life questionnaires, along with measures of sleep and physical activity, over a full 12 months of follow-up. Women in the exercise group felt less fatigued than the usual-care group at several points during radiation treatment and recovered faster once treatment ended, while the usual-care group's fatigue did not meaningfully improve until 6 weeks after finishing radiation and took a full year to fully resolve. Quality of life followed a similar pattern, improving sooner and more in the exercise group. Sleep quality was poor in both groups throughout the study and did not improve with exercise. Notably, the women only managed modest amounts of exercise -- about 1 to 2 strength sessions and 30 to 40 minutes of cardio per week, less than typical guidelines recommend -- yet still saw real benefits, and no one was hurt by the program. These results suggest that even a small, home-based, unsupervised amount of exercise can meaningfully speed up recovery from cancer-related fatigue and improve quality of life during breast cancer radiotherapy, without needing a gym, a trainer, or a large time commitment. However, the study lacked a group that skipped radiotherapy entirely, so it cannot fully separate the effects of exercise from the natural course of treatment, and the fatigue and quality-of-life benefits appeared to fade once the structured 12-week program ended, suggesting ongoing activity is needed to keep the benefits going.

Anna Pyszora et al. (2017) · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

This randomized trial with 60 adults tested whether a short course of physiotherapy could ease cancer-related fatigue in people with advanced cancer who were receiving palliative (comfort-focused) rather than curative care -- a group rarely included in fatigue research even though fatigue is one of their most common and distressing symptoms, often dismissed as an inevitable part of advanced illness rather than something physiotherapy could actually help treat. Conducted at a palliative care unit and hospice in Poland, the study split participants evenly into a physiotherapy group and a no-exercise control group, with everyone continuing their usual medications. The physiotherapy group did six 30-minute sessions over two weeks, combining gentle active arm-and-leg exercises with myofascial release (a hands-on technique that eases tight connective tissue) and proprioceptive neuromuscular facilitation, or PNF (stretching-and-contracting patterns that improve movement and reduce stiffness). Fatigue and its impact on daily life were measured with the Brief Fatigue Inventory, while nine common symptoms -- including pain, mood and appetite -- were tracked with the Edmonton Symptom Assessment Scale. By day 8, the physiotherapy group already showed significantly less fatigue than the control group, and by day 12 their fatigue scores had dropped from about 6.4 to 4.4 out of 10 (p<0.01) across every fatigue measure, while the control group barely changed on most items. The therapy group also reported significantly less pain, depression, anxiety and drowsiness, and better appetite and overall well-being (all p<0.01) -- benefits the control group did not show over the same two weeks. Nearly all physiotherapy patients (26 of 29 evaluated) rated the program positively on a satisfaction scale, and not a single patient rated it negatively, suggesting the approach was both effective and well tolerated even in a population that is frail and seriously ill, which many clinicians would have assumed could not handle any exercise at all. These results suggest that even patients in palliative care, who are often assumed too frail for exercise, can safely benefit from a brief, well-tailored physiotherapy program that reduces fatigue and improves overall comfort. The study's small size, single location, lack of blinding, and short two-week follow-up mean the findings need confirmation in larger, longer trials, and a chance imbalance in gender between the two groups (more women ended up in the control group) is a limitation worth noting, though it did not appear to affect the fatigue results.

Eduardo J Fernandez-Rodriguez et al. (2023) · International journal of environmental research and public health

This randomized clinical trial with 48 cancer patients explored whether a one-month, home-based program combining supervised exercise with functional rehabilitation could reduce cancer-related fatigue and help patients regain independence after being discharged from an oncology hospital stay. Cancer-related fatigue, also called asthenia (tiredness without a clear physical cause), affects most cancer patients yet is often dismissed by care teams as an unavoidable side effect rather than something that can be actively treated with structured therapy. Conducted in Salamanca, Spain, the trial split 48 recently hospitalized patients (average age about 63, with lung, digestive, prostate and breast cancers) into two equal groups. Both received standard cancer care, but one group also completed daily home exercise sessions (short aerobic-and-strength workouts, twice a day) plus hands-on retraining in daily activities like dressing and moving safely, energy-saving strategies, and sleep coaching. Independence, fatigue, quality of life, physical performance and fear of movement were measured before treatment, at 15 days, and at 1 month by evaluators who did not know which group each patient was in. Patients in the exercise-and-rehabilitation group showed significantly better independence, less cancer-related fatigue, and stronger physical performance than the control group at both check-ins (p<0.001 for the final comparisons on all three), while the control group's scores stayed flat or worsened over the same month. Fear of movement related to fatigue also improved more in the treatment group by the one-month mark. Pain levels did not differ meaningfully between groups. Quality-of-life results were more mixed: one specific overall-wellbeing rating improved more with treatment, but the broader quality-of-life questionnaire actually improved slightly more in the control group, a puzzling result the researchers think may reflect that instrument's limits for this population. These results suggest a structured, home-based exercise and rehabilitation program can meaningfully help newly discharged cancer patients regain daily independence and feel less fatigued. However, patients could not be kept unaware of which group they were in, the study ran for only one month so longer-term benefits are unknown, it took place at a single hospital, and adherence relied on patients' own reports. Larger, longer trials with cancer-specific quality-of-life tools are needed to confirm and extend these findings.

Dilek Yildirim et al. (2025) · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

This single-blind randomized controlled trial with 100 hospitalized adults explored whether inhaling lavender essential oil could ease two of the most disruptive symptoms of chemotherapy for blood cancer patients: fatigue and poor sleep. Fatigue here means a persistent, whole-body exhaustion that isn't relieved by rest and that chemotherapy drugs are known to intensify, while sleep quality captures how deep, continuous, and restorative a night's sleep actually is rather than just its duration. Lavender oil, extracted from a hybrid of two Mediterranean Lavandula species, is inhaled rather than ingested, working through its scent's effect on the brain's limbic system rather than any drug-like mechanism. Fifty adults with hematological cancers (multiple myeloma, leukemias, lymphomas) receiving chemotherapy in an Istanbul hospital were assigned to inhale two drops of lavender oil from a shoulder-pinned sponge for 20 minutes each night before bed, for five consecutive nights; another 50 received unscented saline the same way. Neither group knew which oil they were smelling. Fatigue was scored with the 22-item Piper Fatigue Scale and sleep with the six-item Richards-Campbell Sleep Questionnaire, both completed at baseline and again the morning after the fifth night. By night six, the lavender group's overall sleep score was meaningfully higher than the saline group's (70.80 vs. 59.16 out of 100, p = 0.001 — lavender users reported deeper, less interrupted sleep), with clear advantages in sleep depth, time to fall asleep, and number of awakenings. Fatigue told the same story in reverse: the lavender group's fatigue score dropped to 4.54 versus 5.51 in the control group (p = 0.001, lower is better), with the steepest improvements in the subscales measuring fatigue's effect on daily activities, physical sensations, and mental clarity. A statistical model combining lavender use and sleep score explained about 17% of the variation in how fatigued patients felt (R² = 0.171, p < 0.001) — a modest but real share, meaning sleep and scent worked together rather than independently. One subscale, emotional response to fatigue, improved but didn't quite reach statistical significance (p = 0.052). For hematology-oncology nurses, this points to an inexpensive, side-effect-free option — no adverse events were reported — that can be added to nightly care without special training or equipment. The trial only tracked five nights, so whether the benefit holds up over a full chemotherapy course is unknown, and the researchers grouped all blood cancer types together rather than testing whether effects differ by diagnosis. Larger, longer trials are needed before lavender aromatherapy becomes a standard recommendation rather than a promising adjunct.