Walking Improves Fatigue, Sleep in Breast Cancer Patients

PONTE VEDRA BEACH, Fla—Walking 60 minutes or more a week could have a positive effect on fatigue and sleep disturbance in breast cancer patients, according to preliminary results presented by Barbara Poniatowski, MS, RNC, AOCN, at the Oncology Nursing Society’s Sixth National Conference on Cancer Nursing Research.

Ms. Poniatowski, an oncology clinical nurse specialist at Greater Baltimore Medical Center, found that patients who undertook a moderate-intensity walking program were less tired and slept better than a control group that did not exercise more than 45 minutes per week.

Each woman in the exercise arm of the study received an individualized walking prescription based on a 12-minute walking test. The walking could be done at their leisure at any time and place that was comfortable for them, she said.

The randomized study drew 120 women (average age, 52) from five large cancer centers participating in a larger investigation of fatigue and exercise intervention in cancer patients. All were receiving adjuvant chemotherapy or radiation therapy during the program, which Ms. Poniatowski conducted with Victoria Mock, DNSc, AOCN, of Johns Hopkins University School of Nursing, principal investigator for the project.

The investigators are still analyzing results based on individual exercise diaries that all participants kept, a 19-item sleep scale, the Piper Fatigue Scale, and the 12-minute walk test.

Fatigue, depression, and total mood disturbance all correlated with sleep disturbance, Ms. Poniatowski said. "The greater the sleep disturbance, the higher the fatigue level," she said.

While breast cancer patients are generally expected to be anxious, Ms. Poniatowski reported the researchers were concerned that a significant number did not sleep well before their treatment started. "About 30% reported sleep quality as fairly bad or very bad at baseline—before they began treatment," she said. "For the clinicians, it tells us we need to do a good initial assessment to facilitate early problem identification and implement appropriate intervention."