For patients suffering with cancer-related fatigue, indulging in exercise -- such as gentle yoga, walking, running or cycling -- and/or psychological therapies may work better than medications and should be recommended first to patients, researchers say.

Fatigue in cancer patients is the most common side effect caused by treatment with chemotherapy, radiation therapy and some biologic therapies. This type of fatigue is different from being chronically tired. It's a crushing sensation that's not relieved by rest or sleep, and can persist for months or years. "If a cancer patient is having trouble with fatigue, rather than looking for extra cups of coffee, a nap, or a pharmaceutical solution, consider a 15-minute walk," said lead author Karen Mustian, Associate Professor at the University of Rochester, New York.

The findings showed that exercise alone -- whether aerobic or anaerobic -- reduced cancer-related fatigue most significantly. Psychological interventions, such as therapy designed to provide education, change personal behaviour and adapt the way a person thinks about his or her circumstances, also helped in reducing fatigue. Importantly, drugs tested for treating cancer-related fatigue -- including stimulants like modafinil, which can be used for narcolepsy, and Ritalin, which treats ADHD -- were not found as effective.

"The study bears out that these drugs don't work very well although they are continually prescribed. So any time you can subtract a pharmaceutical from the picture it usually benefits patients," Mustian said. For the study, published in the journal JAMA Oncology, the team analysed the outcomes of 113 unique studies, involving more than 11,000 patients. According to researchers, the cancer-related fatigue might be the result of a chronic state of inflammation induced by the disease or its treatment. Most concerning is that fatigue can decrease a patient's chances of survival because it lessens the likelihood of completing medical treatments, Mustian said.