Journal of Radiotherapy in Practice Journal of Radiotherapy in Practice 2002 2,207-214 © Greenwich Medical Media Ltd. 2002 Original Article The effect of the recommendation of two different physical activity strategies on fatigue experienced during radiotherapy D. M. Flinton*, R. J. Thome*, S. Waller**, N. Nelson**, P. Thapar-Francis*, R Cherry* ^Department of Radiography, City University, London; **Department of Radiography, Essex County Hospital, Colchester; ^Department of Radiography, St Bartholomew's Hospital, London, UK Abstract Patients undergoing cancer treatments, including radiotherapy, frequently report fatigue during their treatment. Recent research indicates that structured exercise programmes can alleviate fatigue and, in light of this research, many centres are now advocating activity as part of the strategy with which to combat fatigue. The aim of this investigation was to see how well this strategy would be received by patients and what effect it would have on fatigue levels. Of the 147 patients who agreed to take part in the study 123 completed all the questionnaires. Fifty- four of the patients received the standard advice whilst 69 received the modified advice. Fatigue was measured at four time points using the MFI scale. Fatigue scores at the end of treatment were significantly higher than at the start of treatment but there was no difference in fatigue scores between the two groups of patients receiving the different advice. Activity levels between the two groups were comparable, as was their change in activity level compared to normal, indicating a reluctance to use this strategy. Keywords Cancer related fatigue; radiotherapy; physical activity INTRODUCTION Fatigue is a condition that exists in many cancer patients and is one of the most frequently reported symptoms in patients undergoing the various types of cancer treatments available. It has been reported that 58% of cancer patients experience fatigue "somewhat" or "quite a bit", 1 and that 52% of patients consider fatigue to be their biggest problem. Despite the high incidence of fatigue within this group of patients and the high impor- tance given to it by patients very little research had been devoted to this area of study until recently. Over the past few years research into this area has appreciably increased, highlighting the issue of Correspondence to: D. Flinton, City University, Department of Radiography, Rutland Place, Charterhouse Square, London EC1M 6PA, UK. cancer related fatigue which was accepted as a diag- nosis by the World Health Organisation in 1999. 2 The fatigue experienced by cancer patients is different to that experienced in healthy indi- viduals. Firstly, cancer related fatigue does not arise as a result of muscular activity or intense mental exertion, both of which are common reasons for people experiencing fatigue. Secondly, cancer related fatigue tends to be chronic rather than acute in nature and unlike "normal" fatigue it is not easily resolved by rest. Levels of fatigue are generally seen to increase in patients undergoing the various treatment modalities used in this group of patients 3 " 5 which, in the case of radiotherapy, can be for as long as seven weeks. Post treatment, fatigue levels are seen to decline, although many patients still report elevated fatigue levels over three months post treatment. 6 207