People who have been treated for cancer often have lingering fatigue, but a new analysis of more than three dozen studies suggests regular walking or cycling might help boost their energy.
Patients' long-lasting tiredness has been blamed both on the cancer itself, including cancer-related pain, and on the effects of treatments such as chemotherapy.
Prior studies point to talk therapy, nutrition counseling and acupuncture as possible ways to ease cancer-related fatigue during or after treatment. But light-to-moderate exercise has the advantage of being something people can do on their own time, for little or no cost.
"We're not expecting people to go out and be running a mile the next day," said Fiona Cramp, who worked on the analysis at the University of the West of England in Bristol.
"Some people will be well enough that they're able to go for a jog or go for a bike ride, and if they can, that's great. But we would encourage people to start with a low level of activity," she told Reuters Health — such as a 20-minute walk a couple of times each day.
Cramp and her colleague James Byron-Daniel pooled findings from 38 studies that directly compared more than 2,600 people with cancer-related fatigue who did or didn't go through an exercise program.
The majority of that research looked at women with breast cancer. The type of exercise program varied, from walking or biking to weight training or yoga. More than half of the studies included multiple exercises or allowed participants to choose their own type of physical activity.
The amount of prescribed exercise ranged from two times per week to daily workouts, lasting anywhere from ten minutes to two hours, depending on the study.
When they combined the results, the researchers found physical activity both during and after cancer treatment was tied to improved energy. In particular, aerobic exercise such as walking and cycling tended to reduce fatigue more than resistance training, they reported this week in the journal The Cochrane Library.
"What we do know is there will be an appreciable difference; the average patient will get a benefit from physical activity," Cramp said. "The actual amount of reduction in fatigue is going to vary according to the individual."
For example, the team saw exercise-related benefits for people with breast cancer and prostate cancer, although not for those with the blood and bone marrow cancers leukemia and lymphoma.
"Some of the hematologic patients may not have the reserves to always tolerate the aerobic exercise," said Carol Enderlin, who has studied fatigue and cancer at the University of Arkansas for Medical Sciences in Little Rock.
"They do not always have the oxygen carrying capacity, for instance," because the disease and treatment affect blood cell counts. For those people, non-aerobic exercise or exercise at a lower dose may be a better option, said Enderlin, who wasn't part of the research team.
Regular moderate exercise is one non-drug therapy recommended by the National Comprehensive Cancer Network.
Although it might seem intuitive to deal with fatigue by getting lots of rest and avoiding extra activity, that could lead to more loss of muscle mass and fitness, according to Cramp and Byron-Daniel.
One cancer specialist not involved in the new study said that along with reducing fatigue, a combination of moderate exercise and nutrition therapy may help women with breast cancer in particular lower their risk of recurrence. Women being treated for breast cancer tend to gain weight, said Dr. Roanne Segal, from the University of Ottawa in Ontario, Canada.
"We are now pushing… lifestyle programs which incorporate diet and exercise to get you to either maintain your weight or reduce your weight," she told Reuters Health.
But the most appropriate exercise program, Segal added, will depend on where patients are with their treatment and the details of their particular cancer.
Cramp emphasized that people will have different goals and abilities when it comes to exercise, and that they should discuss those with their doctor. And although most patients will be able to do some kind of physical activity, fragile bones and anemia might hold others back.
"Cancer patients should of course first talk with their doctor to see if it's safe to exercise," Enderlin told Reuters Health. "If it's felt they are safe to exercise, they should maintain a level of at least comfortable activity in order to keep up their endurance, to keep up their strength (and) to promote function."
Tired after cancer treatment? Walking may help
Tired after cancer treatment? Walking may help
Recipes for Success: Chef Aniket Chatterjee offers advice and a mutton curry recipe
DUBAI: Aniket Chatterjee — currently chef de cuisine at Atrangi by Ritu Dalmia in Dubai — says his cooking is shaped as much by memory and personal history as it is by technique.
Working closely with celebrity chef and restaurateur Dalmia, Chatterjee has developed a style that looks at Indian food not through trends, he says, but through stories — from home kitchens and street food to lesser-known regional traditions.
Many of his dishes at Atrangi are contemporary adaptations of familiar Indian flavors and everyday recipes. His approach reflects how Indian cuisine in Dubai, and beyond, is shifting, with more diners interested in regional cooking, comfort food and the stories behind where dishes come from, he tells Arab News.
When you started out, what was the most common mistake you made?
I put a lot of stress and pressure on myself, which was leading to my passion getting depleted.
What’s your top tip for amateur chefs?
Always cook with intuition and intent. Cooking depends a lot on your mindset. Once you start cooking not because someone wants to eat, but because you want to feed them, that’s a game changer.
What one ingredient can instantly improve any dish?
Simple: salt. Seasoning is key. Someone once said: “The difference between good food and great food is a pinch of salt,” and I strongly believe that. And love, of course.
When you go out to eat, do you find yourself critiquing the food?
Obviously it’s a mechanism, after working for so many years, that I try to analyze anything that I eat. But it’s just for understanding or inspiration purposes. I do believe in giving feedback because I genuinely want the restaurant or the cook to be better.
What’s the most common issue that you find in other restaurants?
The thing that ticks me off is anything which starts with “viral.” I’m out. I don’t like it when restaurants follow trends and don’t do what they are actually capable of doing or love to do.
What’s your favorite cuisine or dish?
I love Japanese food. It’s simple yet complex. But my favorite dish changes weekly. It is like that one song that you listen to on a loop and then you get sick of it. I do the same with food. Last week it was mandi with haneeth ribs — the fat, the freshness from the tomato, rice and laban is so beautifully balanced. This week, it’s mostly ramen.
What’s your go-to dish if you have to cook something quickly at home?
I love to make a nice bowl of pasta. Usually, back home, in my pantry, we always have the ingredients, because even my mom loves it. It’s usually a nice simple tomato and basil spaghetti with some fresh mozzarella or a ragu or an aglio e olio.
What customer behavior most annoys you?
When they tell us they are allergic to something but later turns out they just don’t like the particular thing. That has happened multiple times.
What’s your favorite dish to cook and why?
A nice spicy curry — chicken or lamb. It’s therapeutic. Making curry, for me, is the most beautiful thing in the world. It’s very complex and layered, and it’s completely based on understanding, not a recipe.
What’s the most difficult dish for you to get right?
It’s not a dish, it’s two ingredients: doodhi (bottle gourd) and karela (bitter gourd). I absolutely despised both those vegetables with all my heart, until I took on a challenge to work around it. It worked out and I have had a lot of my fellow haters end up liking both.
As a head chef, what are you like? Are you a disciplinarian? Or are you more laid back?
I don’t like shouting; I feel that’s a very weak approach to leading a team. You have to be calm and composed. I’m a firm believer in energies and that it transpires into the food, so I don’t want a stressful work environment and having fun in the kitchen is mandatory. Of course, there are some non-negotiables, and that’s where the discipline kicks in.
Chef Aniket’s lazy Sunday mutton curry
(serves 4)
Ingredients
Marination:
Mutton or lamb curry cut – 600g
Mutton or lamb fat (preferably in cubes) – 100g
Full fat yoghurt – 50g
Red onion (sliced) – 450g
Ginger and garlic paste – 80g
Coriander stems (whole) – 15g
Mustard oil – 30ml
Kashmiri red chilli powder – 16g
Turmeric powder – 8g
Coriander powder – 14g
Roasted cumin powder – 14g
Black salt – to taste
Garam masala:
Cumin – 8g
Cinnamon – 4g
Cloves – 2g
Green cardamom – 6g
Black cardamom – 2g
Bay leaf – 2 pcs
Whole dried red chilli – 1 pc
Black pepper – 3g
Fennel seeds – 6g
For the tempering:
Mustard oil – 80ml
Whole dried red chilli – 2 to 3 pcs
Bay leaf – 2 to 3 pcs
Black pepper (whole) – 6g
Cinnamon sticks – 2 to 3 pcs
Instructions:
Take a bowl and combine all the ingredients listed under marination. Let it sit for at least three hours, preferably overnight in the fridge.
For the spice mix, combine all the ingredients listed under garam masala in a cold non-stick pan and slowly bring to heat. Toss the spices as they warm so they roast evenly without burning. Once cooled, blend into a coarse powder.
Take a pressure cooker and add the mustard oil from the tempering. Once hot, add the dry spices and saute for a minute.
Add the marinated mutton or lamb directly into the oil. The marinade will have released some water, so separate it and add only the meat, onions and fat first. This helps the meat and onions sear and caramelize properly.
Once browned, add the remaining marinade liquid and cook for another 10 to 15 minutes. Cover and cook for two whistles plus 30 minutes for mutton, or two whistles plus 15 minutes for lamb. Let it rest for 15 to 20 minutes until the steam releases naturally.
Once the meat is tender, adjust the consistency and seasoning to taste.
Turn off the heat and add one tablespoon of the garam masala. At this point, add one tablespoon clarified butter or ghee, julienned ginger (5 g), lemon juice to taste and a pinch of sugar.
Finish with plenty of fresh chopped coriander and serve hot with rice or parathas.
