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CRF Exercise Breast — SCE Medical Oncology MCQ

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EasyBreast CancerCRF Exercise BreastSCE Medical Oncology

A 62-year-old woman with breast cancer completed chemotherapy and is on adjuvant endocrine therapy. She reports persistent fatigue affecting her daily activities. All investigations (FBC, TFTs, cortisol, B12/folate, liver/renal function) are normal. What is the most effective intervention for cancer-related fatigue after excluding reversible causes?

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Correct answer: C — Structured exercise programme (combination of moderate-intensity aerobic and resistance training) — the strongest evidence-based intervention for cancer-related fatigue

After excluding treatable causes (anaemia, hypothyroidism, depression, sleep disorders, medication effects), structured exercise is the strongest evidence-based intervention for cancer-related fatigue (CRF). Multiple Cochrane reviews and ASCO guidelines support moderate-intensity aerobic + resistance exercise. Psychological interventions (CBT, mindfulness) are also beneficial. Pharmacological agents (methylphenidate, modafinil, corticosteroids) have weaker evidence and more side effects. Exercise should be individually prescribed by a cancer rehabilitation specialist.

Reference: ESMO 2024 Survivorship; ASCO CRF Guidelines; Cochrane Review; NICE NG