Schwartz, A. L., Thompson, J. A., & Masood, N. (2002). Interferon-induced fatigue in patients with melanoma: a pilot study of exercise and methylphenidate. Oncology Nursing Forum, 29, E85–E90.
Patients took methylphenidate 20 mg sustained release every morning and followed an aerobic exercise program for 15 to 30 minutes four days a week. Aerobic exercise is hypothesized to decrease fatigue by improving physical conditioning and mental concentration.
This was an open-label pilot study with comparison to historic controls.
All patients adhered (as determined by patient diaries) to the exercise portion of the intervention over the four months of the study. Four of 12 patients were unable to adhere to methylphenidate: three refused to continue on methylphenidate beyond the first 48 hours of the study (reasons for discontinuation included indigestion, mild nervousness, and unwillingness to take more pills), and one had methylphenidate discontinued by the investigators due to marked anxiety. Patients receiving exercise and methylphenidate or exercise alone experienced lower fatigue levels compared to historic controls. Patients who exercised and took methylphenidate reported the lowest levels of fatigue. The exercise-only group experienced a greater decline in cognitive function when compared with patients who exercised and took methylphenidate. Patients in the in exercise and methylphenidate group lost 8.1 kg, and those in the exercise-only group lost 8.2 kg.
Special training or consultation may be required to prescribe an exercise program for patients with cancer. Cost is related to drug acquisition.