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Two decades of research support the assertion that exercise is both safe and beneficial during cancer treatment. Most standard exercise protocols are well tolerated by patients. However, it is important that the fitness professional be aware of the specific effects of cancer and its treatments on the exercise response. Exercise prescriptions must be individualized according to the specific needs and health status of each patient. During each exercise session, modifications may need to be made to ensure patient safety, depending on the changing health of each patient. With the right program, remaining physically active during and after cancer treatment will improve the patient's muscular strength and aerobic

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*Committee Report*. US Department of Health and Human Services, Philadelphia, PA.

functioning, decrease fatigue, improve QOL and have a favorable effect on anxiety.

Fig. 12. Upper body stretch.

**5. Conclusion** 

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**10** 

*USA* 

Garth L. Nicolson

*Department of Molecular Pathology,* 

**Nutritional Supplements for Cancer-Associated** 

Cancer patients routinely take multiple – dietary supplements to prevent recurrence or chronic disease, to improve quality of life and overall health, or to reduce the adverse effects of cancer therapy (Gansler et al., 2008; Miller et al., 2009; Ströhle et al., 2010; Velicer & Ulrich, 2008). In fact, one of the most common behavior changes among cancer patients is

Although cancer patients routinely use dietary supplements, there is often little consideration as to their safety, efficacy and potential negative effects (Cassileth et al., 2009; Giovannucci & Chan, 2010). In fact, some data suggest that higher than recommended doses of some vitamins and minerals might result in enhancement of carcinogenesis, changes in survival in some cancers and interference with therapy or prescription medications (Cassileth et al., 2009; Giovannucci & Chan, 2010). Nonetheless, several potentially beneficial effects of dietary supplements have been recorded, including reductions in the risk of cancer carcinogenesis and tumor progression, enhancement of immune responses against cancers or immune systems in general, improvements in nutrition and general health, and reductions in the adverse effects of cancer therapy (Cassileth et al., 2009; Doyle et al., 2006; Isenring et all, 2010; Miller et al., 2009; Conklin, 2000; Nicolson & Conklin, 2008; Nicolson,

This review will concentrate on one particularly troublesome aspect of cancer and cancer

Cancer-associated fatigue adds considerably to cancer morbidity (Brown & Kroenke, 2009; Hofman et al., 2007). It exists in all types of cancers from the least to the most progressed cancers (Brown & Kroenke, 2009; Hofman et al., 2007). Along with pain and nausea, it is one of the most common and troublesome symptoms of cancer (Hofman et al., 2007; Prue et al., 2006), especially in advanced cancers (Curt et al., 2000; Prue et al., 2006; Respini et al., 2003). In patients receiving adjuvant therapies the prevalence of cancer-associated fatigue is reported to be as high as 95% (Sood & Moynihan, 2005). Thus cancer-associated fatigue is a

**1. Introduction** 

2010; Ströhle et al., 2010),

therapy—cancer-associated fatigue.

**2. The importance of cancer-associated fatigue** 

the use of dietary supplements (Miller et al., 2009).

**Fatigue and Cancer Therapy – A Molecular** 

**Basis for Restoring Mitochondrial Function** 

*The Institute for Molecular Medicine, Huntington Beach, California,* 

