Interferon-induced fatigue in patients with melanoma: a pilot study of exercise and methylphenidate.

PURPOSE/OBJECTIVES: To examine the effect of exercise and methylphenidate on fatigue, functional ability, and cognitive function in patients with melanoma.

DESIGN

Pilot study with comparison to historic controls.

SETTING

University-based cancer center.

SAMPLE

12 patients with melanoma entered and completed the study. The mean age was 44 years.

METHOD

Eligible patients were recruited before their first dose of interferon-a (IFN-a). Patients were instructed to take 20 mg sustained-release methylphenidate every morning and follow an aerobic exercise program four days a week for 15-30 minutes. Measures included a 12-minute walk, the Schwartz Cancer Fatigue Scale, Trail Maker Forms A and B, Medical Outcomes Study 36 Short Form, body weight, and daily logs. Fatigue scores were compared to usual care historical controls with melanoma receiving only IFN-a.

MAIN RESEARCH VARIABLES

Fatigue, functional ability, and cognitive function.

FINDINGS

66% adhered to exercise and methylphenidate; all adhered to exercise. Fatigue was lower for the exercise and methylphenidate group than historic controls. Functional ability increased 6% for all patients and 9% for the exercise and methylphenidate group. Cognitive function was stable for the exercise and methylphenidate group. The exercise-only group showed marked cognitive slowing.

CONCLUSION

The combination of aerobic exercise and methylphenidate may have a positive effect on fatigue, cognitive function, and functional ability. A larger sample size and randomized trial is needed to more rigorously evaluate the results of exercise and methylphenidate alone or in combination.

IMPLICATIONS FOR NURSING

Although further study is needed, a combination of exercise and methylphenidate may be a practical intervention for patients receiving IFN-a for melanoma.