Cancer-related fatigue (CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre- and active treatment phases, evidence supporting its efficacy in advanced stage remains limited. This systematic review and meta-analysis aimed to quantify the effects of exercise on CRF and its common complications in patients with advanced lung cancer. A systematic search of 4 databases (PubMed, Embase, Cochrane, and Web of Science) was conducted up to July 10, 2024 to identify relevant randomized controlled trials (RCTs). Studies were selected based on predefined eligibility criteria, including adult patients with advanced lung cancer reporting fatigue as an outcome. Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, and the risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Random- or fixed-effects models were used for meta-analyses based on heterogeneity levels. Eight RCTs involving 749 patients were included. Meta-analysis revealed that exercise significantly improved CRF in patients with advanced lung cancer (standardized mean difference (SMD) = -0.33; 95% confidence interval (95%CI): -0.54 to -0.12); p = 0.00; I² = 0.00%). Subgroup analysis showed greater efficacy in patients aged ≤60 years (p = 0.028), those engaging in traditional Chinese exercise (p = 0.003), and interventions lasting fewer than 12 weeks (p = 0.017). Exercise also significantly improved quality of life (SMD = 0.29; 95%CI: 0.02-0.55; p = 0.04; I² = 0.00%) and reduced dyspnea (SMD = -0.43; 95%CI: -0.71 to -0.16; p = 0.00; I² = 0.00%). No significant effects were observed on sleep quality, anxiety, or depression. The risk of bias across studies was moderate, and the quality of evidence, as evaluated by GRADE, was rated as low due to study limitations. Adverse events were minimal, with only one mild, exercise-related event reported. Exercise significantly alleviates CRF in patients with advanced lung cancer, improves certain complications, and enhances quality of life. The intervention's effectiveness varies by age, type of exercise, and duration. Further high-quality studies are needed to validate these findings.

Background: Fatigue is a common source of distress for cancer survivors. The severity of cancer-related fatigue varies significantly, which may be due to individual differences in host factors.Aim: This cross-sectional study aims to explore how demographic, oncological, sociological, psychological, and stress-related hormones levels interact to influence the distinct experiences of fatigue (Cancer-related fatigue [CRF] occurrence and fatigue degree).Methods: A cross-sectional study carried out at the oncology outpatient and ward department of Xiyuan Hospital of China Academy of Chinese Medical Sciences recruited 306 cancer patients between January 2021 to December 2021. General information, fatigue, psychological factors was evaluated by general information questionnaire, the Revised Piper’s Fatigue Scale-Chinese Version (RPFS-CV), and the self-report Hospital Anxiety and Depression Scale (HADS). Stress-related hormones were measured with chemiluminescent enzyme immunoassay (Zhengzhou Antobio).Results: 306 patients were included, 229 (74.8%) were diagnosed with CRF, including 94 (41.0%) with mild fatigue, 121 (52.8%) with moderate fatigue, and 14 (6.1%) with severe fatigue. Multivariate regression analysis showed that higher depression scores, aldosterone levels may increase the risk of CRF. Patients who are obese (Body mass index ≥ 28 kg/m²) may help to reduce the risk of CRF. Other contributing factors for increased levels of fatigue (p< 0.05) include being female, having anxiety, depression and high aldosterone levels.Conclusion: The research suggested that CRF was a common symptom in cancer survivors and pay attention to these influencing factors may help to better identify patients susceptible to fatigue and provide long-term, targeted interventions.

Objective: To provide higher level evidence on the benefits of a Chinese patent medicine (CPM) (Fufang E’jiao Syrup, FFEJS) for alleviating cancer-related fatigue (CRF), this article describes a protocol for a randomized controlled trial. Methods/design: We designed a double-blind, placebo-controlled stratified permuted block randomization clinical trial on CRF among 3 types of cancer in China. Participants will be equally allocated to FFEJS group or placebo group according to the randomization sequence and the hospitals they were enrolled at. Each patient will receive 20 ml of either the study formula FFEJS or a placebo formula, 3 times a day for 6 weeks. The follow-up period will be another 4 weeks for safety evaluation. The primary outcome is the difference in improvement of fatigue as measured with the Revised Piper Fatigue Scale-Chinese Version (RPFS-CV). Secondary outcomes include change in fatigue (measured by routine blood panel and hormones in peripheral blood) and QoL (measured by Edmonton symptom assessment scale and Functional Assessment of Cancer Therapy). Patient safety will be measured by liver, renal or cardiac damage, and the risk of FFEJS having a tumor promotion and progression effect will be monitored throughout this study. Cost-effectiveness will also be evaluated mainly by incremental cost per each quality-adjusted life year gained. Discussion: This article describes the study design of a CPM for CRF in patients with advanced cancer through exploring the effectiveness, safety, and cost-effectiveness of FFEJS. Trial registration: ClinicalTrials.gov, NCT04147312. Registered on 1 Sep 2019.

Previous research has demonstrated that different cancer survivors with the same disease history or treatment may have different experiences of fatigue. This cross-sectional study aims to explore how demographic, oncological, sociological, psychological, and serum hormone levels interact to influence the distinct experiences of fatigue (Cancer-related fatigue occurrence and fatigue degree). General information, fatigue, psychological factors was evaluated by general information questionnaire, the Revised Piper's Fatigue Scale-Chinese Version, and the self-report Hospital Anxiety and Depression Scale. Serum hormones were measured with chemiluminescent enzyme immunoassay (Zhengzhou Antobio). 306 patients were included, 229 (74.8%) were diagnosed with CRF, including 94 (41.0%) with mild fatigue, 121 (52.8%) with moderate fatigue, and 14 (6.1%) with severe fatigue. Multivariate regression analysis showed that higher depression scores, aldosterone levels may increase the risk of CRF. Patients who are obese (BMI ≥ 28 kg/m²) may help to reduce the risk of CRF. Other contributing factors for increased levels of fatigue (p < 0.05) include being female, having anxiety, depression and high aldosterone levels. The research suggested that CRF was a common symptom in cancer survivors and pay attention to these influencing factors may help to better identify patients susceptible to fatigue and provide long-term, targeted interventions.

Background: Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, with incidence steadily increasing in China. Early detection through screening significantly reduces morbidity and mortality. However, awareness and participation remain inadequate, especially in rural populations, who account for nearly 39% of China’s total population. Understanding awareness levels and associated factors is essential for developing targeted interventions. Methods: A population-based cluster cross-sectional study was conducted between September 2022 and March 2024 in two rural villages in Beijing and Henan Province. All permanent residents were eligible for this observational assessment of CRC awareness, for this observational assessment of CRC awareness; when the number of eligible residents exceeded the required sample size, participants were randomly selected from household lists provided by local village committees to ensure proportional representation across age and sex. Data were collected using a standardized questionnaire assessing knowledge of CRC risk factors, preventive measures, early symptoms, and screening methods. Logistic regression was performed to identify factors associated with high awareness, defined as a total score ≥ 90 on the awareness scale. Results: Of the 2,091 participants, 60% demonstrated high awareness of CRC screening. Recognition of major risk factors such as advanced age (83.5%), colon polyps (88.1%), and family history (87.3%) was high, as was awareness of protective factors like dietary fiber intake/whole grains/yogurt (85.5%). Awareness of early symptoms such as blood in the stool (88.4%) and abdominal pain/incomplete evacuation (95.5%) was strong, but recognition of fatigue and anemia was lower (77.4%). Awareness of fecal occult blood testing (82.0%) and fecal genetic testing (85.1%) was slightly lower than for colonoscopy (86.7%). Logistic regression showed that age, gender, education level, alcohol consumption was significantly associated with higher awareness ( P < 0.05). Conclusions: This study provides the first evidence of CRC awareness among rural populations in Northern China, revealing knowledge gaps in non-specific symptoms and non-invasive screening methods. Despite relatively high awareness, uptake of screening remains limited, indicating barriers such as access, cost, and cultural factors. Tailored education, accessible screening, and behavioral interventions are needed to improve prevention and early detection in these underserved communities.

Background: This study aimed to conduct a bibliometric analysis of clinical trial research among older people with colorectal cancer. It presents the research landscape, highlights advancements, and reveals research hotspots, evolutionary trends, and gaps to identify areas for future research. Methods: We analyzed publications on all types of clinical trials among older people with colorectal cancer indexed in the Web of Science Core Collection database between 2005 and 2025. We used CiteSpace software to develop visual maps showing the current research status and the evolution of research hotspots and gaps. Results: In total, 1,354 publications were included, with the volume of publications increasing over time. The top 10 authors published approximately 5% of the research in the field. Most of the top institutions were North American, and few strong collaboration networks were identified between authors or between institutions. Key research hotspots centered on clinical studies, with primary outcome measures focusing on quality of life, improvement in symptoms, and overall survival. There were important gaps in the literature, with few trials of immunotherapy and the gut microbiota among older people, suggesting a lack of evidence on how these therapeutic advances might benefit this group. Conclusions: This bibliometric analysis has highlighted the predominance of North American institutions and the lack of international collaboration in this field, both of which may have implications for the future. Our findings also suggest a progressive shift from a treatment-oriented approach toward risk stratification and individualized interventions within the framework of precision medicine but indicate a slower pace than in many other areas of cancer. Future studies must consider how to fill these gaps.