Efficacy and cost-effectiveness of physical training and behavioral medicine strategies in reducing fatigue, improving well-being and disease outcome in cancer patients – a randomized intervention study with long term follow-up

Principal Investigator (PI):

Professor Karin Nordin

This project is a collaboration between researchers from Uppsala University, Lund University and Linköping University in Sweden, the University of Agder and Bergen in Norway,University of Copenhagen, Denmark, The Netherlands Cancer Institute, VU University Medical Centre, Amsterdam, University of Amsterdam and University of Leeds, UK 



Research project


12.6 million SEK. The Swedish Cancer Society (Cancerfonden)

9.6 million SEK. The Swedish Research Council (

30 000 EURO. Nordic Cancer Union (Nordic Cancer Union)

Time table



Recent relevant reviews have shown evidence for positive effects of physical training during and after cancer treatments but they emphasized the lack of well-designed randomized controlled intervention studies with large sample sizes.


This project will evaluate the efficacy and cost-effectiveness of individually tailored high and low intensity physical training, with or without behavioural medicine support strategies (BM).

We will look at:

  • Cancer Related Fatigue (CRF)
  • Quality of Life (QoL)
  • Mood disturbance
  • Adherence to the cancer treatment
  • Adverse effects
  • Disease outcome
  • Return to a daily life after completed treatment

We will also describe changes in inflammatory markers and cytokines related to physical training and gene expressions following training to investigate whether these serve as mediators for the effects of physical training on CRF and QoL. In addition, we aim to improve cost-effectiveness of rehabilitation programs.


It is a controlled multi-centre study including newly diagnosed breast, colorectal and prostate cancer patients during adjuvant therapy at three different centres in Sweden; Uppsala, Lund and Linköping.A 2x2 factorial design will be used. With this design we can study main effects and interactions between factors. Patients will be randomized to one of the following groups; I) individually tailored high intensity training twice a week with behavioral medicine support strategies (H+BM) or without (H) or II) individually tailored  low intensity training  twice a week with (L+BM) or without behavioral medicine support strategies (L).

All patients will exercise twice a week during 6 months which is equal to the most extensive adjuvant treatment period. It is also an optimal period to achieve physical training effects and to establish physical activity behavior. Physical training under the guidance of trained coaches will be offered twice a week. Training intensity is 40-50% (low intensity group) or 80-90% (high intensity group) of maximal cardiorespiratory fitness/muscular strength. Physical training sessions consist of both cardiorespiratory and resistance exercise. Motivational and self-regulatory behavioral medicine support strategies will be provided for the H+BM and the L+BM groups i.e. strategies to enhance engagement in the high and low intensity exercise programs respectively, and to maintain health enhancing physical activity after the completion of the programs.



Principal Investigator

Karin Nordin

018-471 3487