{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T21:36:06Z","timestamp":1781818566526,"version":"3.54.5"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Maryland Department of Health\u2019s Cigarette Restitution Fund Program","award":["CH-649-CRF"],"award-info":[{"award-number":["CH-649-CRF"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Cancer-related fatigue is a debilitating side effect among patients with cancer. Exercise is recommended to manage cancer-related fatigue; however, clinical guidelines lack specificity on modality, intensity, and duration. This study aimed to determine the optimal doses of walking to mitigate cancer-related fatigue.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In a nationwide, prospective cohort study of patients with stage I-IIIC breast cancer, we assessed walking volume (metabolic equivalent task [MET] hours per week) via Aerobics Center Longitudinal Study Physical Activity measure and cancer-related fatigue via Multidimensional Fatigue Symptom Inventory at prechemotherapy (T1), 1 month postchemotherapy (T2), and 6 months postchemotherapy (T3). A receiver operating characteristic curve analysis identified a cut point for walking volume needed for a clinically meaningful cancer-related fatigue reduction from T1 to T2 (\u22124.5 points Multidimensional Fatigue Symptom Inventory score). Linear mixed models controlling for age, body mass index, and other modes of moderate-vigorous intensity exercise characterized cancer-related fatigue at each time point.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 577 participants (mean age = 53.4\u2009years; 76% stage I-II), higher walking volume was associated with lower general, emotional, physical, overall cancer-related fatigue, and higher vigor postchemotherapy (T2; all P\u2009&lt;\u2009.05). Those who walked at least 4.3 MET hours per week, equivalent to walking 88-172\u2009minutes at a low-intensity pace (&lt;2.5\u2009mph) or 43-83\u2009minutes at a moderate-intensity pace (2.6-4.5\u2009mph) at pre, during, and postchemotherapy demonstrated statistically significantly lower cancer-related fatigue at postchemotherapy (T2) compared with those who walked less than 4.3 MET hours per week (P\u2009&lt;\u2009.05).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our data indicate that higher walking volume was associated with lower cancer-related fatigue, and a minimum walking volume of 88-172\u2009minutes at a low-intensity pace or 43-83\u2009minutes of moderate-intensity pace may attenuate cancer-related fatigue following chemotherapy.<\/jats:p>\n 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