Clinical Study

Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors

  • British Journal of Cancervolume 118pages13131321 (2018)
  • doi:10.1038/s41416-018-0044-7
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Testicular cancer survivors (TCS) are at increased risk of cancer-related fatigue (CRF), psychosocial impairment, and poor mental health-related quality of life (HRQoL). Here, we examine the effects of high-intensity interval training (HIIT) on patient-reported outcomes (PROs) in TCS. Secondarily, we explore cardiorespiratory fitness as a mediator of intervention effects and select baseline characteristics as moderators of intervention effects.


TCS (n = 63) were randomly assigned to 12 weeks of supervised HIIT or usual care (UC). PROs included CRF, depression, anxiety, stress, self-esteem, sleep quality, and HRQoL assessed at baseline, post-intervention, and 3-month follow-up.


TCS (median 7 years postdiagnosis) completed 99% of training sessions and achieved 98% of target training intensity. ANCOVA revealed that, compared to UC, HIIT significantly improved post-intervention CRF (p = 0.003), self-esteem (p = 0.029), and multiple HRQoL domains (ps ≤ 0.05). Effects on CRF (p = 0.031) and vitality (p = 0.015) persisted at 3-month follow-up. Cardiorespiratory fitness changes mediated CRF and HRQoL improvements. CRF effects were larger for TCS with an inactive lifestyle, lower fitness, higher testosterone, and clinical fatigue at baseline.


HIIT significantly improves CRF and HRQoL in TCS. Mediation by cardiorespiratory fitness and moderation by clinical characteristics suggests opportunities for targeted exercise interventions to optimise PROs in TCS.

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We thank all HIITTS trial participants for their dedication and time, without which this study would not have been possible.

Author contributions

Conception and design: All authors. Acquisition, analysis, or interpretation of the data: All authors. Drafting the article: S.C.A. Reviewing the article: All authors. Final approval of article: All authors.

Author information

Author notes

    • Scott C Adams

    Present address: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA


  1. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada

    • Scott C Adams
    • , Darren S DeLorey
    • , Margie H Davenport
    •  & Kerry S Courneya
  2. Department of Surgery, University of Alberta, Edmonton, AB, T6G 2B7, Canada

    • Adrian S Fairey
  3. Alberta Urology Institute Research Centre, Edmonton, AB, T6G 1Z1, Canada

    • Adrian S Fairey
  4. Department of Oncology, University of Alberta, Edmonton, AB, T6G 2R7, Canada

    • Scott North
  5. Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada

    • Scott North


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Competing interests

The authors declare no competing interests.

Ethical approval:

All procedures complied with the ethical standards of the local (University of Alberta), regional (Health Research Ethics Board of Alberta–Cancer Committee), and national (Canadian Institutes of Health Research) committees on human experimentation and the Helsinki Declaration.

Informed consent

Informed consent was obtained for all study participants prior to study inclusion.

Availability of data & material

Study data is available upon request.

Corresponding author

Correspondence to Kerry S Courneya.

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