Fatigue

Introduction
Fatigue is a common symptom for patients with almost any cancer type ^{(1) (2)} and it can prevent normal levels of activity. About 88% of chemotherapy patients and 76% of radiation therapy patients experience fatigue. ⁽³⁾ It is commonly described as feeling tired, weak, exhausted, worn-out or slow. This feeling can be both acute and chronic. Acute fatigue is defined as a tired feeling that starts quickly and lasts for a short time. Chronic fatigue is a nagging weakness that is present for long periods of time.

The only way your doctors can know if you are fatigued is if you tell them, so do not be afraid to speak up. The cause of cancer related fatigue is not yet fully understood, but it is associated with the stress of the disease and its treatments. ⁽⁴⁾

Importance
Fatigue can affect cancer patients because they may not have the motivation to go to work, visit with friends, continue with treatment or continue other normal activities. A study has shown that of employed cancer patients experiencing fatigue, 75% changed their work schedule and 28% stopped working altogether. ⁽⁵⁾ Cancer related fatigue is more severe, more mentally stressful and less likely to be relieved by rest than non-cancer related fatigue. ⁽⁶⁾ Studies show that fatigue can be more distressing to patients than pain, nausea and vomiting because fatigue is not easily treated with medications. ⁽⁷⁾ Fatigue may be made worse by pain, emotional distress, eating habits, sleep patterns, decreased activity and/or other diseases. ⁽⁷⁾

Treatment
Exercise (as suggested by a doctor) and psychosocial interventions (support groups, stress management, education and behavioral intervention) often help alleviate fatigue due to chemotherapy and radiation therapy. ^{(8) (9)}

Suggestions for dealing with fatigue:

• plan your events (appointments, etc.) during the times when you expect to have the most energy
• take short naps throughout the day
• let friends and family help you
• continue doing what you enjoy but monitor your energy levels and reduce the amount of time you spend doing these activities accordingly
• consider joining a support group

Watch the full interview with Jan Niles.

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3. Stasi R, Abriani L, Beccaglia P, Terzoli E, Amadori S. Cancer related fatigue: evolving concepts in evaluation and treatment. Cancer. (2003) 98: 1786-1801 [PUBMED]
4. The National Cancer Institute. Fatigue. U.S. National Institutes of Health. Accessed Aug. 8, 2007. [http://www.cancer.gov/cancertopics/pdq/supportivecare/fatigue/patient ]
5. Curt GA, Breitbart W, Cella D, Groopman JE, Horning SJ, Itri LM, et al. Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 2000 5:353-60. [PUBMED]
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7. National Comprehensive Cancer Network. Cancer-related fatigue. In: Clinical Practice Guidelines in Oncology. Accessed June 20, 2006 [http://www.nccn.org/professionals/physician_gls/default.asp ]
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9. Uitterhoeve RJ, Vernooy M, Litjens M, Potting K, Bensing J, De Mulder P, et al. Psychosocial interventions for patients with advanced cancera systematic review of the literature. Br J Cancer 2004;91:1050-62 [PUBMED]