Cancer Related Fatigue

Hello!

Here is a brief report for our discussion board reviewing information about cancer related fatigue. Fatigue is the number one side effect experienced by those receiving cancer treatment or those who have completed treatment.

Some of the information is technical for those who like data, but please scroll to the bottom of the report as it outlines 3 important things to bring to your health care provider. Fatigue can really impact your quality of life, so any method to diminish this side effect is a plus in my book.

-KarenD

Palliative Care in Oncology Symposium
Boston, Massachusetts
October 24-25, 2014
Cancer Related Fatigue

The National Cancer Institute states that “Fatigue is the most common side effect of cancer treatment with chemotherapy, radiation therapy, or selected biologic response modifiers”. (National Cancer Institute, n.d.). It is an often under-reported symptom which may persist even years after treatment.

One of the very interesting sessions I attended was lead by Julienne Bower, PhD from the University of California, Los Angeles. She has done extensive research involving fatigue in cancer patients and survivors. What she shared with attendees was information about the ASCO committee which works to improve the lives of survivors through evidence based practices. A screening assessment for fatigue has been developed for health care provider usage. This assessment assists them in evaluating the true degree of fatigue that someone may be experiencing. Certain steps are then taken depending on where the person rates themselves on the scale. This scale is a part of the ASCO clinical practice guidelines on fatigue publication. http://www.asco.org/screening-assessment-and-management-fatigue-adult-survivors-cancer-american-society-clinical

Dr. Bower’s interest in cancer related fatigue (CRF) not only focuses on the possible causes for this symptom, but ways in which to treat it. It has been hypothesized that CRF is a result of inflammation within the body. An older study that Dr. Bower co-authored in 2007 discusses how this might occur. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630796/pdf/nihms30265.pdf

Because it has been speculated that inflammation is a possible cause of CRF, and inflammation is a complicated body response to stress, methods to reduce stress were studied.

1. Mind-body treatment
2. Exercise
3. Activity modification

Restorative yoga was the mind-body/exercise that Dr. Bower has shown to produce a measurable improvement in the degree of CRF experienced by cancer patients and survivors. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601551/

The possibility that a gentle exercise program such as yoga has been clinically shown to decrease the level of fatigue and depressive symptoms, and increase vigor, is very promising in my opinion. Yoga is a non-pharmacological intervention that has in this study, been shown to work.

For those of you reading over this information who may not be medical professionals, what I would take away from this report is as follows:

1. Fatigue is a common symptom that cancer patients experience. You are not alone.
2. Tell your physician, oncology nurse, or other health care provider if you are experiencing fatigue that impacts your daily activities.
3. Discuss with your healthcare provider the potential for you to engage in stress reduction techniques such as a gentle yoga program, walking, stretching, or other simple exercise routine.

Thank you,
Karen D, CCF patient advocate

References
Bower, J. (2014, October). Fatigue and the cancer survivor: ASCO guidance recommendations. Palliative Care in Oncology Symposium. Lecture conducted from Boston, Massachusetts.

National Cancer Institute. (n.d.). Fatigue. Retrieved from http://www.cancer.gov/cancertopics/pdq/supportivecare/fatigue/HealthProfessional/page1