In this article, we will see cancer related fatigue treatment methods and what are its various causes and how it is measured.
Cancer-related fatigue (CRF) is one of the most common and distressing symptoms faced by cancer patients.
Fatigue is a symptom that is perceived by the patients and is not visible or assessable by the physician or caregiver. Cancer related fatigue is different from the normal fatigue because it is not relieved with rest. A cancer patient may describe it as a feeling of being tired, weak, restless, weary, heavy, worn out, drained, exhausted, washed-out, slow, or inability to perform routine activities which they could perform with ease before encountering cancer.
If you are having any of cancer-related fatigue issues, then you can join our cancer forums/support communities to interact with people who have been in similar situations. Also, we would recommend you to seek medical help from your healthcare professional as soon as possible.
For some people, cancer related fatigue is more bothersome than other cancer-related symptoms like pain, nausea, vomiting, or depression. Following are some pointers that direct to CRF:
Before understanding how cancer related fatigue is treated, let's first see how it is measured.
Fatigue is perceived by a patient, and thus the patient can only tell about the level of fatigue experienced by him/her.
Therefore, in order to measure cancer related fatigue, the patient is asked to rate his/her level of experienced fatigue on a Visual Analog Scale (VAS) from 0 to 10. Where “0” represents no fatigue and “10” represents the worst imaginable fatigue.
When the VAS score is 1–3, 4–6, and 7–10, level of fatigue is termed as mild, moderate, and severe, respectively.
These tools may be appropriate in some instances and are generally employed in clinical trials to assess the change in the level of fatigue over time.
Now, that we know about cancer related fatigue scale, let's see 7 ways to treat cancer related fatigue.
Based on the clinical assessment of the patient, the physician will suggest the most appropriate measures to reduce the cancer related fatigue.
Following are some examples of such measures that can help in reducing the CRF:
1. Increase physical activity: It may seem contrasting but light exercise or aerobics can help in reducing cancer related fatigue. Various research studies have revealed that cancer patients who exercise regularly experience less fatigue and depression.
Light exercise helps the lungs and heart to work better and reduce fatigue. Also, exercise makes you sleep better thereby reducing depression. Thus, increased physical activity is recommended for all cancer patients.
2. Maintain proper nutrition: To prevent fatigue, it is important to maintain proper nutrition. You should get enough calories along with essential nutrients like carbohydrates, protein, fats, vitamins, minerals, and others.
This can be achieved with the help of a balanced diet. Take plenty of fluids to keep yourself hydrated and to drain-off wastes from your body via urine. Consume easily digestible food and avoid consuming junk food. You may consult a nutrition counselor for deciding upon your diet chart and eating schedule.
3. Relaxation techniques/Behavioral therapy: Being relaxed is helpful in reducing fatigue. You may choose to practice a brief morning/evening walk, meditation, yoga, spending time in a garden, bird watching, painting, or prayer whatever you like and what makes you feel relaxed.
You can opt for getting a behavioral or alternative therapy like acupuncture or naturopathy for relaxing.
4. Utilize your energy wisely: It is very important to save energy and utilize the same for the most important activities. You can achieve this by keeping a tack of energy level during a day and performing routine activities accordingly.
Exercise and stretching can be done when you have the most energy. You should know your limits and should not strain too much while exercising. Also, don't feel shy in accepting help from others.
It will be good for you if others can take care of some activities that you cannot perform like driving, cooking, scheduling, etc.
5. Distract yourself: Try to distract yourself from the feeling of fatigue by indulging yourself in things you enjoy. You can listen to your favorite songs; read a joyful novel; watch a movie of your choice; hang on with friends, or do other relaxing tasks that do not require too much labor.
6. Take adequate sleep: Maintaining good sleep habit helps in relieving fatigue. You should try to sleep for at least 7 to 8 hours in the night with a fixed schedule for going to and getting out of the bed each day.
If naps are required during the daytime, they should be short (<30 minutes) and minimal so that they do not affect your nighttime sleep. Too much sleep should also be avoided as this can induce fatigue. In case you face any problem in getting asleep, listen to soothing music that may help in inducing sleep.
Avoid caffeine and exercise during the evening.
7. Pharmacologic Intervention: In the case of poor response from above-noted measures, the physician may recommend certain laboratory tests or medications. The physician may ask for getting a blood test to diagnose anemia or other problems. In the case of anemia, blood transfusion or erythropoietin may be suggested.
In case of other problems, appropriate medicine can be given based on the overall assessment and severity of cancer-related fatigue. Central nervous system stimulants, such as methylphenidate or modafinil, have shown efficacy in the management of CRF and are recommended for this purpose. Antidepressants may also be considered in the case of patients who have developed fatigue due to depression.
Although the exact cause of CRF is not clear, in most cases it is caused by the disease itself, and less commonly by the cancer treatment being given.
Cancer is uncontrolled growth of certain body cells that keep on dividing without dying. Thus, cancer cells consume more resources/energy leading to a shortage of resources/energy for the normal cells. This shortage causes a feeling of fatigue. Cancer may also cause fatigue due to the formation of harmful chemicals that disrupt the normal cell function, especially of those cells involved in the respiration and blood formation/circulation.
The cancer treatment, especially the chemotherapy, radiotherapy, bone marrow transplants, and biologic therapies may cause the destruction of normal cells apart from the cancer cells. This may cause fatigue as the body require extra energy to repair the damage caused by the treatment.
Now let’s discuss the various causes of cancer related fatigue in detail:
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