Monday Medical: Fighting fatigue in cancer patients
August 13, 2017
One of the most common symptoms experienced by patients being treated for cancer is fatigue.
Fatigue isn't the same as being tired; it's not a feeling that will go away after a good night's rest or a day off from work. Rather, fatigue is a pervasive, lasting exhaustion that can be physical, mental and emotional.
"When we're tired, we take a nap, get up and feel better. But when you're fatigued, you actually don't feel better after taking a nap," said Jan Fritz, director of Cancer Services with Yampa Valley Medical Center's Jan Bishop Cancer Center. "You may think, 'I'll just lie here,' then, pretty soon, you're lying down the whole day, and that actually makes it worse. And, fatigue comes with most cancer treatments."
But, there are a variety of ways to help cancer patients lessen fatigue. The first step is to help patients understand what they are experiencing.
"Fatigue is defined as a distressing persistent physical, emotional, cognitive tiredness that's related to cancer and treatment, and that interferes with daily life," Fritz said. "Psychologically, it's hard for people. No one likes that feeling. People are often used to being very independent; then, all of a sudden, they feel like they've been hit by a bus.
"Recognizing fatigue and putting a name to it helps. Someone might say they're just tired and feel like they aren't trying, but if we get them skills to help them manage fatigue, it improves their treatment."
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At the Jan Bishop Cancer Center, doctors help patients rate their fatigue. A cancer patient may fall anywhere on the scale, from having no fatigue and doing everything they'd normally do, to being very fatigued and spending most of the day in a chair.
"We're rating the fatigue and looking at their history and the treatment they're receiving, then seeing what we can do to help," Fritz said. "With some of our integrated health services, we can actually help them minimize fatigue."
One surprising option for treatment is physical therapy.
"People think that's really odd, and may say, 'When I'm already fatigued, why would I want to do physical therapy?'" Fritz said. "But it's an evidence-based practice. Physical therapy actually helps."
Massage and acupuncture are often powerful tools for addressing fatigue. Massage can give people a sense of control over their bodies again and help them experience deeper relaxation and better connection to all their muscle groups. Both massage and acupuncture can help promote blood flow, relaxation, pain relief and better sleep.
Exercise is also important. That might mean starting with simple exercises you do in a chair, then moving on to walking your dog around the block.
"When you exercise, it can improve your aerobic capacity," Fritz said. "After a few days on the couch, our bodies are easily deconditioned, and we may stop using all of our muscle sets. And being more active can also help you eat better."
In addition to recommending exercise and good nutrition, doctors may order lab studies and explore issues related to appetite and sleep. Changes in medications may also help.
Doctors have a range of options for helping patients address fatigue.
"It's very hard for people to manage fatigue. It's one of the most distressing things. Nobody is ready for it," Fritz said. "But we talk about it, we name it, we see how it is affecting your life every day and then we work to see what we can do to make a difference."
Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.