CHEMOTHERAPY RELATED FATIGUE

Chemotherapy Related Fatigue

Chemotherapy Related Fatigue

Introduction

Fatigue is one of the symptoms most frequently reported by cancer patients which impacts patients' quality of life. It is characterized as an overall lack of energy, cognitive impairment, somnolence, mood disturbance, or muscle weakness. These symptoms occur with cancer, and cancer therapy and are not relieved by rest or additional sleep and often interfere with daily activities (Haverkamp et al, 2010, 2239-2245). Cancer related fatigue is more severe and more distressing than fatigue experienced by healthy people, and can persist months or even years after the completion of cancer treatment. Remarkable progress that made in cancer research, and treatment has resulted in longer survival of cancer patients. Therefore, better understanding the etiology, and clinical management of symptoms that affect the quality of life is needed. Results of a multi-centre patient survey revealed that cancer patients identify fatigue as a problem. It affects their daily activities for more of time than either nausea/vomiting or cancer pain. Despite the importance, of this symptom half of patients suffering from fatigue do not report this to their oncologist, and do not discuss strategies of management of this debilitating complaint. Many physicians consider fatigue a “normal condition” among cancer patients, and believe that it is less serious problem for patients than other symptoms like pain (Oldenburg et al, 2010, 52-60). Results of cancer patient survey found that just 14% of patients get treatment or recommendations about the management of their fatigue. These results show that cancer-related fatigue is downplayed, and underestimated symptom. As novel cancer treatments associated with longer patient survival research into the etiology, and clinical management of CRF should receive heightened attention and be consider as a priority for advancing cancer care (Atkinson et al, 2011, 33-44).

Discussion

CRF to Manage Proper Care of Mr. A

Mr. A is 58 yr old gentleman, who has been suffered with primary CNS Lymphoma, and had high dose of cytotoxic Methotrexate chemotherapy, and had side effects of cancer like headaches, generalised pains, fits, confusion and tiredness. His CRF has been under-diagnosed, and under-treated. As this symptom significantly interferes with the person's normal routine, occupational (or academic) functioning, or usual social activities it is very important to identify all cancer patients who experience fatigue like Mr. A. Comprehensive assessment of fatigue is essential for better clinical management of this distressful symptom. Fatigue is subjectively perceived symptom, and can be accurately described by self-reporting, but additional information is also necessary to confirm the correct diagnosis (Velthuis, 2010, 208-221).

In about 50% of cancer patients experiencing fatigue, reversible, and treatable cause of this symptom can be identified (NCCN, 2010). The diagnosis of CRF is achieved when no other treatable contributing factors like hypothyroidism, anemia, sleep disorders, pain, headaches, fits, confusion and, tiredness, climacterium, adverse effects of drugs, electrolyte imbalances, and metabolic disturbances found. To detect these factors, it may be necessary to obtain information by combining anamnestic, physical, laboratory examinations, and discussions with family members of the patient. When all potentially treatable factors are evaluated, or ...