Treatment of Cancer-Related Fatigue

Introduction:

Cancer-related fatigue is commonly found in patients during and after cancer treatment. Though not lethal, the quality of life is affected to a greater extent. Treatment of cancer fatigue depends on treating the related cause. Common side effects of cancer treatments include hair loss, nausea, vomiting, blood clots, pain, and fatigue. Various cancer treatments, which include radiation therapy, chemotherapy, hormone therapy, and bone marrow transplantation, cause fatigue. Certain types of cancer themselves cause fatigue. Patients with fatigue usually describe it as tired, worn out, slow, weak, and lacking the energy to get up and do their work.

What Is the Difference Between Weakness and Fatigue?

Weakness is when the body's strength is decreased, and effort is needed to move certain body parts, whereas fatigue is an extreme feeling of lack of energy or tiredness. Often, the patient feels exhausted. The fatigue that comes with cancer is called cancer-related fatigue.

What Is the Difference Between Cancer-Related Fatigue and Fatigue Felt by Healthy People?

Fatigue in healthy people can be relieved by resting or after a good sleep, whereas cancer-related fatigue remains the same even after a good sleep. They usually get tired even after doing little to no work. It interferes with daily activities and will last for a long time.

What Are the Causes of Cancer-Related Fatigue?

The following are the causes of cancer-related fatigue.

• Anemia - Anemia affects a patient's quality of life and is the common cause of cancer-related fatigue. Certain types of chemotherapy stop producing new red blood cells, causing anemia.

• Anxiety and Depression- The effect of cancer on emotional, physical, and social well-being can lead to anxiety and depression.

• Sleeplessness - Due to the pain and stress during the treatment, sleep disturbances can be common. Poor sleep often causes fatigue.

• Medications - Patients with other diseases apart from cancer tend to take medications for the same, which can worsen fatigue.

• Stress - Emotional stress is common because of cancer and the body's inability to manage the effects of cancer therapies.

• Troubled Breathing - Certain cancerous tumors can block the airways, making breathing difficult. Depending on the patient's clinical condition, it can be normal, mild, or severe.

• Dehydration - As the patient is subjected to more radiation, there is a high possibility of the patient getting dehydrated.

• Loss Of Weight - Fatigue can occur along with decreasing weight when the body cannot take in enough food for its energy.

How Does Cancer Treatment Cause Fatigue?

• Fatigue Related to Surgery - Fatigue is a common side effect after surgery; patients improve with time. However, fatigue can worsen when surgery is combined with other cancer therapies.

• Fatigue Caused Due to Chemotherapy - Fatigue is experienced by patients soon after chemotherapy, reaches a maximum in the mid-period, and decreases over time until the next chemo session. After that, fatigue increases due to pain, anxiety, anemia, and lack of sleep.

• Fatigue Caused by Radiation Therapy - Fatigue after radiation therapy keeps increasing until the therapy is completed. Some patients may also experience fatigue for several months or years after the radiation therapy ends.

• Fatigue Caused by Hormone Therapy - Breast cancer is usually treated with hormone therapy. Fatigue is higher in patients under 55, overweight, or having trouble sleeping.

• Fatigue Caused Due to Immuno-Therapy - There are various types of immunotherapies used. Therefore, fatigue depends on the type of therapy.

What Is the Diagnosis of Cancer-Related Fatigue?

1. Physical Examination - Evaluation of troubled breathing, loss of muscle strength, abnormal posture, and changes in walking are made.

2. Proper Medical History - The patient is asked about all the changes after and during the cancer treatments. The levels and duration of certain findings, like pain and fatigue, are noted and evaluated further.

3. Laboratory Investigations - Blood tests to detect anemia are done. Blood tests are also carried out to check for vitamin B12 and iron levels. The most common blood tests are:

• Complete Blood Count - This blood test shows the number of blood cells and the amount of hemoglobin in the blood.

• Peripheral Blood Smear - This evaluates the presence of any abnormal changes in the blood cells.

How Can Cancer-Related Fatigue Be Treated?

Treatment of fatigue is often done by treating the related causes of the condition.

• Treatment of Pain - Pain can cause fatigue, for which pain medication is prescribed. When the pain still does not subside, the dosage of the medication is changed.

• Treatment of Anemia - After detecting anemia by blood tests, supportive treatment to treat anemia is initiated.

• Diet Modifications - Food rich in iron and vitamins is advised.

• Blood Transfusions - The final and permanent treatment modality for anemia is transfusions.

• Medications - Certain medications that produce red blood cells can be used in chemotherapy patients. Considering the risks, only a few patients are advised to use these medications.

• Treatment of Depression - Fatigue in patients with depression is treated with antidepressant drugs.

• Dietary Supplements to Aid in Treating Cancer Fatigue - Studies show that consuming ginger roots and certain foods as prescribed can help in managing fatigue. However, it can also be a placebo effect (a treatment with no therapeutic value but often aids in getting positive outcomes).

• Exercises to Combat the Effects After Cancer Therapy - Exercise helps patients feel better and have more energy during and after treatment. Cancer survivors who took part in physical activity had less fatigue. Mind and body exercises, including yoga, help the patient feel less fatigued.

How to Manage Cancer-Related Fatigue?

Cancer-related fatigue can hinder many daily activities, including performance at the workplace and the inability to perform daily personal activities. They can be managed by informing them of the medical condition at the patient’s workplace, as less work might be allocated to them, which will help them manage the fatigue.

Overview of Cancer-Related Fatigue:

Cancer-related fatigue is a common and bad side effect of cancer and cancer-related management. This condition worsens because of a lack of rest and sleep. Fatigue due to cancer or cancer- treatment can last for months or years. People with this issue can feel tired, weak, and lack energy. Due to all these symptoms, people will feel depressed and helpless. Most of all, people receiving cancer treatment such as surgery, chemotherapy, radiation therapy, or immunotherapy will end up facing CRF. But fatigue caused by cancer treatment can be managed.

Conclusion:

Various reasons cause cancer-related fatigue. Continuous medication, nutritional maintenance, and exercise are included in the lifestyle of patients with cancer-related fatigue. Even minute changes should be made known to the doctor to get positive treatment outcomes. When the weakness exceeds the normal level, an oncologist is consulted to make the necessary changes to combat cancer-related fatigue.