Cancer-related fatigue: a practical review

Abstract

Fatigue is an exceedingly common often treatable problem in cancer patients that profoundly affects all aspects of quality of life. Prevalence estimates have ranged from 50% to 90% of cancer patients overall. After addressing reversible or treatable contributing factors, such as hypothyroidism, anemia, sleep disturbance, pain, emotional distress, climacterium, medication adverse events, metabolic disturbances, or organ dysfunction such as heart failure, myopathy, and pulmonary fibrosis, patients may be screened with a brief fatigue self-assessment tool. All cancer patients should be screened regularly for fatigue. Those with moderate or severe fatigue may benefit from both pharmacologic and nonpharmacologic interventions, while mild fatigue that does not interfere with quality of life can be treated with nonpharmacologic measures alone. Physicians often have insufficient knowledge about fatigue and its treatments or underestimate the impact of fatigue on quality of life, while patients may consider it an unavoidable and untreatable side-effect and fear that reporting it may incite a change toward less aggressive cancer treatment. A practical review may therefore be useful to health care professionals in order to avoid the common barriers to its treatment that exist on the sides of both physicians and patients.

Use of Blood Transfusion at the End of Life: Does it Have Any Effects on Survival of Cancer Patients?

“…Anemia is one of the main reversible causes of fatigue (Campos et al, 2011). It has been shown that an Hb level >12 g/ dl improves fatigue and quality of life, and even in mild anemia (Hb level between 10-12 g/dl) there is a marked increase in fatigue (Cella, 1997).…”

Avaliação da qualidade de sono em pacientes com câncer de mama em quimioterapia

“…Como os valores do IGI apresentaram níveis elevados na população que apresenta má qualidade de sono, é perceptível a existência do efeito deletério da quimioterapia sobre o sono, muito por causa de alguns agentes quimioterapêuticos induzirem dores e formarem uma relação com a insônia 15 . Embora possa estar ligada também a outros fatores, como possíveis reações a diferentes mecanismos -como efeitos psicológicos ou uma resposta imune 16 -, é possível sugerir que a relação de insônia e o nível de PSQI-Br está associada a fatores secundários como dores, náuseas e a necessidade de ir ao banheiro durante a noite.…”

Fee-for-Service Cancer Rehabilitation Programs Improve Health-Related Quality of Life

“…Fatigue can persist for years after treatment 36 , but can be improved by exercise training 3 . Our finding could either indicate reduced levels of fatigue at follow-up or the possibility that some participants learned to overcome the perception of fatigue as a barrier to exercise.…”

“…Cancer treatment is associated with negative physical side effects, including increased fatigue and pain, diminished cardiorespiratory fitness and strength, and negative psychological side effects, including diminished quality of life, anxiety, and depression [1][2][3][4][5] . Many of those side effects can be long-term and can affect health-related quality of life (hrqol) 6 , a concept that encompasses subjective perceptions of both physical and emotional symptoms and side effects of treatment 7 .…”