PHILADELPHIAEnergy conservation and activity management training
(ECAM) reduces fatigue levels and helps patients maintain normal activities
despite treatment-related fatigue, Andrea M. Barsevick, RN, DNSc, reported.
Dr. Barsevick is director of nursing research and education at Fox Chase
Cancer Center in Philadelphia.
"Research on interventions for managing fatigue has been limited to
correcting chemotherapy-induced anemia or using aerobic exercise. The
purpose of this randomized study was to compare the efficacy of ECAM vs an
attentional control, which was nutrition education," Dr. Barsevick
said. ECAM was defined as "the deliberate and planned management of one’s
personal energy resources to prevent their depletion." It includes
delegating, setting priorities, pacing oneself, and planning activities at
times of peak energy.
"We found that patients in the ECAM group had lower fatigue
intensity (P = .04) and less disruption of activities (P = .01) than the
control group," Dr. Barsevick told Oncology News International.
Over time these differences narrowed. Most cancer patients eventually
discover ways to conserve their energy, she suggested, but this takes longer
in the absence of a patient education program.
The trial included 397 patients with breast, lung, colorectal, prostate,
gynecologic, testicular cancer, or lymphoma. Patients were receiving at
least 5 to 6 weeks of radiation therapy or at least 3 cycles of
chemotherapy, or combined chemoradiotherapy.
Patients were randomized to ECAM or to control groups and were assessed
at baseline and at two follow-up points of expected high fatigue (week 6 and
10 of radiation or 48 hours after the second and third chemotherapy cycles).
Efficacy was measured with validated measures of fatigue, functional status,
negative mood, sleep disturbance, and other side effects of treatment.