NEW YORKThe persistence of fatigue for up to a year after cancer
treatment is a common and debilitating occurrence. Participants in a Cancer
Care, Inc. teleconference were given information on the causes of
cancer-related fatigue and strategies for coping with it.
Denise Reinke, an oncology nurse practitioner from Dearborn, Michigan, urged
patients not to accept fatigue as inevitable, but to communicate with their
doctors and other members of the treatment team in an effort to resolve this
important quality-of-life issue.
"Between 78% and 99% of patients will experience fatigue in varying
degrees at some point in their treatment," Ms. Reinke said.
She added that this fatigue is different in character and intensity from
normal fatigue that results from hard physical or mental effort.
"Cancer-related fatigue is overwhelming and is out of proportion to the
activity that precedes it," she said. Merely bathing or getting dressed
can be so exhausting that patients report needing to go back to bed rather than
proceeding with daily activities.
Forgetfulness, an inability to concentrate, and difficulty with problem
solving are also characteristics of this type of fatigue. These signs of mental
fatigue are not relieved by rest, Ms. Reinke said.
She explained that there is no clear understanding of the mechanism behind
cancer-related fatigue. It is thought that it might be caused by the disease
itself, though that does not explain why treatment often exacerbates the
symptom rather than relieving it.
She pointed out that different treatment modalities produce different
patterns of fatigue. Patients receiving chemotherapy tend to feel the most
intense fatigue for 7 to 10 days post-treatment. The result is that they
frequently begin to feel better just before beginning their next treatment
cycle only to be felled by another cycle of exhaustion.