NEW YORK--Fatigue is too often a part of life for cancer patients and can erode their quality of life. "We need to talk to cancer patients about their energy level and ability to cope, and educate them about how to deal with the treatment and the disease itself," said Lois Almadrones, RN, MPA, OCN, clinical research associate, Memorial Sloan-Kettering Cancer Center.
Ask patients to do their own fatigue assessment by keeping a log for a few days or a week to determine when they feel the most and least fatigued. This could lead to an educational intervention, Ms. Almadrones said at a symposium on fatigue presented by Cancer Care, Inc.
Patients on a 3-week cycle of chemotherapy, for example, are likely to feel most fatigued 7 to 11 days after administration, she said, while patients on radiation therapy will feel most tired toward the end of therapy. "We need to tell them that that is when they need to schedule in more rest periods," she said.
A symptom assessment should also be done, in addition to blood work, she said. Questions to ask include: Are you having diarrhea? Do you have difficulty concentrating, reading, or watching TV? Do you have tingling and numbness in your hands and feet? Chest pains? Pains in the arms or shoulders? Rapid heart beat?
A special sleep assessment may also be necessary. Ask patients what wakes them up at night, Ms. Almadrones said, and suggest that they not think about things that bother them right before going to sleep. If pain is waking them up, a long-acting pain medication that could provide even an hour's more rest would be of benefit, she said. If nausea, vomiting, or diarrhea is awakening them, taking medication before retiring could help.
Since patients often continue to work, they need to think about when they are best able to concentrate. "Sometimes they say, I'm only good for 2 hours in the morning," Ms. Almadrones said. "So all the things that take the most concentration should be done in the morning."
Patients should also be advised to eat healthy, high-caloric food that goes down easily and does not require a lot of chewing. They should be discouraged from using alcohol(Drug information on alcohol), cigarettes, or caffeine(Drug information on caffeine) to cope with their anxiety or stress, and counseled instead to learn relaxation techniques or to join support groups.