Fatigue in cancer refers to a severe state of exhaustion that does not subside even with rest and relaxation measures. More than 75 percent of all cancer patients describe fatigue in cancer as very distressing. The word “fatigue” is derived from French or English and means fatigue, languor, exhaustion.
What is fatigue in cancer?
Fatigue in cancer is a pathological, chronic state of exhaustion and fatigue, which cannot be influenced by recovery measures such as rest or sleep. In addition to the pronounced physical weakness and fatigue, those affected also feel psychologically exhausted or drained. Fatigue in cancer should not be confused with CFS, chronic fatigue syndrome (CSF). An important criterion is the type of cancer. Especially in breast cancer, prostate cancer, leukemia as well as lymphoma, fatigue is frequently observed in cancer. Furthermore, the type of treatment of the cancer also plays a major role. Fatigue in cancer has a negative impact on physical and mental well-being. The quality of life is significantly reduced, which can lead to depression in addition to the ever decreasing performance.
Causes
A specific cause for fatigue in cancer has not yet been determined. However, various factors play a major role in its development. These include the cancer itself and its effect on the body and psyche. Treatments such as chemotherapy, radiotherapy or immunotherapy also put a strain on the human organism, which can lead to fatigue and exhaustion. Undesirable side effects of cancer treatment are often anemia, fever, pain as well as nausea, which can promote fatigue in cancer. Many cancer patients are often malnourished, so that the body is no longer supplied with the necessary nutrients, which in turn can result in a chronic state of exhaustion and thus fatigue in cancer. The cancer itself, as well as the therapies, can have a negative effect on the body’s metabolism. This can result in early onset of menopause or the development of hypothyroidism. These metabolic disorders are known to accelerate the depletion of energy reserves, thus promoting fatigue in cancer. Other diseases that promote fatigue in cancer include the nervous disorders Parkinson’s disease as well as multiple sclerosis.
Symptoms, complaints, and signs
As a rule, fatigue in cancer always has a very negative effect on the quality of life of the affected person and reduces it considerably. The further course and the complaints depend thereby also very strongly on the exact expression and the position of the cancer, so that a general prediction herbei is not possible. First and foremost, fatigue in cancer leads to severe fatigue and exhaustion of the affected person. Patients also show a significantly reduced ability to cope with stress and appear fatigued. They also often do not actively participate in everyday life and always need help in everyday life. Fatigue in cancer can also lead to sleep problems and general weakness in the affected person. Likewise, many patients show a strong listlessness and disturbances in concentration or coordination. The patient’s everyday life is very much restricted by the disease. The disease can also lead to psychological complaints or depression. Many patients also suffer from anemia and may lose consciousness or fall into a coma. However, the severity of the symptoms can vary greatly and is further exacerbated by chemotherapy.
Diagnosis and course
In order to diagnose fatigue in cancer, it is necessary for the affected person to describe his or her symptoms as precisely as possible. Special questionnaires have been developed for this purpose, with the support of which the oncologist as well as the general practitioner can clarify whether fatigue in cancer is present. After the questioning of the symptoms, it is important to find the cause of fatigue in cancer. Various examinations are used here, such as blood tests or ultrasound. With their help it can be clarified whether deficiency symptoms, metabolic diseases or infections are present.Further detailed questioning reveals whether the patient is taking other medications or whether depression is also present, for example. The course of fatigue in cancer is extremely varied, since the intensity of the disease varies from patient to patient and the causes can also be found in a wide variety of areas. As a guideline for fatigue in cancer, it can be assumed that, depending on the type of cancer treatment, fatigue usually begins 3 to 5 days after the start of chemotherapy. The longer the treatment lasts and the more often a chemotherapy cycle is repeated, the higher the risk that the cancer patient will develop fatigue in cancer. It was observed that fatigue in cancer completely disappeared within one to two months during the period of surgery. In chemotherapies, fatigue in cancer prolonged to several months, and in immunotherapies, fatigue in cancer sometimes became so pronounced that sometimes the treatment had to be interrupted.
Complications
Fatigue in many cancer patients is a consequence of treatment with radiation or aggressive chemotherapy. Severe fatigue is itself a complication of cancer treatment. Beyond all the anxiety and pain, the subsequent exhaustion often means a significant reduction in quality of life. Those affected can avoid further complications of their already difficult lives by leading an active life and undergoing accompanying psychotherapy. Typical complications of cancer-related fatigue include social withdrawal, constant headaches, loss of performance or drowsiness. Older cancer patients may additionally experience circulatory problems in the brain, depression or shortness of breath. The possible complications depend on the type, aggressiveness and location of the cancer focus. However, they are also possible due to treatment. For example, some patients may cope better with tumor radiation than with aggressive chemotherapies. These leach out the organism. They transform what was once a good nutrient situation into a dramatic deficiency situation. Fatigue in cancer means constantly working against exhaustion, managing one’s fears of relapse, and maintaining a diet that addresses nutrient deficiencies. With psychosocial support, emotional distress and anxiety can be treated. Tumor-associated fatigue is not itself a depression. However, it can trigger depression. These impair the patient’s resistance. Therefore, tumor-associated fatigue is a complication of many cancers that requires treatment.
When should you see a doctor?
In most cases, fatigue in cancer is already treated directly as part of tumor treatment, so an additional visit to a physician for diagnosis is no longer necessary. However, the disease cannot be completely limited, and the further course of the disease also depends very much on the type of tumor and its spread. A doctor should always be consulted if the patient’s everyday life is severely restricted by fatigue with cancer or if the affected person suffers from pain. Therefore, a visit to the doctor is particularly suitable if the patient suffers from sleep disorders or depression, as a healthy psyche can have a positive effect on the course of cancer. In serious cases, patients with this disease are dependent on a stay in a hospital if the complaints cannot be treated at home or with the help of medication. A visit to the doctor is therefore also advisable if the affected person requires care from a nurse and can no longer cope with everyday life alone. Especially with chemotherapy, the side effects can be very severe and should therefore always be monitored by a doctor.
Treatment and therapy
The treatment of fatigue in cancer must be individually adapted to the patient. The most important criterion here is communication between physician and patient. Only when the physician has as much information as possible can a successful treatment plan be created. Depending on the symptoms, physical exercise in the form of endurance training, physiotherapy, occupational therapy as well as swimming can be considered. Relaxation exercises such as autogenic training, yoga or Qi Gong also have a positive effect on fatigue in cancer. Since there are often problems falling asleep and sleeping through the night, a visit to the sleep laboratory can provide relief.The psyche and its stability play a very important role, so it is useful to conduct behavioral therapy in the company of physical as well as drug therapies.
Prevention
The preventive measures for fatigue in cancer are limited. It is important to seek professional help as soon as the cancer is diagnosed. Light exercise, a healthy diet, and adequate sleep are recommended prophylactic measures. The most important factor is not to conceal the symptoms and complaints and to talk openly about them with the doctor, because due to the individuality of fatigue in cancer, each case is different.
Follow-up
The so-called fatigue in cancer is a common phenomenon. This form of fatigue occurs as a result of radiation or chemotherapy treatments. As part of cancer follow-up care, psychotherapeutic measures and nutritional medicine take on greater importance in addition to regular medical examinations. Chronic fatigue can persist for years after medical treatment has long since ended. The exhaustion that accompanies it places varying degrees of stress on those affected. The better the aftercare for fatigue is geared to the individual, the more promising are the measures taken. In this case, oncological aftercare provided on an outpatient or inpatient basis can include an attempt at fatigue rehabilitation. In all offers, the degree of exhaustion of the treated patients is decisive. Overtaxing of those affected must be avoided. Psychological care is often provided in groups of similarly affected people. In addition, individual discussions are possible. Guidance on individual activity management is provided. A cognitive training program and exercise therapy tailored to individual needs are also part of the aftercare for fatigue after cancer. Relaxation methods or so-called mind-body therapies such as yoga, mindfulness meditation, MBSR or Qi Gong can provide valuable support for fatigue. Nutritional counseling or therapy provides nutrients so that the stressed and exhausted organism can regenerate. If necessary, pharmacological adjunctive therapy can supplement follow-up care.
What you can do yourself
The agonizing exhaustion and constant fatigue of cancer place an enormous burden on everyday life. To best manage the daily routine with fatigue, self-help plays the supporting role. The first and most important step concerns one’s own family. It is difficult for them to empathize with the physical and emotional state of the sick member. A conversation helps to describe one’s own hardships. The result is a much more understanding atmosphere at home. Afterwards, it becomes easier to spare the remaining strength. First and foremost, this means dividing daily tasks into small steps and scheduling short periods of rest. A diet that gives the emaciated body new strength also contributes significantly to relief. This can be achieved with a varied and wholesome diet. A menu that incorporates the preferences of all relatives is helpful. Furthermore, those affected should try to regain their former fitness in order to strengthen their self-esteem. At the beginning, walks are suitable, later light endurance sports such as hiking, cycling or swimming. Alternatives include fitness studios or supervised cancer sports groups. At the same time, these activities revive social contacts with friends. The familiar way of life gradually returns and gives the long-lost boost. Additional relief is provided by contacts with self-help groups. They show further reliable ways of coping with the disease and enable the exchange of experiences with third parties.
