Cancer-related fatigue is not the same as being tired from the activities of daily life. In most cases, everyday, ‘normal’ fatigue – especially and the end of a busy day – doesn?t last long. It often gets better with a good night’s sleep and rest.

In contrast, cancer-related fatigue or CRF, one of the most common side effects of cancer and cancer treatment, can be paralyzing. It often comes on suddenly, is generally unrelated to activity or exertion, and is not relieved by rest or sleep. Furthermore, it may not end – even when cancer treatment has been completed.

Although CRF may be related to both the disease process and treatments, including surgery, chemotherapy, and radiation therapy, the exact reason for cancer-related fatigue remains unknown. And effective treatment options have not yet been developed.[1]

Contributing factors
Factors that may contribute to CRF may include anemia (result from blood counts that are reduced by treatments reducing hemoglobin, and, as a result, the oxygen-carrying ability of blood. Generally 7 out of 10 patients may experience this); a tumor-induced hypermetabolic state in which tumor cells compete for nutrients, with normal cell growth and metabolism, leading to weight loss, decreased appetite, and fatigue; hypothyroidism, in which the thyroid is underactive slowing down metabolism (often the results after radiation therapy to the lymph nodes in the neck); pain (chronic, severe, pain is known to increases fatigue); stress (including stress from dealing with the disease and the unknowns to worrying about daily accomplishments as well as worrying about the inability to meet expectations); depression; insomnia (the inability to sleep 8 hours a night) and decreased nutrition from the side effects of treatments caused by, among others, nausea, vomiting, mucositis (a painful inflammation and ulceration of the mucous membranes in the moth and lining the digestive tract), a change of tastes, heartburn, and diarrhea.

Cancer-related fatigue may also cause, distress.
Patient’s who have experienced cancer-related fatigue often say that it is not the same as the tired feeling they remember having before they were diagnosed with cancer. They often describe it as feeling weak, listless, drained, or ?washed out.?

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Some patients may feel so tired that they are unable to to eat, walk to the bathroom, or even use the TV remote. And generally, the feeling, does not make it go away with rest or sleep.

Patient-engagement survey
For healthy people it can be hard to understand that just a little activity can be exhausting or even cause more distress than pain, nausea, vomiting, or depression. To understand the effects of fatigue and how this may influence a patinet’s selection and continuation of cancer treatment, Belong.Life, the world?s fastest-growing and largest cancer patient and caregiver social network, has released results of its patient-engagement survey on how fatigue

Founded in 2015, is a free patient navigation app that gives voice to cancer patients and their support network to explore and better manage their treatment journey and improve quality of life. Using a proprietary big data platform and machine learning technology the patient and caregiver social network enables people to connect, receive and share clinical information anonymously as well as privately discuss important issues related to cancer and cancer treatment. Belong has partnered with the American Cancer Society, Colorectal Cancer Canada and others organizations.

Survey results
The results indicate that while physical fatigue is a matter of concern to most respondents, 10% cite fatigue as a direct cause stopping, delaying or changing treatment. In addition, 58% see their cancer-related fatigue a key source of anxiety.

?Fatigue is the most cited cancer-related symptom that cascades into the emotional and therapeutic decisions that can impact adherence and outcomes. This Belong community survey highlights how patients are navigating and coping with these challenges,? said Eliran Malki, Co-founder and CEO of Belong.

?Data point to the importance of going beyond traditional support methods to proactively advise patients of what to expect throughout their treatment, providing direct physician connection and including emotional navigation into the treatment in order to improve the patient journey,? Malki added.

The 500+ survey respondents included 86% cancer patients and 14% caregivers of cancer patients.

Sixty-seven percent of the participants said that they were currently in treatment or receiving maintenance treatment while in remission. The respondents also shared that fifty-eight percent said that they experience anxiety due to fatigue, 44% struggled with depression due to fatigue, while 46% said that they worry due to fatigue and 36% feel anger anger result from fatigue

In addition, 10% of all respondents said they had stopped, delayed or changed treatment due to fatigue. One respondent explained that they ?couldn?t make it physically to another appointment,? while another stated they were ?too tired to go.?

?These survey data demonstrate that the confidence that the healthcare team feel in the therapeutic approach needs to always consider the patient?s physical journey during the course of care,? explained Daniel A. Vorobiof, MD, past Medical Oncology Director of The Sandton Oncology Centre in Johannesburg, South Africa.

?Information must be part of the care, and that knowledge will translate into an inspired and aware patient who sees fatigue as a point-in-time and not part of the cycle of endless despair,? Vorobiof added.

Common concern
Regardless of cancer type, fatigue is a common and concerning symptom for cancer patients, and the Belong Patient Concerns survey found that 65% of participants deal with fatigue daily, and another 17% deal with fatigue every week.

The survey also highlights how lifestyle changes help many patients alleviate fatigue, even more than medication. Outside of recommended rest and sleep, respondents approach to dealing with their fatigue varied.

Thirty-two percent of the participants noted that nutrition played a role in helping alleviate their fatigue, while thirty-one percent of participating patients said that exercise helped them. Furthermore, 13% said to turn to medication, while 11% noted that having a community is helpful.

Survey findings also show that 44% of participants felt that the Belong app connecting physicians, community, and providing information and helpful tools, was instrumental in dealing with their fatigue.

On of the patient-participants noted that it is “helpful knowing that others are going through the same thing, so you don?t think your doctor is just telling you what he thinks you want to hear.”

Last Editorial Review: May 9, 2018

Featured Image: Cancer Related Fatigue Courtesy: ? 2010 – 2018 Fotolia. Used with permission.

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