Chronic fatigue syndrome in cancer patients. Diagnostic and treatment options.

Czech version

Authors: F. Jedlička ¹; L. Elbl ¹; I. Vášová ²; I. Tomášková ¹; J. Vorlíček ²; J. Špinar ¹
Authors‘ workplace: Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC ¹; Interní hematoonkologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jiří Vorlíček, CSc. ²
Published in: Vnitř Lék 2007; 53(9): 979-985
Category: Reviews

Overview

Fatigue is the most frequent symptom accompanying a cancer disease and its treatment according to the visual analogue scale. Fatigue is reported by as many as 100 % of patients in the course of cancer treatment and still by 40 to 70 % of patients one year after the treatment has finished. This symptom has become known under the designation of „cancer-related fatigue“ in the English language literature on the subject. The knowledge of the causes and mechanisms of fatigue is relatively limited. Based on practical guidelines, an algorithm has been used to detect, evaluate and influence by treatment the syndrome of fatigue caused by a cancer disease. Research in the field has been focused on both pharmacological and non-pharmacological approach. The highest efficiency in the treatment of fatigue syndrome has been recorded for the treatment of anaemia with erythropoietin, while aerobic exercise programmes have proven to be most efficient among the behavioural measures. In spite of a dramatically growing interest in the above problem in the past decade, a number of issues continue unresolved with respect to chronic fatigue syndrome related to a cancer disease or to its treatment. Based on their own experience and on the relevant literature, the authors deal with issues of chronic fatigue syndrome and the options for its diagnosing and treatment in patients undergoing cancer treatment.

Key words:
chronic fatigue syndrome – cancer disease – aerobic exercise

Sources

1. Mock V. Fatigue management. Cancer 2001; 92: 1699-1707.

2. Ahlberg K, Ekmar T, Gaston-Johansson F et al. Assessment and management of cancer-related fatigue in adults. The Lancet 2003; 362: 640-650.

3. Stricker CT, Drake D, Hoyer K-A et al. Evidence-based practice for fatigue management in adults with cancer: exercise as an intervention. Oncol Nurs Forum 2004; 31: 963-976.

4. Mock V, Atkinson A, Barsevick A et al. Panel. NCCN practice guidelines for cancer-related fatigue. Version 1.2003. J Natl Comp Cancer Network 2003; 1: 308-331.

5. Mock V, Olsen M. Current management of fatigue and anemia in patients with cancer. Semin Oncol Nursing 2003; 19: 36-41.

6. Wagner L, Cella D. Fatigue and cancer: causes, prevalence and treatment approaches. Br J Cancer 2004; 91: 822-828.

7. Lawrence DP, Kupelnick B, Miller K et al. Evidence report on the occurence, assesment, and treatment of fatigue in cancer patients. J Natl Cancer Inst Monogr 2004; 32: 40-50.

8. Kurzrock R. The role of cytokines in cancer-related fatigue. Cancer 2001; 92: 1684-1988.

9. Brach P, Siebeneck B, Buderer NF. Relationship between fatigue and nutritional status in patients receiving radiation therapy to treat lung cancer. Oncol Nurs Forum 2001; 28: 1027-1031.

10. Bruera E, Brenneis C, Michaud M et al. Association between asthenia and nutritional status, lean body mass, anemia, psychological status, and tumor mass in patients with advanced breast cancer. J Pain Symptom Manager 1989; 4: 59-63.

11. Geinitz H, Zimmermann FB, Stoll P et al. Fatigue, serum cytokine levels and blood cell counts during radiotherapy of patients with breast cancer. Int J Radiat Oncol Biol 2001; 51: 691-698.

12. Dean GE, Spears L, Ferrel BR et al. Fatigue in patients with cancer receiving interferon alfa. Cancer Pract 1995; 3: 164-172.

13. Jones T, Walter S, Hupart K Endocrine-mediated mechanisms of fatigue during treatment with interferon-alfa. Semin Oncol 2001; 28: 54-59.

14. Redeker NS, Lev EL, Ruggiero J. Insomnia, fatigue, anxiety, depression, and quality of life of cancer patients undergoing chemotherapy. Sch Inq Nurs Pract 2000; 14: 275-290.

15. Loge JH, Abrahamsen AF, Ekeberg O et al. Fatigue and psychiatric morbidity among Hodgkin’s disease survivors. J Pain Symptom Manage 2000; 19: 91-99.

16. Wu HS, McSweeney N. Assessing Fatigue in Persons with Cancer. Cancer 2004; 101: 1685-1695.

17. Mendoza TR, Wang XS, Cleeland CS et al. The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer 1999; 85: 1186-1196.

18. Aaronson NK, Ahmedzai S, Bergman B et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85: 365-376.

19. Piper BF, Dibble SL, Dodd MJ et al. The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 1998; 25: 677-684.

20. Yellen SB, Cella DF, Webster K et al. Measuring fatigue and other anemia-related symptoms with the functional assessment of cancer therapy (FACT) measurement system. J Pain Symptom Manage 1997; 13: 63-74.

21. Schwartz AL. The Schwartz Cancer Fatigue Scale: testing reliabilty and validity. Oncol Nurs Forum 1998; 83: 711-717.

22. Smets EM, Garssen B, Bonke B et al. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 1995; 39: 315-325.

23. Glaus A Assessment of fatigue in cancer and non-cancer patients and healthy individuals. Support Care Cancer 1993; 1: 305-315.

24. Okun A, Stein RE, Bauman LJ et al. Content validity of the Psychiatric Symptom index, CES-Depression Scake, and State-Trait Anxiety Inventory from the perspective of DSM-IV. Psychol Rep 1996; 73: 1059-1069.

25. Lupínek P. Spiroergometrie. In: Chaloupka V, Elbl L et al. Zátěžové metody v kardiologii. Praha: Grada Publishing 2003: 62-88.

26. Weismann IM, Zeballos RJ. Clinical Exercise Testing. Basel: Kaerger 2002.

27. Randy WB. Role of exercise in rehabilitation of cancer survivors. Pediatr Blood Cancer 2005; 44: 595-599.

28. Mock V. Evidence-based treatment for cancer-related fatigue. J Natl Cancer Inst Monogr 2004; 32: 112-118.

29. Dimeo FC, Timan MHM, Bertz H et al. Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation. Cancer 1997; 79: 1717-1722.

30. Watson T, Mock V. Exercise as an intervention for cancer-related fatigue. Phys Ther 2004; 84: 736-743.

31. Braith RW. Role of exercise in rehabilitation of cancer survivors. Pediatr Blood Cancer 2005; 44: 595-599.

32. American College of Sports Medicine. ACSM’s Exercise Management for Persons With Chronic Diseases and Diasabilities. Champaign, III: Human kinetics, 2002

33. Mock V, Dow KH, Meares CJ et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 1997; 24: 991-1000.

34. Mock V, Pickett M, Ropka ME et al. Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 2001; 9: 119-127.

35. Schwartz AL, Mori M, Gao R et al. Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med Sci Sports Exerc 2001; 33: 718-723.

36. Segal RJ, Reid RD, Courneya KS et al. Resistance exercise in men receiving androgen therapy for prostate cancer. J Clin Oncol 2003; 21: 1653-1659.

37. Adamsen L, Midtgaard J, Roeth M et al. Transforming the nature of fatigue through exercise: qualitative findings from a multidimensional exercise programme in cancer patients undergoing chemotherapy. Eur J Cancer Care 2004; 13: 362-371.

38. Chicco AJ, Schneider CM, Hayward R. Exercise training attenuates acute doxorubicin-induced cardiac dysfunction. J Cardiovasc Phramacol 2006; 47: 182-189.

39. Chicco AJ, Hydock DS, Schneider CM et al. Low-intensity exercise training during doxorubicin treatment protects against cardiotoxicity. J Appl Physiol 2006; 100: 519-527.

40. Littlewood TJ, Bajetta E, Nortier JW et al. Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinium chemotherapy: results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 2001; 19: 2865-2874.

41. Sandstrom R, Gelin J, Lundholm K The effect of indomethacin on food and water intake, motor activity and survival in tumour-bearing rats. Eur J Cancer 1990; 26: 811-814.

42. Lundholm K, Gelin J, Hyltander A et al. Anti-inflamatory treatment may prolong survival in undernourished patients with metastatic solid tumours. Cancer Res 1994; 1: 5602-5606.

43. Breitbart W, Rosenfeld B, Kaim M et al. A randomized, double-blind placebo-controlled trial of psychostimulants for the treatment of fatigue in ambulatory patients with human immunodeficiency virus disease. Arch Intern Med 2001; 12: 411-420.

44. Bruera E, Macmillian K, Hanson J et al. A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer. Cancer 1995; 66: 1279-1282.

45. Given CW, Given B, Azzouz F et al. Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. J Pain Symptom Manage 2001; 21: 456-466.

46. Given B, Given CW, McCorkle R et al. Pain and fatigue management: results of a nursing randomized trial. Oncol Nurs Forum 2002; 29: 949-956.

47. Elbl L, Vasova I, Tomaskova I et al. The role of cardiopulmonary exercise testing in the evaluation of functional capacity after treatment of lymphomas in adults. Eur J Echocardiography 2006; 7(Suppl): S169.

48. Elbl L, Vasova I, Tomaskova I et al. Cardiopulmonary exercise testing in the evaluation of functional capacity after treatment of lymphomas in adults. Leuk Lymphoma 2006; 47: 843-851.

49. Chaloupka V, Elbl L et al. Zátěžové metody v kardiologii. Praha : Grada Publishing 2003.