Exercise may also help patients with advanced cancer, even those in hospice care. More benefit may result when family members are involved with the patient in the physical therapy program.
Mind and body exercises such as qigong, tai chi, and yoga may also help relieve fatigue. These exercises combine activities like movement, stretching, balance, and controlled breathing with mental exercise such as meditation.
Cognitive Behavior Therapy
Cognitive behavior therapy (CBT) is a method used by therapists to treat a variety of psychologicaldisorders. CBT aims to change a patient's awareness (the cognitive) in order to change the way he acts (the behavior). CBT sessions may be helpful in decreasing a patient's fatigue following cancer treatment by focusing on factors such as:
- Stress from coping with the experience of having cancer.
- Fear that the cancer may come back.
- Abnormal attitudes about fatigue.
- Irregular sleep or activity patterns.
- Lack of social support.
Activity and rest
Any changes in daily routine require the body to use more energy. People with cancer should set priorities and keep a reasonable schedule. Health professionals can help patients by providing information about support services to help with daily activities and responsibilities. An activity and rest program can be developed with a health care professional to make the most of a patient's energy. Practicing sleep habits such as not lying down at times other than for sleep, taking short naps no longer than one hour, and limiting distracting noise (TV, radio) during sleep may improve sleep and allow more activity during the day.
Treating chronic fatigue in patients with cancer means accepting the condition and learning how to cope with it. People with cancer may find that fatigue becomes a chronic disability. Although fatigue is frequently an expected, temporary side effect of treatment, other factors may cause it to continue. Learning the facts about cancer-related fatigue may help patients cope with it better and improve their quality of life. For example, some patients in active treatment worry that fatigue is a sign that the treatment is not working. They may feel that reporting fatigue is complaining. Anxiety over this can make fatigue even worse. Knowing that fatigue is a normal side effect that should be reported and treated may make it easier to manage.
Since fatigue is the most common symptom in people receiving outpatientchemotherapy, patients should learn ways to manage the fatigue. Patients should be taught the following:
- The difference between fatigue and depression
- Possible medical causes of fatigue (not enough fluids, electrolyte imbalance, breathing problems, anemia)
- To observe their rest and activity patterns during the day and over time
- To engage in attention-restoring activities (walking, gardening, bird-watching)
- To recognize fatigue that is a side effect of certain therapies
- To participate in exercise programs that are realistic
- To identify activities which cause fatigue and develop ways to avoid or modify those activities
- To identify environmental or activity changes that may help decrease fatigue
- The importance of eating enough food and drinking enough fluids
- Physical therapy may help with nerve or muscle weakness
- Respiratory therapy may help with breathing problems
- To schedule important daily activities during times of less fatigue, and cancel unimportant activities that cause stress
- To avoid or change a situation that causes stress
- To observe whether treatments being used to help fatigue are working
Current Clinical Trials
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about fatigue and anemia that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.