Virtually Exhausted: Doctors, Others Get a Taste of Cancer Patient Fatigue

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Feb. 18, 2000 (Atlanta) -- Making toast, answering the doorbell, even picking up the remote control: These can become near-insurmountable tasks for patients with cancer, many of whom suffer from an obvious, yet often overlooked, side effect: fatigue.

But now some health care workers have been given a taste of what cancer patients go through, thanks to a virtual reality machine called In My Steps. "It's designed to provide physicians and health care workers of all types a feeling of what it's like to be fatigued," says Gregory A. Curt, MD, clinical director at the National Cancer Institute and one of the designers of the machine. "You put on one of these virtual reality helmets ... [are taken] into a home and try to do simple tasks like answering the door, answering the phone. Your feet are in a passive-resistance machine, which makes you feel like you're treading through molasses."

Numerous hospital workers experienced that frustrating feeling last year after Ortho Biotech, one of the makers of In My Steps, took it on a demonstration tour across the U.S. The company is now doing the same thing in Europe. Ortho Biotech's interest in the issue of cancer fatigue is not wholly academic. The company manufactures a synthetic version of erythropoietin, a hormone that stimulates the production of red blood cells -- and which can therefore be used to treat anemia, a leading cause of fatigue in cancer patients.

But anemia isn't the only reason cancer patients get so tired. Curt says depression, stress, trouble sleeping, and using morphine-based painkillers are among the common reasons they can suffer extreme fatigue.

And cancer patients say it is, indeed, extreme. "It's very hard to explain to someone," says 59-year-old Marilyn Sonenshine of Atlanta, who is currently under treatment for lung cancer. "You don't have enough energy to walk across the room. You just feel so wiped out. It's a different sort of fatigue; a helpless feeling."

"Even talking is very tiring," says Robin McIlvain of Marietta, Ga., who was treated last year for breast cancer. "I'm a very social person, and I find even long conversations can tire me out."


And they're not alone. "We're just beginning to realize how common it is," says Terri Ades, RN, MS, director of Health Content at the American Cancer Society's national office in Atlanta. "It's sort of like pain control. For many years patients put up with their pain. And I think patients have put up with their fatigue, as well."

In fact, Curt says fatigue is the No. 1 problem cancer patients complain about -- far ahead of nausea or pain -- and that few discuss the problem with their doctor, in part because they assume nothing can be done about it. But he says there is nearly always a way to lessen the problem.

And it's important to do so, says Russell Portenoy, MD, chairman of the Department of Pain and Palliative Care at the Beth Israel Medical Center in New York. "I don't think there's any question that fatigue can have an impact on how patients physically deal with the disease," he says. Fatigue can lead to secondary problems such as blood clots associated with not moving around much, and it can also have an indirect negative affect on the immune system.

Portenoy now knows about extreme fatigue firsthand, thanks to the virtual reality fatigue machine. He says he spent a "miserable" 10 minutes hooked up to it. "The bottom line -- it was an intense, negative feeling," he says.

Vital Information:

  • Health care workers can now experience severe fatigue, a common complaint among cancer patients, by using a virtual reality device.
  • Common causes of fatigue among patients are anemia, depression, stress, difficulty sleeping, and the use of morphine-based painkillers.
  • Fatigue often goes untreated, in part because patients don't know there are remedies and don't discuss the problem with their physicians.
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