Fatigue Syndrome

Fatigue

Fatigue is one of the most common and troublesome side effects of tumour therapy. Patients suffer even more from the debilitating sense of exhaustion than they do from pain. Yet often, fatigue remains undetected and untreated. Fatigue is defined as an ongoing state of physical and mental exhaustion that does not improve even when patients get enough rest and sleep. Healthy people find it hard to understand this extreme state of exhaustion, so conflicts often ensue. Doctors still underestimate fatigue frequently too.

ICD10-Code: G93.3

 

Causes

There is no single cause for tumour-induced fatigue. Possible causes include:

  • Tumours
  • Side effects of tumour therapy (operation, radiotherapy, chemotherapy, cytokines)
  • Hormone deficiency symptoms (thyroid gland, adrenal gland, sex hormones)
  • Secondary disease and organ damage
  • Psychological factors (anxiety, depression, stress)
  • Sleep disorders
  • Malnutrition
  • Chronic infections
  • Lack of physical exercise (muscle atrophy)

 

However, fatigue is more than just the sum of these symptoms. It is a multi-level condition that can severely impair patients during illness and therapy, and can prevent them from leading a normal life.

Symptoms

The main symptoms of Fatigue Syndrome are tiredness and exhaustion; lethargy and depression are also typical. The physical exhaustion means patients cannot pursue their normal daily activities, while the mental exhaustion means they can barely concentrate or think clearly. On the emotional level, sufferers lack drive and creativity. Additional symptoms can include headaches and dizziness.

Unlike the exhaustion that healthy people experience after strenuous physical, mental or emotional activity, periods of rest or sufficient sleep cannot alleviate the symptoms. Even small, easily handled tasks become too much, so patients limit their work and leisure activities more and more. As a result, Fatigue Syndrome not only has a big impact on sufferers’ quality of life, but also has pronounced social and economic implications.

 

Frequency

Fatigue is one of the most common side effects of tumours. Nearly all cancer patients suffer from Fatigue Syndrome at some point during their therapy, and it can last for weeks or months. For roughly one in four patients, tumour-induced fatigue becomes a long-term problem that persists after therapy is completed.

Therapy

Fatigue Syndrome has multiple causes, and calls for multidisciplinary therapy.

Depending on the cause, the following therapy methods are available:

  • Treatment for anaemia (transfusion or erythropoietin therapy to stimulate red blood cell production)
  • Treatment for hormone disorders (e.g. thyroid gland, adrenal glands) or diabetes induced by cortisone therapy
  • Targeted nutrition therapy in cases of malnutrition
  • Review of undesired side effects from medication (e.g. tiredness from sleeping pills)
  • Physical training programme under medical supervision, ideally from the outset of cancer therapy, to improve patients’ energy levels, general sense of wellbeing and quality of life
  • Psychotherapy
  • Supplementary micronutrients (e.g. L-Carnitine) in cases of deficiencies

Conclusion

For many cancer patients, fatigue is the biggest problem of all. They suffer more from their chronic exhaustion, accompanied by physical and mental lethargy, than from any other side effects of cancer and cancer therapy.

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