Cancer-Related Fatigue - Physiological Background and Methods of Deliverance - Term Paper Example

Cancer-related Fatigue Introduction After cancer treatment, some patients develop a type of fatigue associated with the treatments. The symptoms adding up to the fatigue include feeling exhausted, tired, or generally weak. Health practitioners point at the fatigue as resulting from the treatment of cancer, although no one definite explanation has been offered towards the occurrence. There may be several causes of the fatigue, such as the type of cancer that one suffered from, the type of treatment they receive, resulting anaemia, pain, emotions, or hormonal changes which may be inflicted during the aftermath of the cancer amongst many other factors. The fatigue after cancer treatment is normal, but it is recommended that if it persists, then one should consult their physicians for assistance lest it develops into a more complex condition. This resulting fatigue can be a problem in itself, and as such, requires to be managed. To evaluate on the potential evaluations which can save the situation, this study text will analyse the case of one John, who is a patient recovering from cancer and is experiencing fatigue from the chemotherapy. He feels that his life has been limited by the fatigue and requests a mediation strategy to help him out of the situation. The study highlights the causal factors of fatigue, an intervention approach to curb his current fatigue, and finally an approach to prevent him from experiencing fatigue during the rest of his chemotherapy treatment. This study text is based on a cancer patient, John, who is a recuperating cancer patient. He has undergone surgery and included in his after-treatment is chemotherapy. He has undergone four chemotherapy sessions while in hospital but the fifth he receives from an outpatient clinic. The chemotherapy is having side effects on him, and especially fatigue which comes with cancer treatment. He complains of excessive tiredness, has reduced his working time, and still feels tired after resting for long hours. Additionally, he has maintained his pre-treatment diet, and says exercising at the gym is not necessary since he has been participating in some projects which keep him busy such as helping in local charities and looking after his grandchildren. He therefore requests information as to how he can deal with his current fatigue, and the extra fatigue expected as he continues with his chemotherapy Cancer-related Fatigue Fatigue resulting from cancer and chemotherapy is similar to the common fatigue. It is simply lack of energy which adds up as tiredness and weakness. A person with fatigue feels that their normal pace of doing things has been slowed down since they get exhausted fast, or feel that their body is “unwilling” to execute duties normally. The difference between cancer fatigue and the normal fatigue is that with the cancer fatigue, it does not go away after the patient has rested. Rather, it proceeds for weeks, months and even years and as such, can be a tormenting experience (Kuebler et al, 2007). Normally, a cancer patient recovers from this fatigue in about half a year to one year, but in the event that it persists way longer than that, then additional medical intervention becomes necessary. Further adverse effects of cancer fatigue according to Yarbro, Wujcik, & Gobel (2011) are that during the time it exists, it affects the spiritual, physical, emotional, and mental aspects of the victim meaning the person’s normal way of life can be halted. For instance, fatigued people may feel they are underperformers thus shun off from others into solitude. On the other hand, fatigued persons may have to cut down on their working hours, thus earn less than they usually did. Spiritually, the fatigue may remind one of the cancers they are fighting, and this may turn into fear that their cancer is getting worse. Concisely, this type of cancer haunts one out of their normal life. Fatigue Assessment The statistics about the occurrence of cancer fatigue in all cancer treatments are alarming. This is so because about 70 to 90 percent of all treated patients experience this type of fatigue. In a simplified form, it means that of every 10 patients treated for cancer; about 7 to 9 of them experience the fatigue (McNeely & Courneya, 2010). It is therefore an inevitable occurrence which must be acted upon so that people like John can recover comfortably from their cancers and resuscitate their normal lives. In as much as recovering from cancer is like a miracle, patients claim that the resulting fatigue is one of the most disruptive side effects that come with the aftermath. Furthering the desperation of the suffering is the fact that only one person out of every five believe that some mitigation into the problem is possible. There are several known causes of cancer fatigue. One of them is that the type of cancer that one suffered from interfered with their body systems. Some cancers release cytokines, which are fatigue-causing proteins (Fawcett & McQueen, 2011). Some cancers will damage organs such as the kidney and lungs resulting in the fatigue. There exist several methods of assessing cancer-related fatigue. The best method of assessing cancer-related fatigue in John would be asking him to explain what he feels is “excessive” or abnormal tiredness from what he felt before the diagnosis (Jean-Pierre et al, 2007). This is chiefly so because it is the only way to devise the best method of deciding upon the intervention approach. For John to be provided with the best intervention methods to help with his cancer-related fatigue there needs to be an assessment tool to determine what he is going through, and to what extent they are affecting him. According to the National Cancer Nursing Education (EdCan), there is no one sufficient method which can sufficiently provide an effective assessment. However, there are three collective assessment factors which are used; the effect of the fatigue on the cognitive, psychomotor, and affective skills. These three factors are assessed using direct observation, self evaluations, and examinations. John’s case would be assessed using the Piper Fatigue Scale. This instrument uses amongst others the intensity of fatigue, nature of symptoms, and the level of diversion from normal life activities. The patient is assessed by use of a questionnaire which has queries regarding their experience with the emerging symptoms. Their answers are rated 0 to 10 and depending on what rating the patient scores on individual questions; the intervention methods can be devised (Piper, et. al, 2008). Behavior-oriented Intervention Approach for managing Current Fatigue Cancer-related fatigue will occur as early as after the diagnosis and last even past several treatments. It is therefore important that there exist several means of intervention and especially immediately after the diagnosis, and during the treatment period. In John’s case, his fatigue occurred after his diagnosis, and after a few chemotherapy sessions. At this stage, his fatigue presents symptoms such as being overly tired, not getting enough rest even after spending 9 hours in bed, he is unable to work his full hours, he feels that the gym is not necessary, and focuses on other projects just so he escapes the reality of the cancer and treatments he is receiving. The best intervention method for his case would be a behaviorally-oriented one (Armes et al, 2007). The reason for this being that much of his fatigue can be taken care of if he alters some patterns of the way he is currently living. First of all, his idea of keeping up with work, some projects, and helping with the kids is a commendable one since it adheres to the rule that one should try to stay as active as they can regardless of the fatigue’s downplay (Cancer Org, 2014). By remaining active, he is assured of his body not conforming to the weakness or tiredness which is bound to emerge from his treatments. However, he should take to activities which are less stressing such as work or baby keeping. In short, he should avoid the tasks which require of him to strain his brain. This would help ease his feeling of fatigue channeled from his mental aspect. The other behavior he should alter is taking to activities just so he can take his focus off the cancer treatments. While this may seem like a clever way of taking the load off his mind, it is not commendable since it may add up to stress and eventually depression as he seeks to avoid the issue. Instead, he should take up activities which he enjoys doing with the intent of remaining active, but not running away from the problem. In so doing, he will ease the psychological trauma which may be forcing him to seek ways out of his problem (Brown & Kroenke, 2009). The other important factor he should look into is to improve his diet. Concisely, his diet should not be similar to what it was before the diagnosis. The reason for this being that the chemotherapy (and other treatments) alters his body balance of cells, such as the destruction of blood cells alongside cancer cells (Turkington & Edelson, 2005). As such, he needs a diet which will be effective in restoring his lost cells. Additionally, it may be that his type of cancer has affected blood production or blood levels in his body and as such, he needs to alter his diet so that it compensates for the depleted necessities in his body (Rock et al, 2012). Finally, John can ease his fatigue by taking time on his own and “listening” to himself. In as much as he continues to get outpatient cancer care, he should maintain a close relationship with his physician (Wu & McSweeney, 2007). This is important because he would be able to tell any different sensations which may inhibit his body, such as increased fatigue or additional symptoms not diagnosed before. This means that he should offer himself more time, concentrate more on his health, and be keen in monitoring his progress with treatment. If he notes both improvement and/or deterioration, it would be much easier to direct his treatment in the right way. Pharmacological Intervention Approach to Prevent Future Fatigue As John advances with his treatment and recovery from his cancer, more symptoms of fatigue may emerge, and which may complicate the current fatigue he is experiencing. As such, it would be important to devise an intervention strategy which would save him the torture caused by later cancer treatment. This approach is largely pharmacological, that is, uses more pharmaceutical substances such as drugs. This recommendation is based on studies which have proven that patients using pharmacological interventions during their advanced cancer treatment periods resisted fatigue better than those who did not (Carroll et al, 2007). As the chemotherapy continues, John will lose more healthy cells as his treatment seeks to eliminate existing cancer cells or preventing growth of more. This means that his blood level may decrease and he may develop anaemia. As such, he should take up hematopoietic treatment. This treatment is prescribed to patients with cancer-related anaemia to reverse or prevent the effects of low blood count in their system. Drugs such as epoetin alfa or darbepoetin fall under this category. It is proven that patients on hematopoietic treatment showed less signs of fatigue, lived better lives, had increased haemoglobin levels, showed improved energy levels, and resisted cancer-induced anaemia (Henry, 2014). As earlier stated, patients on cancer treatment may end up depressed owing to the intensity or the demands of the processes. The same may apply to John if he does not alter his way of trying to evade his problem. There is, however, a simpler way which may intervene in his case to curb the onset of stress and depression- use of antidepressants (Cleeland, Dunn & Fisch, 2010).  Fatigue and depression may coexist in cancer patients, leading to deterioration of their wellbeing. It is therefore important that cancer patients be monitored for any signs of stress and if need be, antidepressants such as bupropin may be prescribed. Previous studies showed that patients taking antidepressants exhibited less signs of depression and were better placed in managing cancer-related fatigue (Minton et al, 2010). Daytime drowsiness, excess sleep, and insomnia are likely to emerge during the cancer treatment period. These conditions may arise from psychological imbalances caused by the treatment (Yarbro, Wujcik & Gobel, 2014). These factors contribute to fatigue and therefore require mitigation measures. In the light of these, cancer specialists recommend psychostimulant medication in countering their emergence. Psychostimulants help to restore vigilance, improve alertness, and restore normal sleep patterns. These factors combined, it becomes easier to reduce the psychological strain on a person, and giving them a peaceful mind thus reduced feelings of fatigue. This is supported by the fact that lack of sleep and too much sleep may lead to fatigue (Kim, 2012). One side effect of chemotherapy is decreasing L-carnitine levels in the cells (Challem, 2011). L-carnitine is a component which is used in the synthesis of fatty acids in mammals. Fatty acids are in turn necessary for the production of energy in the cells. The obvious sense is that low levels of L-carnitine mean less synthesis of fatty acids, thus the feeling of weakness, and most importantly contributing to fatigue. In correcting this, cancer patients are treated with L-carnitine for a length of about one week to a month in the event that low levels of the micronutrient are proven to be the cause of fatigue in a patient (Holland, Breitbart & Jacobsen, 2010). Other factors contributing to fatigue may be treated pharmacologically but the ones described herein are the most important. Conclusion In this study, cancer-related fatigue is alienated from the common fatigue, which can be treated through resting or minor medical intervention. Cancer-related fatigue is described as a major concern because it may originate from factors deep within the body, such as effects of cancer eating away cells, or the treatments interfering with the systematic balance of the same. Intervention measures, however, exist, such as countering existing fatigue or preventing fatigue originating from advanced treatment. As the discussion highlights, behavioural, and pharmacological interventions are effective in reducing the occurrence of fatigue in patients. All these factors combined, cancer patients can easily cope with fatigue as they continue with their cancer treatment and management. References Armes, J., Chalder, T., Addington-Hall, J., Richardson, A & Hotopf, M. 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