Spring 2001
Cancer Librarians Section Newsletter

Article: Fatigue in Cancer

By Cheryl Warren, AHIP
ValleyCare Health Library

Web Sites
Materials for the Collection
Literature Review

Cancer fatigue has long been recognized as a problem for the cancer patient impacting quality of life considerably. In 1996, the Fatigue Coalition was formed to thoroughly study and analyze the problem. After conducting a national survey of oncologists, cancer patients and caregivers, the Coalition undertook to promote national and community level education on the importance of diagnosing and treating fatigue in cancer patients.

The fatigue experienced by a person with cancer is different from the fatigue of everyday life. Cancer patients suffer from weakness and fatigue as a result from the disease itself, the treatment process and emotional concerns. Debilitating exhaustion can last days, weeks, months, or even after treatment is over. Fatigue is the most common side effect of cancer, affecting 78 percent of patients in treatment. Complicating the problem is the difficulty of assessing, describing or diagnosing the problem. Fatigue, not easily measured, can be frequently overlooked and under treated by the medical profession, and it is often not fully understood by family or caregivers of cancer patients.

In addition to the tiredness produced from treatment that leaves patients too exhausted to do activities of daily living, such as walking, showering, and climbing stairs, cancer fatigue can have mental and emotional effects. Patients often have difficulty concentrating, or have trouble thinking clearly and making decisions. Fatigue can increase feelings of low self-esteem and frustration, often resulting in anxiety, depression, despair, and a sense of helplessness. Various resources are available to manage cancer fatigue. Anemia resulting from treatment can be managed with medication such as Procrit. Proper nutrition, vitamin and mineral supplements, anti-depressant and anti-anxiety medications, lifestyle modifications and even psychological counseling can help improve the quality of life for cancer patients suffering fatigue.

Emphasis is now being placed on researching the problem and increasing awareness, by the health profession, patients and caregivers. For example, recent studies have shown that exercise programs during treatment help reduce fatigue. The library may be called upon to provide nurses, allied health staff and other members of the patient's multidisciplinary treatment team with resources on the topic. The patient, caregiver or family member should also be given patient education information and coping tips and strategies.

Web Sites

Excellent information and patient education sheets on cancer fatigue can be found on the web.

CancerNet by the National Cancer Institute
http://cancernet.nci.nih.gov/
Entire pamphlet on fatigue available online

NOAH -: Cancer Fatigue
http://www.noah-health.org/english/illness/cancer/fatigue.html
Has a well-organized section of links under cancer fatigue.

Oncology Nursing Society
www.cancerfatigue.org
Designed for patients, the site presents information in three areas: Learn, Ask, and Manage. Under Ask, the patient has the ability to submit email questions to an oncology nurse.

Oncolink
http://www.oncolink.org/
Excellent resource write up with links to other sources.

Materials for the Collection

For collection development purposes, good patient education and information sheets are available on the web. Some information and coping strategies are also mentioned in consumer books on cancer.

Fatigue in Cancer: A Multidimensional Approach / Maryl Lynne Winningham. Jones & Bartlett Pub,2000. 445 p. ISBN: 0763706302. Using essays and interviews, the book presents clinicians with the current thoughts on fatigue in cancer. Chapters deal with areas such as rehabilitation, behavioral medicine, assessment and measurement and quality of life issues.

Fatigue in Patients with Cancer: Analysis & Assessment / Agnes Glaus. Springer Verlag, 1998. 172 p. ISBN: 3540635564. Presenting a review of the literature on fatigue in cancer, this research-oriented textbook is for researchers, oncology nurses, physicians, and psychologists. Offers a comparison view on fatigue assessment tools.

Solving the Puzzle of Fatigue: a Program for Coping with Fatigue. SmithKline Beecham 1998. Provided by SmithKline Beecham, which recently merged with Glaxo Welcome, this packaged patient education program contains a patient diary for tracking symptoms and planing schedules, an information guide on cancer fatigue with coping tips and a guided imagery audiocassette tape by Belleruth Naparstek, a leader in the guided imagery field.

Literature Review

The following citations represent only a few of the citations available in the literature on cancer fatigue. These have an emphasis on patient education or assessment.

Cancer-related fatigue: suffering a different fatigue. S. Holley. Cancer Pract 2000 Mar-Apr; 8(2): 87-95. Study involving a small population to describe the differences between cancer related fatigue and usual fatigue. Extensive references included.

Managing fatigue related to cancer treatment. Ca. Sept 2000, 50(5): 274. Easy to read patient education information on what fatigue with cancer is and tips on coping.

The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Tito R. Mendoza, Shelley Wang, Charles S. Cleeland, Marilyn Morrissey, Beth A. Johnson, Judy K. Wendt, Stephen L. Huber Cancer 1999 Mar 1; 85(5): 1186-96. Professional article contains an assessment tool.

Resolving the frustration of fatigue. Wendy S. Harpham Ca May 1999, 49(3): 33. Article explains the types of fatigue that cancer patients experience and effects on family and emotional state of the patient.

Fighting cancer fatigue. Sherry Greifzu RN August 1998, 61(8): 41+. Nursing article provides the nurse with a description of cancer fatigue, symptoms to evaluate and tips on helping their patient cope with cancer fatigue.

Tired out: Patients find few easy answers for cancer-related fatigue. Brian Vastag, Nora Beidler Journal of the National Cancer Institute 1998 Nov 4; 90(21): 1591-4. Brief, succinct article describing the problems patients encounter with cancer fatigue.

Fatigue overlooked as cancer symptom. Cancer Weekly Plus March 10, 1997 p17. Presents statistics on problems with cancer fatigue that the patient encounters. NCCS and The Fatigue Coalition programs for education and awareness of cancer fatigue are mentioned.