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Arkansas Geriatric Education Collaborative (AGEC)

Arkansas Geriatric Education Collaborative (AGEC)

by Lisa VanHoose, Ph.D., PT, MPH, Assistant Professor, Physical Therapy
University of Central Arkansas (UCA), AGEC Fellow

What is the most common cancer treatment-related side effect in senior cancer survivors?
You probably guessed it, if you are a cancer survivor or the loved one of a cancer survivor. Fatigue is the most common cancer treatment related side effect in senior cancer survivors1, 2. Senior is defined as 65 years of age or older. Cancer increases the risk and severity of fatigue in older persons2. Most senior cancer survivors report cancer related fatigue (CRF) at some time during cancer treatment1, 2. The National Comprehensive Cancer Network defines CRF as “a distressing, persistent subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual function”3. In layman’s terms, CRF the condition affects one’s ability to perform routine tasks and does not respond to typical strategies, such as rest, change in diet, or lowering stress. The disruptive symptoms can begin with the start of treatment and may continue years after treatment has ended4.5.

How is cancer-related fatigue (CRF) treated?
The first step in CRF treatment focuses on reducing any personal factors that may be contributing to one’s stress. Cancer survivors may benefit from counseling regarding issues that may contribute to stress such as finances, nutrition, and behavior management including coping. Strategies such as mind-body awareness, relaxation, or sleep therapy may also be beneficial in minimizing stress. Next, the cancer survivor will need to work with his/her medical and rehabilitation team (s) to identify potential medical causes for CRF. Nutritional deficits, anemia, pain, and other conditions and diseases can contribute to the severity of fatigue. A management plan will be created, put in place, and evaluated for its impact. Fatigue is a unique symptom. The medical/rehabilitation team and the patient will work together to identify strategies that will work best for the patient. Medications will be assessed for adverse drug effects and interactions that may be responsible for CRF. Medications will include prescribed and over-the counter medications, including herbal supplements.

Physical activity has been strongly encouraged to address CRF. A customized exercise plan from a community, medical, or rehabilitative care provider can minimize the risk of injury and address the special considerations of the older cancer survivor. An exercise plan will include both endurance activities (walking, jogging, or swimming) and light weight training. Yoga has been recommended to address CRF, pain, and other side effects of cancer3. Other recommendations include scheduling activities during times when you have the most energy, limiting naps to less than one hour, focusing on one task at a time, and delegating or eliminating nonessential tasks. Cancer related fatigue (CRF) is a common side effect of cancer treatment, but it can be effectively treated for improved function and quality of life.

Disclaimer: The comments/opinions are those of the author and not necessarily those of the AGEC. All content found in this article is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this newsletter. Dr. VanHoose may be reached at lvanhoose@uams.edu if you have questions about the content.