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Cancer-Related Fatigue: Integrative Therapies Can Help

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integrated.jpgBy Alex De Alvarado and Lorenzo Cohen, Ph.D.

If you're a patient with cancer, most likely you've experienced fatigue -- and you're not alone. Fatigue is one of the most common cancer-related symptoms described by cancer survivors.

The National Comprehensive Cancer Network defines cancer-related fatigue as "an unusual, persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning." For people with cancer, chronic fatigue can be distressing and can dramatically interfere with quality of life.

Understanding the causes of fatigue and finding the right approach for managing it could help to improve your quality of life and daily functioning.

Causes of fatigue
It may be difficult to find one cause of fatigue. Actually, there may be multiple contributing factors including, but not limited to:  
  • Surgery
  • Chemotherapy or radiation treatments
  • Low red blood counts
  • Pain
  • Sleep disorders
  • Psychological symptoms such as depression, anxiety or emotional distress
  • Pre-existing medical conditions such as uncontrolled diabetes, thyroid problems, heart disease or rheumatoid arthritis
Tips for managing fatigue
Conserve energy: Organize your daily activities to be more efficient by combining tasks or delegating them when possible. Make sure to pace yourself and develop a routine that includes alternating activities with periods of rest. Also, use assist devices such as walkers, carts and backpacks to reduce the energy you expend.

Restructure your environment:
Make spaces such as your workplace or kitchen more user-friendly and prioritize your daily activities instead of trying to do it all.

Improve sleep habits: Stick to a routine sleep cycle and stay on schedule. Limit naps and stay out of bed when not falling asleep. Set aside 1-2 hours of quiet time before sleeping. In addition, avoiding caffeine can help you get a better night's sleep.

Integrative therapies for fatigue
Integrative medicine is playing a larger role in cancer centers across the country and research is exploring how integrative therapies may improve cancer-related symptoms, including fatigue. Adding a physical activity routine such as aerobic walking, swimming and/or resistance training has proven helpful in managing fatigue. There's also growing evidence supporting mind-body practices such as yoga, meditation and tai chi as useful therapies for managing fatigue. Massage therapy may also be a useful way to relax, sleep better and improve fatigue.

There's limited research on the benefits of acupuncture for managing fatigue. However, if fatigue is due to uncontrolled symptoms such as nausea or pain, acupuncture may provide some relief.  In addition, professionally evaluating your nutrition to ensure the right nutritional intake of essential vitamins and minerals with your diet can be critical to improving your health and may affect your symptoms.

It's important to communicate with your physician about evaluating the cause of your fatigue symptoms and treatment options. If it's convenient for you to visit MD Anderson , you may want to ask your doctor for a referral to our Fatigue Clinic. You can contact the Fatigue Clinic at 713-563-7100. 

To participate in group programs that could help with fatigue, like yoga or NIA, please call the Integrative Medicine Center at 713-794-4700 for more information. 

If you are interested in evaluating integrative therapy options, ask your primary oncologist to submit an online consultation request under Integrative Medicine.

3 Comments

We got 3 very good questions/comments in response to this post from our fans on Facebook.
We are working with Ask MDAnderson to find and post the answers.

Kathy U.
my family wants me to take this herbal pill that is very expensive; it has cow colostrum in it plus a few herbs..I'm on Avastin for ovarian cancer. Does anyone have ideas regarding this type of therapy?


Christy L.
And please, please, PLEASE answer the doctor & staff honestly when they ask how you are doing! My Mom used to drive me up the wall when she would anser, "I'm fine." And she knew darn well that she was exhausted, in pain or sick! I had to remind her that the doctors cannot provide her with the care that she needs, if she doesn't give them the complete picture! When they ask, they REALLY want to know. And you will not be a burden to them! If you lie to the doctors, you are only hurting yourself!


Kim K.
I finished 9 rounds of taxol/carbo in October 09. Also had about 6 surgical procedures since diagnosis of stage 4 fallopian tube cancer in Feb 09. I am still feeling quite fatigued some days even now...is that normal?

Ask MD Anderson provided answers to this question posted on Facebook.

Kathy U. asked: my family wants me to take this herbal pill that is very expensive; it has cow colostrum in it plus a few herbs..I'm on Avastin for ovarian cancer. Does anyone have ideas regarding this type of therapy?

Ask MD Anderson says:
Assuming that the question is in regards to the use of bovine colostrums, I searched our website and databases for information regarding cow colostrums, but there is no mention of this agent on our website. I also did not find any information on the websites of the American Cancer Society, National Cancer Institute (other than a definition of colostrum), or Cancer Backup; these are our most frequently used online resources.

From our CIMER page, I did find a link to the following article from the Natural Medicines Comprehensive Database, which looks at hundreds of natural, biologic, and alternative therapies and agents:

http://naturaldatabaseconsumer.therapeuticresearch.com/nd/Search.aspx?cs=UTEX_ANDERSON&s=NDC&pt=100&id=785&fs=NDC&searchid=27984405

The article does not mention bovine colostrum being used to treat cancer. It does discuss the evidence of proven effectiveness, and among a list of those conditions for which there is insufficient evidence to draw a conclusion, it mentions “other conditions”. Cancer of any type is not mentioned at all.

We unfortunately do not have any information which definitively discusses the use or effectiveness of bovine colostrum for treating cancer patients. Obviously, it is vitally important that a patient speak with their treating physician before taking any drug or supplement, especially with regards to possible interaction with any treatment that they are currently taking.

Ask MD Anderson answered this question posted on our Facebook page.

Kim K. asked:
I finished 9 rounds of taxol/carbo in October 09. Also had about 6 surgical procedures since diagnosis of stage 4 fallopian tube cancer in Feb 09. I am still feeling quite fatigued some days even now...is that normal?

Ask MD Anderson says:
According to the web resource MedlinePlus (a service of the US National Library of Medicine and the National Institutes of Health which reviews hundreds of drugs and supplements), both Carboplatin and Taxol (also known as Paclitaxel) can cause fatigue or “extreme tiredness”. Their informational page on Taxol says that any fatigue that is severe or lasts more than a few hours should be addressed with the treating physician. The page on Carboplatin can be accessed at the following link from the MedlinePlus website:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a695017.html

The page for Paclitaxel does not use the term “fatigue” but it does state that if a patient experiences “extreme tiredness” (among other symptoms) while taking Paclitaxel, they should inform their treating physician immediately. This and more information about Paclitaxel can be viewed at the following link:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a607070.html

Both pages contain information regarding the drug in question, what it is used for, precautions, FDA warnings (where applicable), side effects, and other useful information regarding each drug. Obviously, the best resource for addressing any concerns will be the treating physician, as he or she will be most familiar with the patient’s case.

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