Fatigue in patients with advanced cancer: concept, assesment and management

Abstract

Fatigue is the most prevalent symptom occurring in 75% to 95% of the patients with advanced cancer. It is debilitating, reduces the ability of a person to accomplish his daily life activities and the quality of life. In the current study it was analyzed the concept, prevalence and fatigue-related factors, and described the instruments and management of this symptom. The bibliography was obtained on the data base MedLine, during the period of 1996-2001, using the key-words "fatigue and cancer and palliative care". Twenty-one out of 68 published articles were analyzed, as well as four chapters of books and five Internet sites. It was observed that although the concept and causes of fatigue are not well established, it is considered a syndrome affected in its origin and manifestation by physical and psychological factors. Eight instruments to assess fatigue were identified. Pharmacological, non-pharmacological, hematological, and oxygen therapies were accepted as ways to manage fatigue. Among the non-pharmacological resources, the organization of moments of activity/ rest, adequate diet, acupuncture, relaxation techniques, and physical activities are of great importance. There is a need to educate health care providers, patients and caregivers that fatigue is a symptom that should be subjected to intervention.