Is called fatigue and virtually all people diagnosed with cancer know what it is. a symptom complex leading to a reduction of physical energy, mental abilities and also affects the psychological state: it is too often underestimated, because it is considered an inevitable part of the life of a cancer patient. Instead there is something that can be done to stem it, starting with gymnastics and psychological support. Just to diagnose and treat it in a timely manner, the first ones have just been published European guidelines approved by the European Society of Medical Oncology (ESMO), whose first author the Italian Alessandra Fabi, head of the Phase 1 and Precision Medicine Unit of the Regina Elena National Cancer Institute.
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It affects at least 65% of cancer patients
According to the statistics cancer fatigue affects at least 65% of patients with cancer, 40% of people feel fatigue already at the time of diagnosis, the percentage rises to 80% -90% during chemotherapy The radiotherapy and in 20% it persists many years after treatment. Most likely it arises from the accumulation of stress that the person undergoes from the moment of the diagnosis of cancer, as a sum of both psychological and physical tension that the organism forced to endure. But it is also one of the most common side effects of anticancer treatments: chemotherapy is the main cause of the onset of the disorder, followed by hormone therapy and fromimmunoterapia. After 20 years of study and observation of this phenomenon, the European guidelines, a valuable tool that helps clinicians first of all to understand, and then to deal with, this complex symptom. The publication is particularly useful in this historical period – he underlines Gennaro Ciliberto, scientific director of Regina Elena -, because unfortunately we are witnessing an increase in the predisposition to fatigue in cancer patients, significantly tested from an emotional point of view by the Covid epidemic.
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Rarely diagnosed
But what is the best cure to counteract the disorder? No specific drug for now. The guidelines recommend theaerobic exercise, mindfulness techniques, yoga and psychosocial interventions – explains Alessandra Fabi -. Steroids only in selected patients, while very unsatisfactory, until now, have been shown to use psychostimulant and antidepressant drugs. Removing fatigue during therapy means improving adherence to treatment. Being free from it once the oncological treatments are over, giving you the opportunity to take life back in your hands in a totalizing way. After cancer, the person recreates his own existence, he must do it with attention and awareness of the psycho-corporeal sphere. Perceived as a persistent and subjective sense of physical, emotional and cognitive exhaustion, fatigue is rarely diagnosed due to its multidimensional nature. a symptom underestimated by doctors, also because it is not always reported by the patient during visits. Today more than ever the problem emerges within the social networks created by the same groups of patients, important areas for sharing experiences of the individual’s experience.
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Inactivity worsens the situation
Fatigue linked to cancer a container of situations of subjective inadequacy – says Fabi -: the fatigue is what the person tells. It differs from other types of fatigue for its persistence and the inability to alleviate it through rest or restful sleep. Until a few years ago it was impossible to define a measure of its severity, but today it is identified and measured through questionnaires validated at European level. This is a recent and very important goal that we have achieved thanks to the identification of tools for screening that take into account the multifactorial nature of the disorder and thus allow the targeted and multidisciplinary management of symptoms. However, “treatment” still remains difficult: patients with a similar intensity of fatigue can have very different levels of disability. In cancer patients, during and after treatment, prolonged inactivity is an element that fuels fatigue. This state, in fact, causes loss of muscle mass and strength. This gradually affects the ability to perform simple gestures such as climbing stairs or balancing, and can lead to cardiovascular problems and increased anxiety and depression. A structured exercise program that aims to increase the patient’s musculoskeletal mass, improves the quality of life and helps to counteract fatigue – concludes the alert -. The coronavirus health emergency did not help, but now we must take the opportunity to resume a physical exercise adequate, aerobic and constant and follow the indications of the multidisciplinary teams for the treatment of fatigue.
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15 September 2020 (change September 15, 2020 | 19:51)
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