Study finds doctors are recommending few fatigue treatment strategies
A variety of therapies exist for the severe, debilitating fatigue that often follows cancer treatments. However, a recent study shows that few doctors are offering or prescribing these therapies to patients suffering from cancer-related fatigue.
For instance, patients can alter daily habits and increase restfulness by learning stress reduction and coping techniques. Regular physical activity, such as walking with a pedometer, has also been shown to ease fatigue. However, study results, published in Supportive Care in Cancer, showed only 10% of patients said their oncology teams instructed them to become more active or try other nonmedication-related fatigue-reducing measures. Furthermore, although sleep-enhancing medications have been shown to be the least effective approach, more than 35% of patients had been offered them.
“Fatigue is a factor that not only significantly diminishes quality of life but is also associated with reduced survival,” says study author Andrea Cheville, MD, a physiatrist with the Mayo Clinic Department of Physical Medicine and Rehabilitation. “Our results suggest that cancer patients are not receiving appropriate treatment for a significant and widespread problem.”
Cheville and colleagues evaluated questionnaires from 160 stage IV cancer patients, both male and female, diagnosed with breast, colon, lung, or prostate cancer and suffering from moderate to severe fatigue (greater than 5 on an 11-point scale). Participants were queried on whether their oncology teams had suggested any of the cancer-fatigue treatments recommended by the National Comprehensive Cancer Network guidelines. These recommendations include increasing exercise, seeking psychosocial and behavioral help, and medications. Questionnaires also addressed the extent of the information patients had received, whether physicians had provided specific counseling, instructions, and recommendations or a prescription to tackle fatigue.
Researchers discovered that a patient’s type of cancer was a factor in whether patients received treatment for fatigue. Almost half (48%) of breast cancer patients had been advised of psychosocial interventions, but only 15% of patients with colon cancer and 17% with prostate cancer had their fatigue addressed.
Analysis showed significant room for improvement in regard to patients’ habits at home. “We found the vast majority of patients were not engaging in behavioral practices that could reduce fatigue and potentially enhance quality of life,” Cheville says. “And almost a third reported napping during the day, which can actually worsen fatigue.”
Cheville says the study provides a wake-up call, because oncologists’ jobs are growing more complex and patient bases continue to expand. This growing change means less time and resources to address quality-of-life concerns. Ultimately, Cheville says, the medical field may require specialists who focus on supportive care issues in cancer treatment, including depression, fatigue, and pain.
Source: Mayo Clinic.