Many terminal cancer patients state that they are tired and weak every day, although they eat a lot, but often feel that their legs are like lead, they can't lift their strength, they are easy to drowsiness, and even after a long period of rest, this fatigue can not be alleviated. Why is this happening? In fact, there is a clinical name for this symptom, called cancer-associated fatigue (CRF, referred to as cancer fatigue). Cancer-associated fatigue has been seen as the sixth major vital sign, the sixth sign after body temperature, pulse, breathing, blood pressure, and pain.
How common is cancer fatigue?
In all cancer patients, the incidence of cancer fatigue is as high as 70% to 100%. 65% to 100% of patients receiving chemotherapy, 82% to 96% of patients receiving radiotherapy, more than 75% of patients with advanced metastases, and even more than 40% of postoperative patients experience fatigue, and some fatigue symptoms persist for many years.
Causes of cancerous fatigue
1. Tumor cells secrete cytokines: because the tumor itself can secrete some substances, such as interleukin-1, interleukin-6 tumor necrosis factor, etc., it induces cancer fatigue.
2. Caused by anti-tumor therapy: some chemotherapy drugs, small molecule targeted drugs, biological immune drugs, etc., can cause fatigue. Immunotherapy-related side effects such as hypothyroidism can also lead to fatigue. With the accumulation of doses, fatigue gradually appears and peaks in the last few weeks.
3. Accompanying symptoms of tumors: Most patients with advanced tumors are malnutrition, or there are concomitant symptoms such as nausea and vomiting, pain, and anemia, which will lead to fatigue and weakness in patients. The more severe the degree of malnutrition and anemia, the more severe the patient's fatigue. Cancerous pain can affect sleep, and sleep disturbances can also aggravate fatigue.
4. Decreased physical fitness: Due to the cause of cancer condition and treatment, coupled with the fact that many people think that cancer patients should rest more, resulting in very little activity and physical decline in cancer patients, so it is easy to feel tired. This fatigue makes the patient more reluctant to move, creating a vicious circle.
5. Bad mood: Some bad emotions that cancer patients often have, such as depression, anxiety or insomnia, can also lead to fatigue or aggravate fatigue.
How to improve cancer fatigue?
1. Strengthen nutrition
You can go to the nutrition clinic for a comprehensive nutritional status assessment, and if malnutrition is present, you should actively treat it according to the three-step principle to maintain electrolyte and humoral balance. Family members should also actively prepare meals suitable for the patient's taste, ensure caloric intake, consider eating less and more meals, change the taste, and promote appetite.
2. Exercise appropriately
You can't always think of yourself as a patient and don't want to exercise. Cancer patients should exercise according to their ability, such as walking, jogging, swimming, yoga, baduanjin, tai chi, etc. For bone metastases, fever? Patients with anemia and low platelets should exercise carefully and can only move at the bedside.
3. Regulate mental state
Maintain a positive and optimistic mindset as much as possible, abandon negative emotions, and seek professional psychotherapists to intervene if necessary.
4. Improve sleep
Create a good sleep environment and maintain a regular schedule, such as going to bed at almost the same time every night, and maintaining a regular wake-up time every day, and keeping the time in bed as short as possible during the day. Promote sleep through imaginative relaxation, meditative relaxation, progressive muscle relaxation, abdominal breathing training, self-suggestion, and more.
5. Medication
Patients with severe fatigue and weakness may consider using the central stimulant methylphenidate or short-term cortisol hormones. In the Clinical Practice Guidelines for Cancer-Related Fatigue in China (2021 Edition), traditional Chinese medicine and proprietary Chinese medicine can be added to the treatment of Western medicine to treat cancer fatigue. Traditional Chinese medicine decoction therapy mainly includes spleen and stomach cold dispersion method, lung and qi method, liver thinning and liver nourishment method, kidney yang method, and Proprietary Chinese medicine treatment (Zhengyuan capsule, Fuzheng capsule, turtle deer erxian cream, etc.). And the thymus method is added to the guidelines for this immunomodulator. In addition, it is necessary to actively treat the primary disease, standardize analgesia, and improve symptoms such as anemia and nausea and vomiting.