[Exhaustion and fatigue--a neglected problem in hematologic oncology].
Exhaustion and tiredness are frequent symptoms in cancer patients. They are caused by the tumour itself and by application of chemotherapy, surgery, radiation or cytokine treatment. Exhaustion and tiredness are not a consequence of lacking sleep or exaggerated physical or mental labour, but are due to several other factors: Anemia, tumour cachexia, toxicity of chemo- and radiation treatment probably are the most decisive factors for the development of exhaustion and tiredness. As both were taken as inevitable side-effects of cancer and cancer treatment in the past, only little attention has been paid to exhaustion and tiredness and limited research has been done. Among several validated questionnaires measuring quality of life in tumour patients the FACT-An (Functional Assessment of Cancer Treatment--Anemia) and EORTC QLQ-C30 questionnaire are the most well-known for identifying exhaustion and tiredness. Nevertheless, until today there is no mere exhaustion scale exclusively dealing with the problem of exhaustion and tiredness. According to the 10th revision of the International Classification of Diseases (ICD) exhaustion and tiredness are subsumed under the diagnosis of tumour fatigue. In contrast to tumour fatigue, which comprises physical, mental and emotional dimensions, exhaustion and tiredness primarily refer to physical symptoms: Lacking resilience for activities of daily life, day sleepiness and nocturnal insomnia as well as restricted power of concentration are the mainstays of exhaustion and tiredness. However, regarding lacking interests, diminished energy and reduced mental capacity, exhaustion and fatigue partly overlap. From a therapeutic point of view behavioural interventions and drug therapy have successfully been tried. Beside physical exercise and psychostimulants application of Erythropoietin represents an innovative treatment of exhaustion and tiredness.
Zahner
J
J
Abteilung Medizin und Forschung, Janssen-Cilag GmbH, D-41470 Neuss, Deutschland. jzahner@jacde.jhj.com
Meran
J
J
Karthaus
M
M
D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004921:Erythropoietin / Q000627:therapeutic use; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000628:therapy*; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D010166:Palliative Care; D011788:Quality of Life; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin