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Cancer pain: Relief is possible

From MayoClinic.com
Special to CNN.com

Not everyone with cancer experiences cancer pain, but one of out three does. If you have advanced cancer — cancer that has spread or recurred — your chance of experiencing cancer pain is even higher.

Cancer pain strikes in many ways. Your pain may be dull, aching or sharp. It could be constant, intermittent, mild, moderate or severe. Timothy Moynihan, M.D., a cancer specialist at Mayo Clinic, Rochester, Minn., offers some insight into cancer pain, reasons why people might not get the pain treatment they need and what they can do about it.

What causes cancer pain?

Cancer pain can result from the cancer itself. Cancer can cause pain by growing into or destroying tissue anywhere near the cancer. Cancer pain can come from the primary cancer itself — where the cancer started — or from other areas in the body where the cancer has spread (metastases). As a tumor grows, it may put pressure on nerves, bones or other organs, causing pain.

Recent research has shown that cancer pain may not just be from the physical effect of the cancer on a region of the body, but also due to chemicals that the cancer may secrete in the region of the tumor. Treatment of the cancer can help the pain in these situations.

Cancer treatments — such as chemotherapy, radiation and surgery — are another potential source of cancer pain. Surgery can be painful, and it may take time to recover. Radiation may leave behind a burning sensation or painful scars. And chemotherapy can cause many potentially painful side effects, including mouth sores, diarrhea and nerve damage.

How do you treat cancer pain?

There are many different ways to treat cancer pain. The ideal way is to remove the source of the pain, for example, through surgery, chemotherapy, radiation or some other form of treatment. If that cannot be done, pain medications can usually control the pain. These medications include:

• Analgesics, such as aspirin or acetaminophen (Tylenol, others)
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others)
• Weak opioid (derived from opium) medications, such as codeine
• Strong opioid medications, such as morphine, oxycodone, hydromorphone, fentanyl or methadone

These drugs can often be taken orally, so they’re easy to use. However, it you’re unable to take medications orally, they may also be taken intravenously, rectally or through the skin using a patch.

In September 2006 the Food and Drug Administration approved a new form of the opioid fentanyl (Fentora) that dissolves in your mouth. This medication may be particularly effective for intermittent pain episodes, which are sometimes called “incident pain.” These fentanyl tablets dissolve rapidly, and the drug is absorbed through the lining of your mouth.

Specialized treatment, such as nerve blocks, also may be applicable. Nerve blocks are a local anesthetic that is injected around or into a nerve, which prevents pain messages traveling along that nerve pathway from reaching the brain. Other therapies, such as acupuncture, acupressure, massage, physical therapy, relaxation, meditation and humor, may help.

In your experience, what are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. There are many factors behind that, some of which include:

• Physician knowledge. One factor has to do with a physician’s knowledge and ability to treat and recognize pain. Some physicians and other health care professionals may not specifically ask about pain, which should be a normal part of every cancer patient’s visit. Cancer patients should be asked if they are having any pain. If they are, the physician should stop there and deal with the issue. Some doctors don’t know enough about proper pain treatment. If this is the case, your doctor might refer you to a pain specialist.
• Patient reluctance. A second factor might be a patient’s own reluctance. Some people might not want to “bother” their doctors with the information, or they may fear that the pain means that their cancer is getting worse. Some are reluctant to report it or report it as thoroughly as they should because they’re worried about what doctors or other people might think of them if they complain. They might feel that because they have cancer, they’re supposed to have pain and be able to deal with it. That simply isn’t true.
• Fear of addiction. Another factor might be a person’s fear of becoming addicted to the pain medications. This is something that we know doesn’t typically happen if you take medications for pain. If you take them when you’re not in pain or to get high, then, yes, you can get addicted. But the risk of addiction for people who take pain medications in an appropriate fashion — for pain — is very low, so this shouldn’t be a concern.
• Fear of side effects. Some people fear the side effects of pain medications. Many are afraid of being sleepy, unable to communicate with family and friends, acting strangely, or being seen as dependent on medications. People are also sometimes afraid that taking morphine may shorten their life. There is no evidence of any of these happening if the medication is dosed appropriately. And although strong pain medications can cause drowsiness when you first take them, that side effect usually goes away with steady dosing.

What side effects can you expect from cancer pain treatment, and what can you do about them?

Each pain treatment may be accompanied by its own unique side effects. For example, radiation treatments may cause redness and a burning sensation of the skin. And, depending on what part of the body the radiation is applied to, the radiation may cause diarrhea, mouth sores or other problems, such as fatigue. Chemotherapy certainly can cause side effects, such as nausea, fatigue, infection and hair loss, but it can be effective in relieving pain if it shrinks the tumor. There are medications to help with nausea. Relaxation techniques also may help.

Pain medications each have their own unique side effects that should be reviewed with your physician before taking them. One of the common side effects of the stronger pain medicines is constipation — common to opioids. It can be treated with appropriate bowel regimens as prescribed by your doctor, such as adding a stool softener and something to stimulate the bowels. Preventing constipation is much easier than treating it, so anyone who takes these strong pain medications should automatically begin a regimen to keep their bowels moving. Some of the other side effects of the strong pain medications include confusion, lethargy and sleepiness. The severity of these effects varies from person to person and commonly occurs with the first several doses. But once a steady amount of the medicine stays in your body, the side effects usually resolve. Hallucinations and behavior changes are uncommon.

The less potent pain medications actually may have more side effects, which also should be discussed with your physician before taking them. For instance, anti-inflammatory drugs might damage your kidneys, cause ulcers or increase your blood pressure. Aspirin can cause gastrointestinal bleeding, and acetaminophen (Tylenol, others) can cause liver damage if you take too much.

When should you discuss cancer pain with your doctor, and what points should you bring up?

Report any bothersome pain to your physician. If there is a minor pain that goes away, don’t worry about it. But if the pain interferes with your life or is persistent, it needs to be reported and should be treated. Although no one can guarantee that all pain can be completely eliminated, most pain can be lessened to the point where you can be comfortable.

It may help to keep track of your pain by noting how strong it is, where it’s located, what makes it worse, what brings it on, what makes it better and anything else that happens when you have the pain. A pain-rating scale from 0 to 10 — with 0 being no pain and 10 being the worst pain you can imagine — may be helpful in reporting pain to your doctor. In addition, pay attention to what happens when you attempt to relieve your pain. If you take medicine, do you feel any ill effects from it? If it’s a massage or something physical that relieves the pain, those therapies are important to report, too. Note whether they cause any ill effects.

What steps can you take to make sure you’re receiving adequate cancer pain treatment?

First, you need to talk to your doctor or health care provider if you’re having pain. Second, you and your doctor should set a goal for pain management and monitor the success of the treatment against that goal. Your doctor should track the pain with a pain scale, assessing how strong it is. The goal should be to keep the pain at a level with which you’re comfortable. If you aren’t achieving that goal, talk to your physician. If you’re not getting the answers you need, request a referral to a facility more skilled in the care of pain, particularly a major cancer center. All major cancer centers have pain management programs. For the most part, the medications and treatment for pain are covered by standard insurance.

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If you’re looking for natural cures for your insomnia relief, try some of these popular  solutions.

Bridgett Raffenberg

When it comes to treating your insomnia, you have many treatment options. There are many over-the-counter sleep aids. You can even visit your doctor to get some prescription strength medication. But what if you’re not comfortable taking medicine to cure your insomnia? Luckily, there are many natural cures for insomnia that do not require consuming medication. Insomnia is not a new problem. It has been around as long as people have suffered from stress and anxiety. You won’t be surprised to find that people throughout the ages have found many natural cures for insomnia through trial and error. And as with all history, we can benefit from their trials. There are many natural herbs that can help induce sleep. Chamomile tea has long been a favorite natural cure for insomnia sufferers. Lavender has a pleasant calming effect. Valerian has been a favorite herbal remedy for centuries. If you have trouble falling asleep when you get into bed, a relaxation routine may help you. There are many techniques to help relax your body. If you think your insomnia is stress related, relaxation is the key to getting to sleep at night. When you get into bed, lie on your back and breathe very deeply and slowly. Breathe well into your chest and diaphragm. Exhale slowly. Do this a number of times over to calm your mind. After that, concentrate on relaxing your body, one section at a time. Start with your feet and think about how relaxed they are. Move on to your ankles, your calves, your knees, etc. This may help to calm your mind and body in preparation for sleep. Try to be mindful of your insomnia problem BEFORE you get into bed at night. Wind down. Read a book (but not one that will stimulate your mind like an a thriller), listen to classical music while you do the dishes after dinner, drink a warm cup of milk and have a light snack before retiring. Take a warm bath and relax. Set yourself up to fall asleep before you ever get into bed. Television and computer work can stimulate your mind and is not a good idea at bedtime. Consider your sleeping environment. Is it the right temperature? Are your blinds closed? Would ear plugs block out the noise from a snoring spouse? Many of these little annoyances can be something that will wake you up all night. Waking up because your feet are cold is a common complaint amongst people who wake often. Wear socks. Be sure you have adequate blankets. If it’s hot at night, run a small fan. Think about the things that might be happening to wake you up after you’re asleep and see if you can’t eliminate those problems safely. Exercise can be a great stress reliever. If the stress of your day is causing your insomnia, exercise may be something that will alleviate some stress. Try getting out of the office and walking at lunch. Fit in a session at the gym each day. In addition to relieving stress, the exercise will help to wear out your body.

Article Source: http://www.articlesbase.com/sleep-articles/natural-cures-for-insomnia-relief-754965.html

About the Author:

Bridgett Raffenberg is a former technology teacher who loves techno-gadgets and social media. Known as the ‘Martha Stewart’ of her neighborhood, she also enjoys internet marketing, real estate investing and volunteering.

To learn more about Insomnia Symptoms , join others at http://www.InsomniaSmptomsFAQ.com where you will find this and much more,

includiNatural Cures for Insomnia, Insomnia Symptoms, Natural Sleep Remediesng detailed information on Natural Sleep Remedies . http://www.articlesbase.com/sleep-articles/natural-cures-for-insomnia-relief-754965.html

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By: Bridgett Raffenberg

Insomnia is a wide-spread problem in our society. With our increasingly hectic schedules and a disappearing divide between work and home, it is often difficult for our bodies to know when to wind down. Stress and anxiety from a hectic day can often keep a person from getting the rest needed to face another day.

If you’re having trouble sleeping at night, you might consider trying some herbs for insomnia relief. Herbal sleep aids have been around for centuries and do not have the side effects often associated with over-the-counter sleep aids.

• Lavender: You might notice that lavender is a very popular addition to baby bath soap. That’s because lavender has calming qualities. It helps to ease the mind and induce a sense of calm. If you’re suffering from insomnia due to stress and anxiety, lavender may work to calm your mind at night. It comes in many forms. You can buy a sachet (small packet) and place it under your pillow. You can spray lavender essential oil in the room as part of a insomnia preventative bedtime routine. It’s also available in bath oils, linen sprays and fabric softeners.

• Valerian: This is actually the root of a perennial flower valerian. It is used by herbalists because it is said to work well with other herbs to induce sleep such as passion flower.

• The Passion Flower was used by the ancient Aztecs to induce sleep. It helps relax the mind and body. It can be ingested in pill form or in tea.

• Chamomile: This is an age old remedy for sleeping problems. Chamomile can be most commonly found in tea. Having a cup of chamomile tea before bed is something that may calm your mind. It is widely available at local supermarkets.

About the Author:
Former technology teacher who loves techno-gadgets and social media. Known as the \’Martha Stewart\’ of her neighborhood, she also enjoys internet marketing, real estate investing and volunteering.

Printed From: http://www.articlesbase.com/sleep-articles/the-top-herbs-for-insomnia-relief-754957.html

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by Gen Wright

It is important to take balanced diet during chemotherapy. Patient should eat as much as possible. Eating well during chemotherapy will help to cope with side effects of the treatment and fight infection easily. It also helps to rebuild or repair healthy tissue.

You should choose balanced diet which contain all the nutrients that body needs. Your diet should contain fruits, vegetables, fish, meat, egg, cereals, breads and dairy products. Diet with high calories will help to keep your weight up and also build and repair skin, hair, muscles and organs. It is also important to drink adequate of fluid during your chemotherapy treatment.

When you are taking chemotherapy drugs, your immune system is affected. So, it is important to take varied and balanced diet during the treatment. Following are the tips regarding your diet that you need to follow:

1. Take small snacks and meals through out the day. Eat less but more often.

2. Include protein rich food in your diet at each meal. Protein rich food includes lean meats, eggs, nuts, beans and dairy products.

3. Fruits and vegetables which are high in antioxidants should be included in your diet. It helps your immune system.

4 Food that are rich in carbohydrates such as bread, rice, pasta and cereals are important. They provide energy for the body.

5 Make sure your diet contains adequate amount of calories. Include eggs, milk and cheese in your diet which high in calories. You can also drink calories liquids.

6 Your food should be well cooked and heated.

7 Try different food and recipes. Eat in a different location, eat by candlelight.

8. Eat with friend and family members, watch TV, listen music while eating alone.

9 To avoid infection, ensure cleanliness while preparing your food.

Due to side effects such nausea, mouth or throat problem, you can lose your appetite. It is also difficult to eat if you feel depressed, sick or tired. You should take small meal or snacks whenever you want to eat. It is not necessary to eat regular meals every day. Try different food and recipes. Whenever possible, take a walk before meal. It will increase your appetite. Change meal location, eat by candlelight, eat with friends and family members. This will help you to feel hunger.

Alcohol can interact with some chemotherapy drugs and affect their effectiveness or worsen side effects associate with treatment. Because of this, it is advised to drink less alcohol or avoid it completely. However, small amount of alcohol can help you to feel relaxed and feel hunger. Consult your doctor before taking any alcoholic beverages such wine, beer or any other.

Consult a nutritionist to know what to eat during chemotherapy treatment. A nutritionist can provide you diet plan that you need follow during chemotherapy treatment. This diet plan offer all the nutrients and vitamins that you need.

For more information on chemotherapy and cancer symptoms, please visit our resource sites.Article Source: http://www.articlesnatch.comKey words:What to Eat during Chemotherapy

http://www.articlesnatch.com/Article/What-to-Eat-during-Chemotherapy/380397

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by Beth Ibarra

Sleep is something that many people tend to take for granted. They go to bed after a long day of school or work, and they expect to wake up the next day refreshed. Well, for every person that does, there are many more people who do not, or even go to sleep at all.

People with sleeping problems are generally thought to be suffering from one of the many sleep disorders that have been classified throughout the years. If a person thinks that he or she is indeed faced with a significant sleeping problem, it is important that they first consult their doctor, because what they think might be the result of one of the sleep disorders, might actually be something else.

Take, for example, what is considered to be the most common of sleep disorders: Insomnia. This particular problem is marked by either not being able to sleep for long periods of time, or not being able to fall asleep at all for days at a time. This is actually not a disorder in itself, but instead a symptom of a more serious medical condition.

It goes without saying, but if a person is unable to breathe well, that would definitely hinder sleeping. Insomnia is thus often caused when people with asthma, emphysema, or another breathing problem are not given the right medication. It is also important to keep in mind that sometimes the medication might be alright, but the side effects could cause this sleeping problem.

Also, sleeplessness might be a sign of poor behavioral habits. For example, if a person is in the habit of drinking lots of coffee each day, the amount of caffeine in a regular cup of coffee is enough to keep anyone awake for a long period of time! Caffeine can also be found in soda, as well as even some foods.

Speaking of food, if a person eats right before they go to sleep, that will automatically cause them to stay awake. Why? Because energy is given from ingesting food, so the body, although tired, simply will not act like it is tired at all. In order to prevent gas, and to facilitate the best digestion possible, it is best to eat at least two hours before going to sleep.

All of this having been said, one of the most prevalent actual sleep disorders that people suffer from is sleep apnea. In this sleeping problem, people stop breathing for anywhere from a minute at a time, to several minutes at a time. In order for the brain to remain functioning at all times, it is very important that it get the necessary amount of full oxygen.

So, how can a person tell if he or she is suffering from this condition? When they wake up in the morning exhausted and forgetful, even after getting what they think is a full night’s rest. Thus, it is very important that a sleep study be done on such a person to ensure a proper and timely diagnosis.

More information on sleep disorders, snoring and a sleep disorder treatment options at a sleep clinic in your area is just a click away.

Article Source: http://www.articlesnatch.com/Article/The-Many-Different-Kinds-of-Sleep-Disorders/412626

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Therapy Pain   by Billy Fischer

Where traditional forms of medicine do not work alternative therapies are resorted to. When there is a combination or integrated medical system that is followed, how to blend both the alternative and the conventional needs expertise. Alternative therapies make available services which are not offered in conventional medicine. These treatments could involve homeopathy, new age healing, faith healing and naturopathy. Some diseases might warrant alternative methods of healing rather than the conventional and more and more people seem to be becoming aware of this.

Not only can alternative health therapies help you to improve the quality of your life and feel better, they can also help you to improve your overall general health in order to provide you with a sense of control. It relaxes you by reducing your anxiety, stress, depression, sleeplessness and tension. They reduce some of the side effects, which are normally noticed in the usual cancer treatments and also help in reducing some of the symptoms like poor appetite, tiredness, pain, sickness, diarrhea, constipation and breathlessness.

Alternative health therapies can be very effective at masking pain, which can sometimes hide a more serious underlying condition and are often used in conjunction with conventional medicine. Some cancer support groups for example, offer these therapies for free or make a small charge and some hospitals and hospices provide as part of cancer care, alongside conventional cancer treatments such as chemotherapy or radiotherapy. Many cancer patients to support themselves in their fight against cancer now use these therapies. These therapies are very valuable in that they identify and support spiritual and emotional characteristics and physical features, but they should not be used as the only alternative line of treatment.

More than billion is spent by the Americans annually on vitamins and herbs which are alternative health products. The recent studies that were conducted by Phillips, Tindle, Eisenberg and Davis, reflected that there was roughly seventy two million adults within the United States that use alternative and complementary therapies. The studies conducted by Herman, Craig and Caspi in 2005 also show an out of pocket spend of about billion annually on these therapies.

It is very essential to find out which treatments offered by alternative health therapies are more effective and at the same time making you feel much better and comfortable. The quality of life for many people has improved especially those who have Motor Neuron Disease. It is always advisable to check with your doctor before starting with any of the alternative health therapies and you should also remember to check whether any such treatment adapted would have adverse effect on any of the treatment programs which are already being undertaken.

In case you are thinking of using any alternative health therapy along with your contemporary medication then you must talk to you doctor and find about the pros and cons that are related. You could even find out from your physician if he is qualified to practice any of these therapies. Today doctors are more and more convinced that alternative therapy does have a place in the overall healing of a patient; this gives them the ability to maybe recommend alternative therapy practitioners. For some people, these types of therapies are helpful in coping with effects of conventional treatments, reducing anxiety and giving them back some control over their lives.

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From MayoClinic.com
Special to CNN.com

After your cancer treatment, you were eager to nurse your body back to health. But beyond your initial recovery, you might be interested in ways to improve your long-term health so that you can enjoy the years ahead as a cancer survivor.

The advice for cancer survivors is no different than the advice for anyone who wants to improve their health: Exercise and improve your diet. But for cancer survivors these strategies have added benefits — research shows these simple steps can improve your quality of life, smoothing your transition into survivorship. Follow this guide to what you can do to take care of your body after cancer treatment.

Exercise

Regular exercise increases your sense of well-being after cancer treatment and can speed your recovery. Cancer survivors who exercise often experience:

• Increased strength and endurance
• Stronger immune systems
• Fewer signs and symptoms of depression
• Less anxiety
• Reduced fatigue
• Less difficulty sleeping
• Improved mood
• Higher self-esteem

Adding physical activity to your daily routine won’t take a lot of extra work. Focus on small steps to make your life more active. Take the stairs more often or park farther from your destination and walk the rest of the way. Check with your doctor before you begin any exercise program.

With your doctor’s approval, start slowly and work your way up. The American Cancer Society recommends adult cancer survivors exercise for at least 30 minutes five or more days a week. As you recover and adjust, you might find more exercise makes you feel even better.

Sometimes you won’t feel like exercising, and that’s OK. Don’t feel guilty if lingering treatment side effects, such as fatigue, keep you sidelined. When you feel up to it, take a walk around the block. Do what you can, but know that rest is important to your recovery as well.

While exercise has many benefits, there’s no evidence that exercise can keep your cancer from coming back. Many cancer survivors are concerned about cancer recurrence and want to do all they can to avoid it. It’s not clear why cancer recurs in some people but not in others. Exercise won’t stop your cancer from recurring, but it can make you feel better and help prevent other diseases, such as heart disease.

Eat a balanced diet

Vary your diet to include lots of fruits and vegetables, as well as whole grains. When it comes to selecting your entrees, the American Cancer Society recommends that cancer survivors:

• Eat five or more servings of fruits and vegetables every day
• Choose healthy fats, including omega-3 fatty acids, rather than saturated fats or trans fats
• Select proteins that are low in saturated fat, such as fish, lean meats, eggs, nuts, seeds and legumes
• Opt for healthy sources of carbohydrates, such as whole grains, legumes, and fruits and vegetables

This combination of foods will ensure that you’re eating plenty of the vitamins and nutrients you need to help make your body strong.

While it may be tempting to supplement your diet with a host of vitamin and mineral supplements, resist that urge. Some cancer survivors think that if a small amount of vitamins is good, a large amount must be even better. But that isn’t the case. In fact, large amounts of certain nutrients can hurt you. If you’re concerned about getting all the vitamins you need, ask your doctor if taking a daily multivitamin is right for you.

No special diet is known to prevent cancer from recurring. However, some preliminary research in breast cancer survivors indicates that a low-fat diet may reduce the chance of breast cancer recurring. In this study, which has yet to be completed, it isn’t clear whether the slight reduction in breast cancer recurrence was from women eating less fat or from women losing weight on the restricted diet. It also isn’t clear if a low-fat diet has any application to other cancer survivors.

Maintain a healthy weight

You may have gained or lost weight during treatment. Try to get your weight to a healthy level. Talk to your doctor about what a healthy weight is for you and the best way to go about achieving that goal weight.

For cancer survivors who need to gain weight, this will likely involve coming up with ways to make food more appealing and easier to eat. You and your doctor can work together to control nausea, pain or other side effects of cancer treatment that are preventing you from getting the nutrition you need. Losing even more weight can reduce your quality of life and make recovery more difficult.

For cancer survivors who need to lose weight, take steps to lose weight slowly — no more than 2 pounds a week. Control the number of calories you eat and balance this with exercise. If you need to lose a lot of weight, it can seem daunting. Take it slowly and stick to it. Any amount of weight loss can help you feel better about yourself and improve your health.

Stop using tobacco

Kick the habit once and for all. Smoking or using chewing tobacco puts you at risk of several types of cancer. Stopping now could reduce your risk of cancer recurrence and also reduce your risk of developing a second type of cancer (second primary cancer).

If you’ve tried quitting in the past but haven’t had much success, seek help. Talk to your doctor about resources to help you quit.

Drink alcohol in moderation, if at all

If you choose to drink alcohol, keep it to a minimum. At most, women and anyone over 65 should drink no more than one drink a day, and men should drink no more than two drinks a day.

Alcohol does have health benefits in some people — for instance, consuming a drink or two a day can reduce your risk of heart disease. But it also increases the risk of certain cancers, including those of the mouth, throat, liver and breast. While it isn’t clear whether drinking alcohol can cause cancer recurrence, it can increase your risk of a second primary cancer.

Weigh the risks and benefits of drinking alcohol carefully and talk it over with your doctor.

Do what you can

While you may fear it will take an entire overhaul of your lifestyle to achieve all these goals, do what you can and make changes slowly. Easing into a healthy diet or regular exercise will make it more likely that you’ll stick with these changes for the rest of your life.

· Cancer survivors: What to expect with follow-up care

· On the job with cancer: Managing common workplace challenges

· Cancer survivors: Relationships with family and friends after treatment

· Cancer survivors: Late effects of cancer treatment

· Cancer survivors: Managing your emotions after cancer treatment

· Sexuality after cancer treatment: What women can expect

· Sexuality after cancer treatment: What men can expect

· Cancer recurrence: What it means and how to cope

October 05, 2005

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ScienceDaily (Apr. 27, 2007) — A University of Nebraska Medical Center study has found that even before women with breast cancer undergo chemotherapy, they experience fatigue and disruptions in sleep and activity levels. Researchers say their findings suggest health professionals should address fatigue following breast cancer surgery.

Researchers say controlling fatigue after surgery — before starting chemotherapy — is important because fatigue typically increases during chemotherapy. Between 70 to 95 percent of breast cancer patients experience fatigue while undergoing chemotherapy.

The study was published in the current issue of the Journal of Pain and Symptom Management. Having studied 130 women with early stage breast cancer (stage I, II, IIIA), it the largest study to document the prevalence of fatigue associated with altered sleep and activity patterns before chemotherapy treatment. The data confirms what was reported in a previous smaller study funded by the National Institutes of Health.

“We found women are not going into chemotherapy in the best possible shape,” said Ann Berger, Ph.D., Niedfelt Professor of Nursing, UNMC College of Nursing, who has conducted several studies over the past 15 years related to fatigue in cancer patients. “It makes it that much more difficult to reduce the fatigue during treatment. If you start out with some fatigue, it will probably increase.”

“We as health professionals need to address potential fatigue and sleep issues sooner,” said Dr. Berger, principal investigator of the study. “If women are having sleep problems after surgery, we need to address this symptom before women begin chemotherapy. “What we’ve learned might explain why we’re having problems reducing fatigue in breast cancer patients during chemotherapy.”

The published study comes from initial results of a five-year, $1.5 million grant Dr. Berger and her team received in 2003. The purpose of the study, which was funded by the National Institute of Nursing Research, a division of the National Institutes of Health, was to determine the best ways to reduce fatigue during chemotherapy and to prevent chronic fatigue after treatment.

Researchers measured sleep and activity patterns during the 48 hours prior to the first chemotherapy treatment using wristwatch-sized activity monitors called actigraphs.

Fatigue, the most prevalent and distressing symptom for breast cancer patients receiving chemotherapy, has long been accepted by health professionals and patients alike as a side effect of treatment. Researchers say there are ways to intervene, and now they have found it may be important to intervene during the recovery period after breast cancer surgery.

Researchers say disrupted sleep, low daytime activity and/or reduced activity are likely to contribute to mild fatigue before chemotherapy and moderate to severe fatigue after chemo. They say fatigue should be addressed before and after surgery. Women typically begin chemotherapy three to four weeks after surgery.

Dr. Berger said because inactivity contributes to fatigue, she and colleagues say though women need to rest for several days after surgery, they should try to regain activity when they’re able. “We’ve been telling patients for years to rest and take it easy, but in some cases, we’re finding the patients who remain inactive are the one who report higher fatigue.”

Cancer-related fatigue can have a profound impact on an individual’s life, with significant physical, emotional, social, and economic consequences that may persist for months or years after completing treatment. Even after treatment ends, between 30 and 50 percent of patients say their fatigue remains at least six months or doesn’t ever go away.

Fatigue related to cancer treatment is described as a distressing, persistent, sense of tiredness or exhaustion that is not proportional to activity. The factors associated with fatigue are the presence and severity of anxiety, pain, lower sleep quality, physical inactivity, and poor performance status, leaving little desire to work or socialize.

Dr. Berger said the findings provide an important benchmark to begin looking for interventions to reduce cancer-related fatigue.

The study was undertaken to further establish values for sleep, wake, activity, rest, circadian rhythms and fatigue and how they interrelate in women before and during the first year after chemotherapy.

University Of Nebraska (2007, April 27). Fatigue Affects Breast Cancer Patients Even Before First Chemotherapy Treatment, According To Study. ScienceDaily. Retrieved December 4, 2007, from http://www.sciencedaily.com­ /releases/2007/04/070426135536.htm

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