Cancer-related fatigue is one of the most common symptoms after a cancer diagnosis. Patients experience reduced ability to carry out daily activities and often experience loss of motivation. As soon as patients are diagnosed with cancer, we should be screening patients for side effects, including cancer-related fatigue. We must then continue monitoring for symptoms throughout treatment & well after treatment finishes.
In last week’s episode, we covered what is cancer-related fatigue, so if you haven’t checked that out yet, do that first. In today’s episode, we dive into what can PTs do for the person experiencing cancer-related fatigue.
What can PTs do about CRF?
Use my framework SATER when working with a patient experiencing cancer-related fatigue:
Screen
CRF is one of the most distressing side effects patients experience before, during, & after treatment. The likelihood is that your patients will experience CRF, so screen for it.
Additionally, talk to patients & listen carefully to their concerns.
Assess
Questionnaires can be great tools to quantify a patient’s experience. Some of my favorite questionnaires are found in the EDGE task force annotated bibliography & on FACIT.org.
Then, conduct an objective measures such as a step test/6MWT/2MWT to assess a patient’s aerobic capacity.
Treat
One of the only treatments for cancer-related fatigue is activity.
ACSM’s Effects of Exercise on Health-Related Outcomes in Those with Cancer provides fantastic guidelines on exercise dosing to address CRF:
- Aerobic only: 3 bouts of 30 minutes moderate intensity exercise per week
- Resistance only: 2 bouts of 2 sets of 12-15 repetitions targeting major muscle groups at moderate intensity
- Aerobic + Resistance: combine these.
Additionally, ask patients about their activity levels and how they schedule the activities that are most important to them.
As all patients are different, consider each patient individually when setting goals and creating a treatment program.
Educate
Place emphasis on achieving and maintaining independence in the activities that matter most to the patient.
PTs can teach people with cancer-related fatigue about pacing, or balancing rest and activity over time.
PTs can teach people with cancer-related fatigue about energy conservation techniques.
If needed, help patients set realistic goals for physical performance.
For example, some people may need to work on strategies for scheduling or prioritizing activities or on breathing techniques that prevent breathlessness, while others might focus on gradually increasing their activity levels or modifying their current activities.
Refer
Finally, your patient can need additional help for their CRF. As we know, CRF can be multidimensional. For example, patients may need help for their depression or anxiety. In this case, we should refer patients to psychotherapy or counseling for skilled services.
In conclusion, cancer-related fatigue is common and often overlooked. Physical therapists can absolutely help people experiencing cancer-related fatigue.