CURRENT STRATEGIES AND NURSING INTERVENTIONS IN THE MANAGEMENT OF CANCER-RELATED FATIGUE

Öz

Cancer is one of the leading cause of death worldwide. Cancer patients experience many symptoms such as fatigue, pain, nausea, sleep disturbance, dyspnea, depression and anxiety. Cancer-related fatigue can make patients feel powerless at the time of diagnosis and even years after the end of treatment. Unlike symptoms such as pain and nausea, Cancer-related fatigue continues to be an unrecognized and untreated symptom, as it is considered a natural part of the process by many patients and healthcare professionals. Etiology and pathophysiology of cancer-related fatigue are not sufficiently elucidated, so that there is no gold standard treatment method in its management. However, pharmacologic and non-pharmacologic interventions are used in palliation of cancer-related fatigue. Nurses have a key role in transferring cancer-related fatigue management interventions to clinical practice. In this review, the proposed strategy and nursing interventions for the management of cancer-related fatigue in current guidelines are presented in a systematic way. It is thought that the proposed interventions will contribute to nursing care and increase the well-being of patients by reducing cancer-related fatigue.

Anahtar Kelimeler

• Cancer
• fatigue
• nursing

Kanserle İlişkili Yorgunluk Yönetiminde Güncel Stratejiler ve Hemşirelik Girişimleri

Öz

Kanser, dünya çapında önde gelen ölüm nedenlerinden biridir. Kanser hastaları yorgunluk, ağrı, bulantı, uyku bozukluğu, nefes darlığı, depresyon ve anksiyete gibi birçok semptom yaşamaktadır. Kanserle ilişkili yorgunluk, tanı aşamasında ve tedavinin bitiminden yıllar sonra bile hastaların kendini güçsüz hissetmesine neden olabilmektedir. Ağrı ve bulantı gibi semptomların aksine kanserle ilişkili yorgunluk, birçok hasta ve sağlık profesyoneli tarafından sürecin doğal bir parçası olarak kabul edildiğinden, tanınmayan ve tedavi edilmeyen bir semptom olmaya devam etmektedir. Kanserle ilişkili yorgunluğun etiyolojisi ve patofizyolojisi yeterince aydınlatılamadığından, yönetiminde altın standart bir tedavi yöntemi bulunmamaktadır. Ancak kanserle ilişkili yorgunluk palyasyonunda farmakolojik ve farmakolojik olmayan müdahaleler kullanılmaktadır. Hemşireler, kanserle ilişkili yorgunluk yönetimindeki girişimleri klinik uygulamaya aktarmada kilit role sahiptir. Bu derlemede, güncel kılavuzlarda kanserle ilişkili yorgunluk yönetiminde önerilen stratejiler ve hemşirelik girişimleri sistematik şekilde verilmiştir. Önerilen girişimlerin hemşirelik bakımına katkı sağlayacağı ve kanserle ilişkili yorgunluğu azaltarak hastaların iyilik halini artıracağı düşünülmektedir.

Anahtar Kelimeler

• Hemşirelik
• kanser
• yorgunluk

Kaynakça

1. 1. Lavdaniti M. Fatigue in cancer patients undergoing chemotherapy: A nursing approach. Int J Caring Sci. 2019;12(2):1-5.
2. 2. GLOBOCAN 2020 Global cancer observatory: World Health Organization International Agency for Research on Cancer; 2020. URL: https://gco.iarc.fr/today/data/factsheets/cancers/39-All-cancers-fact-sheet.pdf. 2 Mayıs 2021
3. 3. GLOBOCAN 2020: Turkey World Health Organization International Agency for Research on Cancer: Global Cancer Observatory; 2020. URL: https://gco.iarc.fr/today/data/factsheets/populations/792-turkey-fact-sheets.pdf. 2 Mayıs 2021.
4. 4. Arnold M, Rutherford MJ, Bardot A, Ferlay J, Andersson TM, Myklebust TÅ, et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 2019;20(11):1493-505.
5. 5. Repka CP, Hayward R. Effects of an exercise intervention on cancer-related fatigue and its relationship to markers of oxidative stress. Integr Cancer Ther. 2018;17(2):503-10.
6. 6. Lavdaniti M, Fradelos EC, Troxoutsou K, Zioga E, Mitsi D, Alikari V, et al. Symptoms in advanced cancer patients in a Greek Hospital: A descriptive study. Asian Pac J Cancer Prev. 2018;19(4):1047-52.
7. 7. Cheng C-s, Chen L-y, Ning Z-y, Zhang C-y, Chen H, Chen Z, et al. Acupuncture for cancer-related fatigue in lung cancer patients: A randomized, double blind, placebo-controlled pilot trial. Support Care Cancer. 2017;25(12):3807-14.
8. 8. Bourmaud A, Anota A, Moncharmont C, Tinquaut F, Oriol M, Trillet-Lenoir V, et al. Cancer-related fatigue management: Evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study. Br J Cancer. 2017;116(7):849-58.

9. 9. Tang C-C, Von Ah D, Fulton JS. The Symptom experience of patients with advanced pancreatic cancer: An integrative review. Cancer Nurs. 2018;41(1):33-44.
10. 10. Charalambous A, Berger AM, Matthews E, Balachandran DD, Papastavrou E, Palesh O. Cancer-related fatigue and sleep deficiency in cancer care continuum: Concepts, assessment, clusters, and management. Support Care Cancer. 2019;27(7):2747-53.
11. 11. Smith TG, Troeschel AN, Castro KM, Arora NK, Stein K, Lipscomb J, et al. Perceptions of patients with breast and colon cancer of the management of cancer-related pain, fatigue, and emotional distress in community oncology. J Clin Oncol. 2019;37(19):1666-76.
12. 12. NCCN Guidelines Version 1.2021 Cancer-related fatigue National Comprehensive Cancer Network: 2021 URL: https://www.nccn.org/professionals/physician_gls/default.aspx#fatigue.10 Mayıs 2021.
13. 13. O’Higgins C, Brady B, O’Connor B, Walsh D, Reilly R. The pathophysiology of cancer-related fatigue: Current controversies. Support Care Cancer. 2018;26(10):3353-64.
14. 14. Fabi A, Bhargava R, Fatigoni S, Guglielmo M, Horneber M, Roila F, et al. Cancer-related fatigue: ESMO clinical practice guidelines for diagnosis and treatment. Ann Oncol. 2020;31(6):713-23.
15. 15. Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecol Oncol. 2015;136(3):446-52.
16. 16. Savina S, Zaydiner B. Cancer-related fatigue: Some clinical aspects. Asia Pac J Oncol Nurs. 2019;6(1):7-9.
17. 17. Zhen-hua Y, Fu-rong D, Yin-ping W, Xue Y, Zi Y. Interpretation of NCCN clinical practice guidelines in oncology: Cancer-related fatigue. JITM. 2016;4(1):1-8.
18. 18. Ebede CC, Jang Y, Escalante CP. Cancer-related fatigue in cancer survivorship. Med Clin North Am. 2017;101(6):1085-1097.
19. 19. Werdani YDW. Effect of cancer-related fatigue to the level of independence of cancer patients and caregiver stress level. FMI. 2018;54(2):108-12.
20. 20. Weber D, O’Brien K. Cancer and cancer-related fatigue and the interrelationships with depression, stress, and inflammation. J Evid Based Complementary Altern Med. 2016;22(3):502-12.
21. 21. Jones G, Gollish M, Trudel G, Rutkowski N, Brunet J, Lebel S. A perfect storm and patient-provider breakdown in communication: Two mechanisms underlying practice gaps in cancer-related fatigue guidelines implementation. Support Care Cancer. 2021;29(4):1873-81.
22. 22. Schmidt ME, Bergbold S, Hermann S, Steindorf K. Knowledge, perceptions, and management of cancer-related fatigue: The patients' perspective. Support Care Cancer. 2021;29(4):2063-71.
23. 23. Gerber LH. Cancer-related fatigue: persistent, pervasive, and problematic. Phys Med Rehabil Clin N Am. 2017;28(1):65-88.
24. 24. Borneman T. Assessment and management of cancer-related fatigue. J Hosp Palliat Nurs. 2013;15(2):77-86.
25. 25. Mohandas H, Jaganathan SK, Mani MP, Ayyar M, Thevi GR. Cancer-related fatigue treatment: An overview. J Cancer Ther Res. 2017;13(6):916.
26. 26. Carnio S, Di Stefano RF, Novello S. Fatigue in lung cancer patients: Symptom burden and management of challenges. Lung Cancer. 2016;7:73.
27. 27. Breitbart W, Alici Y. Psychostimulants for cancer-related fatigue. J Natl Compr Canc Netw. 2010;8(8):933-42.
28. 28. Qu D, Zhang Z, Yu X, Zhao J, Qiu F, Huang J. Psychotropic drugs for the management of cancer-related fatigue: A systematic review and meta-analysis. Eur J Cancer Care. 2016;25(6):970-9.
29. 29. Du S, Hu L, Dong J, Xu G, Jin S, Zhang H, et al. Patient education programs for cancer-related fatigue: A systematic review. Patient Educ Couns. 2015;98(11):1308-19.
30. 30. O’Brien L, Loughnan A, Purcell A, Haines T. Education for cancer-related fatigue: Could talking about it make people more likely to report it? Support Care Cancer. 2014;22(1):209-15.
31. 31. Kessels E, Husson O, Van der Feltz-Cornelis CM. The effect of exercise on cancer-related fatigue in cancer survivors: A systematic review and meta-analysis. Neuropsychiatr Dis Treat. 2018;14:479.
32. 32. Zhang Q, Li F, Zhang H, Yu X, Cong Y. Effects of nurse-led home-based exercise & cognitive behavioral therapy on reducing cancer-related fatigue in patients with ovarian cancer during and after chemotherapy: A randomized controlled trial. Int J Nurs Stud. 2018;78:52-60.
33. 33. Howell D, Keshavarz H, Esplen M, Hack T, Hamel M, Howes J, et al. Pan-Canadian practice guideline: Screening, assessment and management of psychosocial distress, depression and anxiety in adults with cancer. Canadian Partnership Against Cancer, Canadian Association of Psychosocial Oncology. 2015.URL: https://www.capo.ca/resources/Documents/Guidelines/3APAN-~1.PDF. 4 Mayıs 2021.
34. 34. Ripamonti CI, Antonuzzo A, Bossi P, Cavalieri S, Roila F, Fatigoni S. Fatigue, a major still underestimated issue. Curr Opin Oncol. 2018;30(4):219-25.
35. 35. Jang A, Brown C, Lamoury G, Morgia M, Boyle F, Marr I, et al. The effects of acupuncture on cancer-related fatigue: Updated systematic review and meta-analysis. Integr Cancer Ther. 2020;19:1534735420949679.
36. 36. Johnson JA, Garland SN, Carlson LE, Savard J, Simpson JSA, Ancoli-Israel S, et al. Bright light therapy improves cancer-related fatigue in cancer survivors: A randomized controlled trial. J Cancer Surviv. 2018;12(2):206-15.
37. 37. Jihong S, Tao W, Yujie W, Rong L, Sitian N, Litao Z, et al. The effectiveness of yoga on cancer-related fatigue: A systematic review and meta-analysis. Oncol Nurs Forum. 2021;48(2):207-28.