July 10, 2008
Options Exist for Fighting Chemo-Related Fatigue
By Patrick B. Massey, M.D.
One of the complaints I have with traditional medicine is that we do not do aftercare very well. Aftercare is the long-term plan and therapies that lead to optimal health after recovering from a serious illness.For decades, traditional medicine has been so concerned with surviving the acute illness that what comes after has been lost.
This is especially evident in the treatment of cancer. Although we perform near-miracles in the treatment of cancer, we forget that chemotherapy and radiation therapy are as hard on the body as on the cancer cells. As health care providers, we should be more proactive in helping our patients along that road to recovery.
One of the more common complaints I hear from cancer patients is that they have a profound feeling of fatigue following chemotherapy. Unlike simply being tired, this fatigue is a sensation of total exhaustion and a "bone-tired" feeling that persists long after the chemotherapy is done. Bed rest seems to have minimal effect in reducing this exhaustion. In addition, this fatigue seems to stymie the benefits of exercise.
Some patients will show symptoms of depression, but it is related more to a lack of energy than true depression. Some of my patients have described this fatigue as a heavy feeling, like "moving though mud."
There are no medical tests that can diagnosis this fatigue, but it is probably related to the body using all of its spare energy to repair itself from the chemotherapy. Theoretically, therapies that increase energy (exercise) or the "flow" of energy (exercise, acupuncture, specific supplements) might be beneficial.
Very little research has been done regarding this type of fatigue. However a recent study done in Great Britain strongly suggests that even a short course of either acupuncture or acupressure can improve post-chemotherapy fatigue. This study, a randomized and controlled clinical trial involving 47 people with fatigue after chemotherapy, was published in Complementary Therapies in Medicine.
The participants received either six sessions of acupuncture, self-administered acupressure at points specific for fatigue relief, or self-administered acupressure at sites not related to fatigue. Participants were evaluated before the study, after two weeks in the study and then two weeks after the conclusion of the study.
After two weeks, the acupuncture group had a 36 percent improvement in fatigue. The acupressure group had a 19 percent improvement and the sham acupressure group was basically unchanged at 0.6 percent. Two weeks after the study, 22 percent of the acupuncture patients and 17 percent of the acupressure patients reported a lasting decrease in fatigue.
The use of acupuncture is increasing common in traditional medicine and some insurance might even cover part or all of the costs (A cautionary note: I do not recommend acupuncturists who use reusable needles. Sterile, single-use acupuncture needles are readily available, inexpensive and greatly reduce the risk of transmitting disease).
- Patrick B. Massey, M.D., Ph.D., is medical director for alternative and complementary medicine for Alexian Brothers Hospital Network.
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