Let’s Talk About Cancer-Related Fatigue

Cancer-related fatigue (CRF) is a pervasive consequence of cancer and represents the most prevalent side effect of both the illness and its treatments. A staggering 90% of individuals experience symptoms while undergoing active cancer treatment, and a quarter of them persistently endure these symptoms for months to years afterward. Occupational therapy (OT) and physical therapy (PT) practitioners play a crucial role in the treatment of CRF.

Notably, the fatigue associated with CRF is disproportionate to the level of physical activity, manifesting as a blend of physical and psychological symptoms, including feelings of tiredness, weariness, exhaustion, listlessness, irritability, challenges with concentration and memory, and sometimes resembling pseudo-depression.

Rehabilitation plays a crucial role in enhancing the quality of life (QOL) and effectively managing CRF. As per the National Comprehensive Cancer Network (NCCN), physical activity and psychosocial interventions are Category-1 evidence-based Physical/Occupational Therapy (PT/OT) interventions and are recommended during and after cancer treatments:

PT/OT interventions may include:

Exercise:

• Providing education on the importance of avoiding inactivity and the advantages of maintaining an active lifestyle, including regular exercise.
• Following the American College of Sports Medicine (ACSM) Exercise Guidelines for Survivors, which involve 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity exercise, strength training of major muscle groups 2-3 times per week, and stretching major muscle groups 2-3 times per week.
• Adapting exercise programs based on individual survivor needs, taking into consideration factors such as lymphedema, Chemotherapy Peripheral Neuropathy (CIPN), bone metastasis, and colostomy.

Psychosocial Interventions:

• Offering education on CRF, including awareness of signs, symptoms, and strategies for reducing and managing fatigue.
• Implementing energy conservation techniques tailored to the individualized needs of each survivor.
• Introducing mindfulness-based stress reduction techniques, such as breathing exercises, guided imagery, and relaxation exercises for the body and mind.
• Incorporating Cognitive-Behavioral Therapy (CBT) for sleep, focusing on improving sleep hygiene.

For further details regarding exercise oncology – encompassing precautions and guidelines for all side effects visit our website: https://specialtyrehab.thinkific.com/courses/exercise-oncology-principles-to-practice-in-any-setting

References:
1. Thong, M.S.,van Noorden, C.J.F., Steindorf, K. et al. Cancer-Related Fatigue: Causes and Current Treatment Options. Curr. Treat. Options in Oncol. 21, 17 (2020). https://doi.org/10.1007/s11864- 020-0707-5
2. Liguori, G., Senior (Ed). (2022). ACSM’s resource manual for guidelines for exercise testing and prescription. (eleventh edition). Philadelphia, PA., Wolters Kluwer.
3. National Comprehensive Cancer Network (NCCN). (2023). NCCN Clinical practice guidelines in oncology. (NCCN Guidelines) Cancer-related fatigue. Version 2.202

For more information/education on CRF: Explore our online courses, introductory through advanced training. 
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