Tired of Being Tired?

Fatigue is rarely an isolated symptom and is perceived by cancer patients to be one of the most distressing symptoms of cancer treatment. You might be physically tired, emotionally tired, cognitively tired or all three. This exhaustion is not proportional to recent activity and interferes with usual functioning.

At 84, Emanuel Tanay is far too busy to be tired. His diagnosis of metastatic prostate cancer 7 years ago has by no means stopped him from doing what he enjoys, but symptoms and side effects from his cancer and treatment have slowed him down.

“My resilience is very low,” says Tanay. “In other words, it takes very little for me to get exhausted.”

Tanay has used strategies like medication, physical therapy and exercise to combat his fatigue. Here are other general strategies to manage fatigue:

  • Self-monitor your energy level
  • Limit naps so you can sleep at night
  • Structure routines
  • Use distractions like games, music or reading
  • Set priorities if you can’t do everything
  • Postpone non-essential activities
  • Drink adequate fluids

Contributing factors of fatigue:

  • Medication side effects
  • Emotional distress
  • Anemia
  • Sleep issues
  • Nutrition issues
  • Other medical conditions

The Cancer Center’s Symptom Management and Supportive Care Clinic helps patients manage the physical aspects of fatigue. The PsychOncology Program can help with the significant emotional aspects, such as depression.

Learn everything you wanted to know about fatigue: causes, symptoms, coping and taking action. How do you cope with fatigue? Share your tricks and tips in the comments.

Keeping Nausea at Bay

Edward Rosario preps fruit for a smoothie fortified with protein powder which he can tolerate to combat nausea.

Nausea is a common side effect of cancer – especially for people going through chemotherapy. When non-Hodgkin’s lymphoma patient Edward Rosario came to the University of Michigan Comprehensive Cancer Center, his nausea was overwhelming.

Although it can be difficult to find relief, there are several ways to combat an unsettled stomach. Rosario’s relief came when the Cancer Center’s Symptom Management and Supportive Care Clinic prescribed him medicine to help treat the symptom.

Emily Mackler, Pharm.D., a pharmacist in the clinic, says there are different medications to treat nausea. A queasy stomach may be caused by neurotransmitters within the brain, and medications can be prescribed to target these. Other medications target receptors lining the gastrointestinal tract that can contribute to nausea. In some cases, more than one medication may be used to provide the best control. “We also look at the medicines a person is already taking to see if those are contributing to the nausea,” Mackler says. “If so, we’ll look at modifying the patient’s medical regimen by changing how they take their medicine or perhaps by switching to a different drug so they can feel some relief.”

Medicine is one way to combat nausea, but staying away from certain foods and rethinking portion size and meal timing can also make a difference in relieving nausea or keeping it under control. Continue reading

Symptom Management is an Ongoing Process

Symptom Management is an Ongoing ProcessRecently, an article in the St. Louis Post-Dispatch pointed out that side effects from cancer treatment can last for years after the cancer has been considered cured. The article notes, “the LIVESTRONG Survey for Post-Treatment Cancer Survivors . . . found 98% of cancer survivors experienced a variety of physical, emotional and practical concerns.”  This can include fatigue, memory problems or lymphedema.

The U-M Comprehensive Cancer Center’s Symptom Management and Supportive Care Program offers a clinic which focuses on helping eliminate or alleviate the side effects of cancer and/or its treatment to patients – both current and former – are faced with.  About 40% of the patients seen by the clinic are referred to physical or occupational therapy .  They are working on focusing services to cancer patients so even more can be referred.  Many patient need help building strength, Walker says.  They are often referred to yoga instructors in their communities or provided with instructions on how to start a walking program.

If you are (or were) a patient of the U-M Comprehensive Cancer Center and are experiencing fatigue, lymphedema or any other possible side effect from your treatment, contact the clinic at 877-907-0859.

Continue learning about cancer-related fatigue and symptom management


When to ask for help: Talking about symptoms is first step in treating them

Larry Stone asked for help with symptoms related to his cancer treatment.

Larry Stone asked for help with symptoms related to his cancer treatment.

Larry Stone joined a clinical trial in fall 2009 to test a medication that offered the possibility of prolonging the effectiveness of the hormone therapy he was taking to stave off prostate cancer. When he started to experience mild numbness in his hands and feet later that spring, he didn’t think too much about it. But by June, pain and swelling sent him to the hospital overnight.

His hospital stay relieved his pain somewhat, but it prompted him to ask his oncology team a question: “Is there a specialist I can see?”

That simple question triggered a referral to the University of Michigan Comprehensive Cancer Center’s Symptom Management and Supportive Care Clinic. Stone met with Susan Urba, M.D. — the clinic’s leader — as well as pharmacist Emily Mackler, Pharm.D. Together, the team mapped out a program to reduce Stone’s discomfort.

“That was the start of a great relationship,” Stone said.

Read more about symptom management in the University of Michigan Comprehensive Cancer Center’s patient publication, Thrive. Or, if you are a U-M patient, call 1-877-907-0859 to make an appointment with the U-M Symptom Management and Supportive Care Clinic.