Madrid, 10 January 2024. Fatigue is one of the subjective symptoms most frequently mentioned by cancer patients.1 This problem mainly involves the appearance of signs such as asthenia, lethargy, lack of energy or weakness and, according to the Spanish Oncology Nursing Society (SEEO), affects a high percentage of oncology patients, between 78% and 96% (1).
Some of these patients are even forced to modify their day-to-day activities, which can lead to emotional problems, according to Ana Garnica, Nursing Training Supervisor at the MD Anderson Cancer Center Madrid – Hospiten. "This symptom alters the patients' family, social and work roles, so they have to make changes in their routine that can affect them emotionally," she adds.
For this reason, María Isabel González, a psycho-oncologist at MD Anderson Madrid – Hospiten, insists on the importance of maintaining a good state of mind to cope with this effect. "Emotional well-being and the capacity for more adaptive coping have a clear relationship. If patients learn to manage their emotions better, they will be more inclined to actively cope with difficulties and, in turn, if they improve the way they cope with their situation, their mood will also improve," she notes.
According to both experts, this symptom has to be tackled from a multidisciplinary approach, always with the aim of alleviating the feeling of exhaustion and discomfort without compromising the treatment, providing various tools that help patients to manage fatigue in an optimal and effective way.
The role of food in fatigue management
Fatigue is a mechanism of action at the cellular level in which the digestive system intervenes and generates tiredness, pain, discomfort and nausea. These effects can be a consequence of both the treatment and the tumour itself and food plays a fundamental part in this. " Firstly, food plays a preventive role against side effects such as nausea, vomiting and diarrhoea. It also plays an essential monitoring role in relation to inflammatory effects such as obesity, diabetes or hypertension. Therefore, food plays a preventive, supportive role during treatment and in support of the patient," stresses Pedro Robledo, Head of the Clinical Nutrition and Dietetics Unit at MD Anderson Madrid – Hospiten.
In many cases, patients already have a degree of malnutrition of various kinds, so "we can always offer support and answer questions about what is going to happen with their treatment, whether it is going to cause disorders, changes in their diet, dyslipidaemia." In this line, Robledo points out that the optimal diet has to be varied and adapted to the needs of the patient's age, as well as the diagnosis and its repercussion on some of the fundamental processes of the digestive phase, such as chewing, swallowing, food degradation and absorption.
Therefore, the best diet would be the most varied, appropriate to the needs and age of the patient. In this sense, the Mediterranean diet is considered to be the one with the most variety, the one that provides all the necessary nutrients, "and the only thing we would have to do would be to adapt it to the energy needs of that patient and the specific features of that person. However, the diagnosis and the part of the body that is affected is fundamental to adapt the diet," he explains.
Adapted exercise and thoughts management
As well as these alternatives or methods to alleviate this side effect of cancer treatment, González adds that fatigue in a person without cancer illness requires periods of rest. However, in the case of oncology patients, it is countered with activity and exercise adapted individually to each patient, according to their physical condition and their current stage of treatment.
"Apart from adapted exercise and following a balanced and healthy diet, I like to recommend relaxation techniques and management of thoughts and emotions, and to understand the energy we have every day as a battery," says the psycho-oncologist.
The specialist reveals that she teaches her patients to be aware that their energy may be temporarily limited by cancer and its treatments, so she suggests that they make a list of daily tasks and organise them according to priority and importance. "It is important to bear in mind that some tasks are draining but others may offer more energy. It is also important that they take breaks so that they don't reach the limit of exhaustion and learn to ask for help and delegate when necessary," she concludes.
References
- Reques, M. J. M., Delgado, T. L., & Perez, P. (2003). La fatiga en el cáncer: impacto y alcance del problema. Enfermería global: Quarterly electronic nursing magazine, 2(1), 1-14 https://seeo.org/wp-content/uploads/2019/05/6.T1-02.pdf