Tumorbedingte Fatigue
Abstract
Zusammenfassung. Die tumorbedingte Fatigue ist ein verbreitetes und den Patienten sehr belastendes Syndrom im Rahmen der Krebserkrankung und -therapie. Tumorbedingte Fatigue (im angloamerikanischen Sprachraum als cancer-related fatigue, CRF, bezeichnet) geht einher mit dem subjektiven Gefühl von physischer und mentaler Müdigkeit, Erschöpfung, Energieverlust und wenig Möglichkeiten der Erholung. Es geht weit über das „normale” Maß an Erschöpfung hinaus, was gesunde Personen erleben. Tumorbedingte Fatigue kommt als Folge der Krebserkrankung selbst und als Nebeneffekt der Krebstherapie vor. Das genaue Ursachengefüge ist jedoch bislang nicht genau geklärt. Zum Diagnosezeitpunkt leiden bis zu 40%, im weiteren Verlauf der Krebsbehandlung mehr als 90% der Patienten unter tumorbedingter Fatigue. Unter der Strahlentherapie tritt die tumorbedingte Fatigue bei über 90%, während der Chemotherapie bei bis zu 80% der Betroffenen auf. Tumorbedingte Fatigue neigt zur Chronifizierung auch nach Abschluss der Therapie und ist dann umso belastender für die Patienten, da eine Ursachenzuschreibung erschwert ist. Die Beeinträchtigungen durch die tumorbedingte Fatigue sind beträchtlich, die Lebensqualität, das psychische Wohlbefinden so wie die Teilhabe am Alltagsleben und die berufliche Leistungsfähigkeit sind in aller Regel massiv eingeschränkt. Trotz dieser hohen Relevanz für Patienten und Behandler hat sich die Forschung über tumorbedingte Fatigue, im Vergleich zu anderen Begleitsymptomen der Krebserkrankung und -therapie, erst in den letzten Jahren intensiviert. Die vorliegende Arbeit gibt einen systematischen Überblick über epidemiologische Grundlagen, krankheitsbegleitende Aspekte sowie evaluierte nicht-medikamentöse Interventionen und ihren Stellenwert innerhalb der Behandlung tumorbedingter Fatigue.
Abstract. Fatigue is a common and debilitating symptom experienced by patients with cancer. Cancer-related fatigue (CRF) is characterized by feelings of physical and mental tiredness, weakness, and lack of energy and is not changed by rest or sleep. CRF is distinct from the normal tiredness experienced by healthy individuals, e.g., after physical activity. CRF occurs both as a consequence of the disease itself and as a side effect of cancer treatment, although the precise pathophysiology is largely unknown. CRF is reported by as many as 40% of patients at diagnosis, and nearly all patients expect fatigue from cancer therapy. Up to 90% of patients treated with radiation and 80% of those treated with chemotherapy experience fatigue. CRF continues for months or even years following treatment in approximately one-third of cancer patients with cancer. The impact of CRF on daily living and patient’s quality of life is remarkable. In addition, CRF is associated with considerable psychological distress and can lead to a significant financial burden by limiting a patient’s ability to work. Despite its high relevance for patients and practitioners, research in the area of cancer-related fatigue lags behind attention that has been given to other cancer-related symptoms. This paper seeks to give a systematic overview of cancer-related fatigue and non-pharmacological interventions for the effective clinical management of CRF.
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