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"Cancer patients suffer significantly from fatigue syndrome"

Fatigue: "Cancer patients suffer significantly from fatigue syndrome"


Susanne Singer

Doctor Susanne Singer; © private

Debilitating fatigue has probably encountered everybody once in a lifetime. In this mood one tries to find innocuous reasons for this mental state: the weather, the season or a sleepless night. However, chronic fatigue, the fatigue syndrome, is a pathological condition that one should take quite seriously. spoke with Associate Professor Susan Singer, employee of the Department of Medical Psychology and Sociology at the University Hospital of Leipzig, on the exhaustion that rises above the normal level of tiredness. But most of all about the new study with cancer patients, who often suffer from this syndrome. Doctor Singer, how does chronic fatigue syndrome differ from ordinary fatigue and weakness?

Susanne Singer: When we talk about chronic fatigue syndrome we mean the kind of exhaustion that exceeds the normal extent of fatigue. A patient who suffers from chronic fatigue syndrome experiences an exhaustion that does not correlate to the exertion he/she just encountered. For example, he/she wakes up after having slept through the night completely exhausted or is very quickly weak after climbing just a few stairs. Roughly 40 percent of all cancer patients suffer from chronic fatigue syndrome, which triggers are responsible for this?

Singer: At the moment we still don’t know exactly which precise triggers are responsible for chronic fatigue syndrome. Based on differences in the occurrence of the syndrome however, you can discern probable triggers. For instance, patients who have underwent chemo treatment or radiation therapy suffer significantly more often from chronic fatigue syndrome than other patients.

But even after surgery, a patient can be very much afflicted with chronic fatigue. According to our study, at the end of a hospital stay 40 percent of cancer patients suffer from increased fatigue. For those patients who underwent chemo treatment, the percentage is 66 percent.

Photo: Sleeping man in bed

A patient who suffers from chronic fatigue syndrome experiences an exhaustion that does not correlate to the exertion he or she just encountered; © belanger Are there other cancer treatments that are known to induce chronic fatigue syndrome in patients?

Singer: Based on our study, patients particularly often suffer from chronic fatigue following chemo therapy. That said, as time goes by the exhaustion decreases – approximately half a year after the diagnosis. For patients who were treated with radiation or a combination of radiation and chemo therapy, the syndrome proceeds more steadily and longer compared to the first group.

Admittedly the cancer itself is also often the trigger for the chronic fatigue syndrome. You just mentioned your study on chronic fatigue syndrome for patients with cancer. How did this study take place?

Singer: We have interviewed cancer patients at the start of their hospital stay and cancer treatment on how they feel during different activities and how much they are still able to concentrate and focus. After all, chronic fatigue syndrome does not just include physical, but also mental and psychological exhaustion. Later on we interviewed the same patients again at the end of their hospital stay. After this we asked them again after another half a year. All in all more than 1500 patients participated in this study.

Afterwards we compared the findings of these surveys with the exhaustion level of healthy people in everyday life. This is also what’s so special about our study.

Photo: Infusion

Based on the study, patients particularly often suffer from chronic fatigue following chemo therapy; © Grahic What new insights were you able to gain?

Singer: We found out that younger patients quite clearly suffer more often from chronic fatigue than older people - compared to their peers of the same age. You also discovered that the subject of chronic fatigue still does not receive much interest in most treatment plans. Why is that?

Singer: Physicians are not yet familiar enough with the fact that many cancer patients are affected by the syndrome. Oftentimes you first think of pain in connection with cancer. A second reason could be that patients do not perceive their tiredness and exhaustion as a syndrome and therefore don’t tell their physician about it. Another factor might be the helplessness of doctors, since so far it isn’t always clear what should actually be done to combat this severe fatigue and exhaustion. If you are only able to offer little help, you might be inclined as a physician not to inquire in detail about this syndrome with the patient. What options are there to better inform and sensitize physicians about chronic fatigue syndrome?

Singer: I believe it particularly helps to raise awareness through the media, so that general practitioners and local oncology doctors are also noticing the syndrome. After this study we also published our findings in scientific journals of course and we report on them in lectures. After all, it is about informing many physicians, patients and family members about this syndrome and to attach greater importance to it in everyday life. How will research of chronic fatigue syndrome continue to develop in the future?

Singer: Chronic fatigue syndrome has been met with great interest in expert circles by now. During the course of this, the German Fatigue Society (Deutsche Fatigue Gesellschaft) was founded which aside from researching this syndrome also provides expert opinions for patients who are no longer able to work due to this syndrome.

Our next step will be the need to find out what can be done to combat chronic fatigue syndrome. There are some great findings for this. In breast cancer patients for example, it was noticed that moderate exercise such as walking or embarking in non-strenuous sports help to reduce chronic fatigue.

We at the University Medical Center in Leipzig soon would like to also examine other patients with hemic diseases or colon cancer, for example, to see what options there are to fight chronic fatigue syndrome. We have just applied for this project and now hope for sponsorship.

The interview was conducted by Diana Posth and translated by Elena O’Meara.


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