It is estimated that each year, approximately 50,000 people are diagnosed with pancreatic or periampullary cancer. The latter forms near the ampulla of Vater, an enlargement of the ducts from the liver and pancreas where they join and enter the small intestine, according to a definition put forth by the National Cancer Institute (NCI).
Further, the NCI reports that chronic fatigue affects up to 96 per cent of people being treated for cancer. It is so common that “sometimes it is overlooked as normal and people tend to write it off,” said Doctor Theresa P. Yeo of the Thomas Jefferson University School of Nursing, Philadelphia. “But this is not the normal ‘I-stayed-up-too-late’ fatigue. It is really being exhausted, and it does not go away with sleep. It hits patients in their daily activities — simple things like doing your personal hygiene in the morning, getting up and getting dressed, going from the bedroom to wherever you eat breakfast.” This type of fatigue can also lead to anxiety and depression.
Yeo and colleagues recruited 102 patients who had undergone surgical resections for pancreatic or periampullary cancer. Most study participants were Caucasian men and women aged 66 or 67 years old with Stage IIA or Stage IIB cancer. The patients also had similar rates and types of chronic conditions, such as hypertension or diabetes, but no conditions that could severely limit mobility. The patients were randomized into two groups just before hospital discharge: The usual care group went home with normal discharge instructions that did not include a walking or exercise routine. The intervention group was charged with walking for increasingly longer intervals each week for three months. The first month, for example, included walking sessions for 20 minutes with five minutes to warm up and five minutes to cool down. “But if people could only walk for three minutes, we said start with that and work your way up,” Yeo explained. If patients felt any discomfort or shortness of breath while walking, they were instructed to slow down or stop. The goal was to increase walking time 90 to 150 minutes each week by the end of the three month program.
Patients in the walking intervention group mailed in monthly logs of their walking durations and distances. Each month, researchers followed up with patients in the walking intervention group to ask a set of outlined questions about their medical condition, adherence to the walking program and their current fatigue and pain level, along with other symptoms such as diarrhea, insomnia, or depression.
Researchers contacted all patients after three months for final reports on fatigue level using standardised survey tools. At the beginning of the study, 85 per cent of all patients reported moderate to severe fatigue. Three months after discharge, the intervention walking group reported a 27 per cent improvement in fatigue, compared with a 19 per cent improvement in the usual care group. The intervention walking group also reported greater improvements in experiencing less pain than the usual care group.
MEDICA.de; Source: American College of Surgeons