Introduction to cancer and fatigueInthe meaning of cancer in the English dictionary can be defined as a seriousdisease that is caused when cells in the body grow in a way that isuncontrolled and not normal, killing normal cells and often causing death.National cancer institute, Cancer is the name given to a collection of relateddiseases. In all types of cancer, some of the body’s cells begin to dividewithout stopping and spread into surrounding tissues. Cancer can start almostanywhere in the human body, which is made up of trillions of cells.
Normally,human cells grow and divide to form new cells as the body needs them. Whencells grow old or become damaged, they die, and new cells take their place. Fatiguecan be described as the lack of energy and motivation (both physical andmental). This is different than drowsiness, a term that describes the need tosleep. Often a person complains of feeling tired and it is up to the healthcare professional to distinguish between fatigue and drowsiness, though bothcan occur at the same time.
Types and stages of cancerAccordingto the cancer institute NSW, there are staging in cancer where process ofmeasuring how far a cancer has spread when it is first diagnosed. It ofteninvolves having scans and other tests. Generally there are four stages incancer which are stage 0, 1, 2&3 and also 4. Stage 0 cancer is oftenreferred to as ‘in-situ’ cancer means that the cancer cells are still in theplace where they started and have not spread at all. Stage 1 is small and hasonly spread a little into nearby tissues. It has not been spread to any lymphnodes or other body areas.
Stage 2&3 means it is larger or has spread intonearby tissues or lymph nodes. Finally, stage 4 has spread to other areas ofthe body. Stage 4 cancer is also called metastatic cancer or advanced cancer.
Metastasis is the spread of cancer cells to new areas of the body which isoften by way of the lymph system or bloodstream. A metastatic cancer, ormetastatic tumour, is one which has spread from the primary site of origin(where it started) into different area(s) of the body. Thereare more than 100 types of cancer, characterized by abnormal cell growth. Thereare many different ranging and causes from radiation to chemicals to viruses;an individual has varying degrees of control over exposure to cancer-causingagents. Measuring fatigue Fatigue is a subjectively experiencedsymptom. Fatigue is most frequently reported side- effect of cancer. Self-report measures are commonly used to measure and describe fatigue.
There are anincreasing number of assessment instruments and this primarily can be dividedinto two sections which are single dimension and multidimensional scales. Thereliable Linear Analog scale Assessment (LASA) is frequently used in theclinical trials. ( McCormack HM, de L Home DJ, Sheather S,1998). Uni-dimensional measures the severity and degree of fatigue.
An example to this isthe Functional Assessment of Cancer Therapy- Fatigue Scale. Example of multidimensionalmeasurement includes The piper fatigue scale, The Functional Assessment ofcancer therapy fatigue scale (FACT-F), The Schwartz cancer fatigue scale, The multidimensionalfatigue inventory( MFI-20), The brief fatigue inventory, The cancer linearanalogue scale(CLAS).Thepiper fatigue scale covers four dimensions which are cognitive, behavioural,sensory and affective and it also includes three open questions with respect tocause, other symptoms, and relief measures. The scale contains 22 items and ona scale of 0-10. The length of the piper fatigue scale may be a weight forpatients if utilized as a part of clinical practice. In any case, it is presumablythe most complete and multidimensional strategy accessible for use as anexploration instrument.
Thefunctional assessment of cancer therapy fatigue scale (FACT-F)consists of 28 items to assess health-related quality of life and 13 extraitems to assess fatigue. The length of the whole questionnaire could troubleexhausted patients, however the weariness subscale is brief, basic, and simpleto utilize. The questionnaire is intended for patients in treatment, whichcould be a confinement.TheSchwartz cancer fatigue scale has 28 items which are separated into foursubscales which are emotional, physical, cognitive and temporal. The multidimensional fatigue inventory(MFI-20) covers 5 zones which are the general fatigue, physical fatigue, reducedactivity, reduced motivation and mental exhaustion and comprises of 20 things.This evaluation has been used and shown good results in patients that gothrough radiotherapy and yet to be tested in other cancer patients.
The brief fatigue inventory includes nineitems that is measured on a ten-point scale. This measures the severity offatigue and its effects on the patient’s activity on a daily basis.Thecancer linear analogue scale (CLAS) incorporates one or a progression of sideeffects or results identified with manifestations, for example, personalsatisfaction and capacity to embrace every day exercises. CLAS/LASA measuresare reliable and have been used broadly in cancer patients.
Preferencesincorporate low burden to patients, the capacity to gauge a few side effectssimultaneously, and simplicity of clinical utilize. Inconveniences incorporateunidimensionality and some detailed challenges when elderly patients endeavourto utilize the scale