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Cancer- Related Fatigue
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“Cancer-related fatigue is a symptom of fatigue that is experienced by nearly all cancer patients”. [ADD CITATION]

“Some management strategies may help all patients and could be supported by the work of an Occupational Therapist. These include scheduling high-priority tasks during the patient's best time of day, using labor-saving devices, delegating tasks to caregivers, and avoiding unimportant activities, so that the patient will have more energy available for other activities”. [ADD CITATION]

“Pain, difficulty breathing, and fatigue form a common symptom cluster. Fatigue often increases as patients with advanced cancer approach death. As a result, people who are dying often sleep much more than a healthy person”. [ADD CITATION]

While antidepressants are ineffective at reducing fatigue in non-depressed cancer patients, psychostimulants such as methylphenidate and amphetamines may reduce fatigue in some patients. [ADD ONTO THIS EXPLAINING THE DIFFERENCE FOR THOSE WHO DO FACE EXACERBATED SYMPTOMS DUE TO MENTAL HEALTH CHALLENGES AND THE SCREENING FOR THIS]

Added:

Forms of exercise that have been proven to be most effective are more aerobic exercises such as walking, running, cycling, and swimming. These forms of activity can be done at various levels of intensity and have been proven as an effective way of improving QOL for cancer patients.

Patients who are not at the end of life may benefit from physical exercise or physical therapy. Engaging in physical activity may reduce fatigue. Forms of exercise that have been proven to be most effective are more aerobic exercise such as walking, running, cycling, and swimming. These forms of activity can be done at all different levels of intensity and have been proven as an effective way of improving QOL for cancer patients.

While antidepressants are ineffective at reducing fatigue in non-depressed cancer patients, psychostimulants such as methylphenidate and amphetamines may reduce fatigue in some patients.

oftentimes cancer patients experience cancer-related fatigue

Secondary sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647480/

https://www.cancer.gov/about-cancer/treatment/side-effects/fatigue

https://www.cancer.org/cancer/managing-cancer/side-effects/fatigue/managing-cancer-related-fatigue.html

https://www.mskcc.org/cancer-care/patient-education/managing-related-fatigue

Post-traumatic stress disorder
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Add more about PTSD from cancer treatment

How to cope with cancer-related PTSD

Look back on reading to find data about PTSD

Add a section about post- traumatic growth!

=== Interventions for the treatment of cancer‐related traumatic stress symptoms: a systematic review of the literature ===


 * Prevalence estimates of cancer‐related PTSD range between 7% and 14%,3 with an additional 10% to 20% of patients experiencing subsyndromal post‐traumatic stress symptoms (ie, PTSS). Both PTSD and PTSS have been associated with increased distress and impaired quality of life, and have been reported in newly diagnosed patients as well as in long‐term survivors.
 * Therefore, as the number of people diagnosed with cancer increases and cancer survivorship improves, cancer-related PTSD becomes a more prominent issue, and thus, providing for cancer patients' physical and psychological needs becomes increasingly important.
 * Evidence‐based treatments such as eye movement desensitization and reprocessing (EMDR) therapy and cognitive-behavioral therapy (CBT) are available for PTSD, and indeed, there have been promising reports of their effectiveness in cancer patients.
 * Both CBT and EMDR are recommended by NICE for the treatment and prevention of PTSD in adults; however, there is no specific recommendation for their use in cancer‐related PTSD.
 * This article provides evidence to support their effective use in treating cancer‐related PTSD.

A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder

The PTSD Field Trials for the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) [CITE DSM 4], revealed that 22% of cancer survivors present with lifetime cancer-related PTSD (CR-PTSD), endorsing cancer diagnosis and treatment as a traumatic stressor.

Caregiver stress
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https://jamanetwork.com/journals/jama/article-abstract/1104895?casa_token=bJfmbABbk-4AAAAA:UBClY0bOUSpKTTaYlzFzzRYBE85K3oAXchDEXGCOLRS2y3AiDROGCAosnVKNyCT4-zTMoy9X3iQ

“This experience is commonly perceived as a chronic stressor, and caregivers often experience negative psychological, behavioral, and physiological effects on their daily lives and health”

In a case study analyzing a husband and his wife who serves as his caregiver it’s noted that “Despite no history of preexisting mental health conditions, the caregiver reported high levels of psychological distress, including anxiety, depression, worry, and extreme loneliness prior to her husband’s transplant”.

Caregiving is labor intensive, with approximately one-quarter of those caring for cancer patients spending in excess of 40 hours a week providing these services to family or friends.

The level of distress reported by many of those caring for someone with cancer can be equal to or greater than that of the cancer patient, with adult daughters seeming to have the greatest difficulties.

Further complicating matters, caregivers of cancer patients prioritize the needs of the patient over their own, leaving little time for maintaining good nutrition, exercising, and undertaking health evaluations

Brief screening questionnaires can be helpful in a busy clinical environment (TABLE 1). Caregivers can complete the questionnaire independently and the responses are easy to interpret by a nurse, social worker, or physician who then can provide guidance regarding possible referrals for specialized care.

Community or Web-based resources for caregivers are plentiful

[ADD THE TABLE ABOUT CAREGIVING RECOURSES]

Care for the cancer caregiver: A systematic review | Palliative & Supportive Care | Cambridge Core
 * "The largest category of studies included in this review was psycho educational interventions. These interventions positively impacted ICs’ knowledge base and ability to provide care, and several also led to improvements in psychological correlates of burden (i.e., depressive and anxious symptomatology) and patient functioning"
 * "The majority of the problem-solving/skills-building interventions (Table 2) were successful in improving ICs’ ability (and confidence in these abilities) to provide care, including the ability to assess and manage patients’ symptoms, identify solutions to problems that arose during caregiving, and enhance ICs’ overall ability to cope with this role. In the study conducted by Bevans et al. (2010), participants attended 90% of sessions and reported high levels of program satisfaction, which further highlights the benefits of delivery of treatment to ICs concurrent with patients’ medical care".