Curt G A
National Cancer Institute, National Institutes of Health, Clinical Center, Oncology Program, Building 10, Room 12N214, 9000 Rockville Pike, Bethesda, Maryland 20892, USA.
Recenti Prog Med. 2001 Jun;92(6):408-12.
As oncologists have become more effective in alleviating pain, nausea and depression, fatigue has emerged as the most important symptom suffered by cancer patients. Indeed, the current literature suggests that fatigue is currently the most important untreated symptom in cancer medicine. In recent surveys of patients and their caregivers, fatigue is more important for the quality of life than pain, nausea or depression. Yet these same surveys confirm that oncologists underestimate the importance of cancer related fatigue. This may be partly because patients often do not fully share the full nature of their concerns. When patients do raise the issue of fatigue, the physicians' recommendations are often non specific. However, recent research has shown that fatigue is not inevitable and untreatable, but a symptom amenable to differential diagnosis and specific intervention. Like pain, fatigue is intrinsically a subjective problem where the doctor relies on the patient's reporting. Weakness, exhaustion, lethargy and asthenia are all used as functional descriptions of fatigue. While these are descriptive terms, clinical research in the measurement and alleviation of fatigue requires reproducible measurement tools. Several studies already exist and have begun to explore this important area of symptom management.
随着肿瘤学家在缓解疼痛、恶心和抑郁方面变得更加有效，疲劳已成为癌症患者所遭受的最重要症状。事实上，当前的文献表明，疲劳是目前癌症医学中最重要的未得到治疗的症状。在最近对患者及其护理人员的调查中，疲劳对生活质量的影响比疼痛、恶心或抑郁更为重要。然而，同样这些调查证实，肿瘤学家低估了癌症相关疲劳的重要性。这可能部分是因为患者常常没有充分说出他们担忧的全部情况。当患者确实提出疲劳问题时，医生的建议往往不具体。然而，最近的研究表明，疲劳并非不可避免且无法治疗，而是一种适合进行鉴别诊断和特定干预的症状。与疼痛一样，疲劳本质上是一个主观问题，医生依赖患者的报告。虚弱、疲惫、无精打采和乏力都被用作对疲劳的功能性描述。虽然这些是描述性术语，但在疲劳的测量和缓解方面的临床研究需要可重复的测量工具。已经有几项研究并已开始探索症状管理这一重要领域。
