Boobs On Ice™

What's Linked to Cancer Fatigue: Depression? Nutrition?

I just had carrot cake and fresh fruit for lunch, but it's not as bad as you think. There's a cottage cheese snack pack for a chaser and honestly I ate around the frosting.

Let's face it, the cake  is mostly nuts, raisins, coconut and even carrots when you have a good one. (This is)

But still, it's quite a change from my normal wheat thins, nuts, fresh fruit and cheese lunch but if I have a real fatigue wall hit in 30 minutes I'll know who to blame. Not cancer - ME.

Fatigue is a big bugaboo

It tends to grab onto cancer patients including me. National Cancer Institutes's website says Cancer patients often experience both depression and fatigue. Gee, no kidding.

I've been trying to get to the bottom of the fatigue thing that has absolutely decked me for over a year - and bigger fish than me are ahead of me. To almost anyone it stood to reason that relieving depression might have something to do with fatigue. But according to the NCI, "a large randomized trial has disproved that theory and shifted researchers' attention to other possible strategies to fight cancer-related fatigue."

I'm not sure that the message has made it's way around to doctors who still seem to feel that fatigue either means cancer patients need to exercise or we're depressed - or maybe unreasonable.

And then Gary showed up

Thank God for Gary R. Morrow, Ph.D., of the University of Rochester, N.Y. who reports that studies have shown that "Fatigue is a serious problem for at least 70 percent of cancer patients"  He reported the findings at the annual meeting of the American Society of Clinical Oncology (ASCO) in San Francisco way back in 2003 see the journal abstract.) Another one of his findings was:

"Unlike normal fatigue, cancer-related fatigue is not relieved by rest and often interferes with everyday activities."

But we didn't need a study to tell us. A couple dozen cancer patients would have gladly shared the information. The researchers thought that a selective seratonin reuptake inhibitor (SSRI) like the common drug Paxil might also reduce fatigue, since biology suggests that serotonin might be involved in both.

"It all made perfect sense," said Morrow. "It seemed to fit a lot of what we had observed and a lot of what we know. It just happened to be inaccurate."

And they tried out the theory. Unfortunately although the Paxil patients had a lot less depression than those who received a placebo, there was little difference in how tired any of the patients in either group were.

"It appears unlikely that serotonin is involved as a common mechanism for both fatigue and depression," Morrow said. He concluded that the question was "not worth further study."

New tricks

On to something else? Or a combination of tricks? I'm using a high protein diet with multiple small meals during the day. And trying to actually do less - even when it comes to the things I do online. I didn't think it was possible to rest more but I do.

Other ideas to help with cancer fatigue include steroids which are used in chronic fatigue syndrome, and an antihistamine loratidine. Also work at M. D. Anderson cancer clinic has shown that Ritalin eases cancer fatigue without adverse side effects.

They've produced a video about it. and the links are below
Windows Media: 256K / 56K
QuickTime: 256K / 56K

Snoozing works too

For now I'm sticking with the "Kate Reynolds small meal, fresh fruit, grains, cheeses, protein diet," a moderate amount of caffeine but little sugar and a lot of rest. It's similar to the tips provided by M.D.Anderson.

Honestly however, I can't wait for something else to come along to give me a boost.

I Wish We Would Have Known

What to Expect of Cancer

• Supportive Care - fatigue - DanaFarber 

• Supportive Care - Pain - DanaFarber

• Fever, Sweats, Hot Flashes in Cancer patients

• Breast Cancer Treatment (PDQ®)

  from a German website, attributed to the National Cancer Iinstitute in the US. Clear guidelines & descriptions of stages, what might be done, etc.

  

Spread of Cancer / Metastasis

• Breast Cancer - resources - info - more about spread to bone - Merck Manual   Radiation therapy is usually the most effective treatment for cancer that has spread to bone, sometimes keeping it in check for years

• Metastatic Cancer: Q&A - National Cancer Institute

• NCI National Organizations Database
  

    Numerous organizations and facilities provide services to people with cancer and our database
  contains many, but not all of them.

• CancerCare: Update on Metastatic Breast Cancer
  

    3 cancer docs discuss updates about breast cancer that has metastasized - spread to other parts of the body

Cancer Issues: Symptoms Signs and Side Effects

• CancerCare : Difficult Side Effects of Breast Cancer Treatment: Memory Changes, Lymphedema & Neuropathy
  

    60 minute podcast with answers from cancer specialists in these specific areas

• UCLA > News: Debilitating Cancer Fatigue
    A survey of cancer patients several years ago reported that 32% reported debilitating tiredness every day, 21% on most  days and 14% at least once a week.
  
  Twelve percent of the patients sampled in the survey actually said that they would rather
  be dead than have the severe fatigue that they were experiencing.

And these things may be of some help

• Yes, most cancer patients rank fatigue more bothersome than pain.  A download PDF is at this link

• Cancer Fatigue Treated w/Modafinil: Presented at ASCO

   
• Turmeric - Alzheimer’s and Cancer Beater
•  

  Lotsa Helping Hands  

    It’s an easy-to-use, private group calendar, specifically designed for organizing helpers, where everyone can pitch in with meals delivery, rides, and other tasks necessary for life to run smoothly during times of medical crisis, end-of-life caring, or family caregiver exhaustion.

 

Update: Five Finger Shoes give me the - er - um -

Though I sent a note to Vibram about those shoes you either love or hate, repeating essentially what I said in my earlier article about how I thought they might make cancer patients feel better - the five finger folks seem initially unimpressed.

I got a polite "dear John" esque letter in return; essentially don't call us and we probably won't call you.

Oh - and there was a caution to talk to my cancer docs before trying the shoes.

- heh - like that's going to happen. I'd use the shoes as an excuse to stop by the office and show off the shoe though.

This lukewarm response could have been because I contacted them through their web-form, which did not separate my lovely paragraphs and provided them with a page of what looked like run-on babble. I did not look like I graduated tenth in my class. Or maybe lke I graduated tenth in a class of twelve.

Or it could be that I did not name names. I should have told them that Devra from Parentopia had sent me or that tweeting about them could really help them since I made @guykawasaki's Alltop tweeters list!

(You think they know what twitter is?)

Speaking of Guy, I wonder if he wants a pair of what Devra calls toeshoes to go with his orange crocs. Five fingers has a pair that's kind of red-orange - or one with bright orange webbing between the toes.

That idea is helping ease cancer pain already as I'm sitting here laughing. And all of our kids could refuse to be seen with us. Maybe they'd pay Vibram NOT to sell them to us! Luckily I just have less living at home than he does.

But off embarrassing our kids and back to toe shoes

OK - it was only yesterday so I'll give them awhile to respond but if they don't it'll be their loss since it would be super if they see the opportunity sponsor my trial of the funny cute adorable shoes that of course will make me feel like tippy-toeing around instead of lying in bed feeling like a truck ran over my chest . . . and then backed up so it could get my back too.

The next option is to take the $ from an acupuncturist appointment or a dozen yummy mocha frappuccinos I beg from @badwolf when she's out.

Focus on the finger

Sooner or later - I'm trying toe-shoes come hell, high water or really bad scan results when I go to Sibley hospital next week for tests. Which begs the question wouldn't these blue ones look cute in the CT scan macine with my adorable little gown?

And if I had them before surgery on June 18th I could sport them around George Washington University Hospital and cause a stir.

Oooooh yes - the perfect way to give a special focus on the finger - ten of them in fact - to the health care system.

Come on, Vibram. You KNOW you want to help me do that! Short of coming out with a GREEN five fingered shoe - the Frozen Peas Ease Pain model . . . ohhh wait now that's even better.

Hmmm . . this could be big for Vibram. Who do we need to explain to the finger guys just how big it could be? The name Scott Monty springs to mind.

Now that is a killer idea if I ever had one. Figuratively speaking of course.

Calgon Take Me Away: Pain - Relaxation Resources Needed

After all the excitement (that's a nice word for it) of the last week concerning pain management hurdles and doctors and bone scans and who will see which patients and a getting a second surgery scheduled for June and just yesterday learning that my reconstructive guru is leaving GW for New York at the end of July - insert screaming in frustration here -  I need a break.

How about a nice Downloadable Relaxation/Guided Imagery Session?

I haven't listened to this MP3 but I'm going to right now, I need time and a way to hopefully enhance my pain medication  kicking in. It's not one of the better mornings I've had and I've yet to really do anything - but it would be nice to spend the rest of Saturday with my spouse who will then be doing a corporate retreat for a few days and I'd rather our conversation not be focused on when I last took my pain meds.

It would be nice if not all our time involved him going to appointments with me and dealing with my limitations at home. If I were he I'd need a retreat too. OK, I do need a retreat, lets face it,

In any case, for now relaxation it is - to try to enhance the 2 doses of meds I've had so far today - and this is the one I'm going to check out:

MP3 - reported to be near CD quality, downloads to computer for later listening at your convenience. From The Wellness Community

                    Voice Only (22:00, 10MB)
                    Voice With Music (22:30, 10.3MB)

If you have other suggestions that are free or low cost to everyone - or to special populations - please let us know in the comments. I'm so ready to be taken off to another place, whether it's in my mind or dragging my body along as well.

Need an MP3 player? Get one here: WinAmp (Windows)  QuickTime7