Zusammenfassung
Fatigue ist ein definiertes psychosomatisches Krankheitsbild infolge einer Tumorerkrankung mit eigenständiger ICD-Nummer. Drei Viertel aller Tumorpatienten leiden darunter. Die Symptome sind multifaktoriell bedingt und werden individuell mit unterschiedlichen Auswirkungen verarbeitet. Fatigue kann den Patienten von der Tumordiagnose an begleiten, durch die Nebenwirkungen der Therapie sogar verstärkt werden und weit über die Rehabilitationsphase hinaus bestehen. Die Dynamik der Erkrankung kann individuell durch Selbsteinschätzung des Patienten mit standardisierten Fragebögen erfasst werden. Die Prognose ist schwer abzuschätzen und korreliert häufig mit dem Verlauf der Grunderkrankung.
Die Therapieansätze folgen dem gegenwärtigen Verständnis der Erkrankung. Sie sind soweit als möglich kausal orientiert, wie am Beispiel der Korrektur von Hämoglobin-Werten bei einer zu Grunde liegenden Tumoranämie, oder symptomorientiert supportiv, psychoonkologisch oder psychosozial. Notwendig sind fast immer multimodale Therapieansätze. Fatigue ist in jedem Fall individuell mit gutem Erfolg für die Lebensqualität der Patienten therapierbar.
Summary
Fatigue is a defined psychosomatic symptom among patients with cancer. Nearly 3/4 of the cancer patients will experience fatigue. Fatigue is described as an unusual, excessive whole body experience that is disproportionate and unrelated to activity and is not relieved by rest or sleep. Cancer related fatigue is a subjective experience and has a great impact on quality of life and the ability to sustain social relationships. The etiology is complex and multifactorial, many contributing factors influence the intensity of fatigue. The underlying pathomechanism is not fully clarified. Fatigue is exacerbated by the treatment and can persist many years after the cancer therapy.
The evaluation and treatment requires a multidisciplinary approach. The therapy is multimodal. The therapy of contributing factors like anemia and depression, symptom control (pain), the normalization of the sleep-activity rhythm, moderate aerobic exercises, psychooncological, psychosocial and pharmacological interventions are ways to treat fatigue.
Schlüsselwörter
Fatigue - Lebensqualität - Tumor - Tumortherapie - Anämie - Depression - immunologische Faktoren - Therapieansätze
Keywords
fatigue - quality of life - tumor - cancer therapy - anaemia - depression - immunological factors
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Korrespondenzadresse
Dr. med. Maria Steingräber
Klinik für Strahlentherapie und Radioonkologie
Vivantes Klinikum Berlin-Neukölln
Rudower Str. 48
12351 Berlin
eMail: maria.steingraeber@vivantes.de
