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Frauenheilkunde up2date 2017; 11(01): 83-96
DOI: 10.1055/s-0043-106955
Interdisziplinäre Themen
Georg Thieme Verlag KG Stuttgart · New York

Tumorassoziierte Fatigue in der Palliativsituation

Grundlagen, Diagnostik und evidenzbasierte Therapie
Irene Fischer
,
Joachim Weis
,
Jens Ulrich Rüffer
,
Manfred E. Heim
,
Peter Bojko
,
Christoph Ostgathe
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Publikationsverlauf

Publikationsdatum:
10. April 2017 (online)

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Tumorassoziierte Fatigue (Cancer-related Fatigue, CrF) ist, auch in der Palliativsituation, ein häufiger, die Alltagsfunktionalität, die Lebensqualität und die Lebenserwartung schwer beeinträchtigender Zustand von Müdigkeit und Erschöpfung. Um das Chronifizierungsrisiko zu reduzieren, sollte CrF frühzeitig wahrgenommen und behandelt werden. Die diagnostischen Möglichkeiten und die Therapieoptionen werden in diesem Beitrag vorgestellt.
Kernaussagen

  • CrF ist ein häufiges und für viele Patienten das schwerwiegendste Symptom, besonders in der Palliativsituation.

  • CrF kann vor,während und nach der Tumorerkrankung bzw. deren Therapie in Erscheinung treten. Der Zeitpunkt der Erstmanifestation ist differenzialdiagnostisch relevant.

  • Gute Informationen über CrF helfen den Betroffenen, Ängste abzubauen undmit den Beschwerden besser umzugehen.

  • Zur (Differenzial-)Diagnostik stehen ein Anamneseleitfaden, psychometrische Fragebögen sowie zur Aufnahme in die ICD-10 vorgeschlagene Diagnosekriterien zur Verfügung.

  • Zur Behandlung kommen nicht medikamentöse undmedikamentöse Therapienmit Evidenz aus randomisierten Studien, systematischen Reviews und Metaanalysen infrage.

  • Entsprechend dermultikausalen Genese der CrF ist einemultimodale Behandlung amerfolgversprechendsten. Dabei sind Kontraindikationen und individuelle Patientenmerkmale zu berücksichtigen. Die Entscheidung, welche der möglichenMaßnahmen im Einzelfall umgesetzt werden, soll imSinne der partizipatorischen Entscheidungsfindung gemeinsammit dem Patienten getroffen werden.

  • Speziell amLebensende sollte bedacht werden, dass CrF eine Schutzfunktion für den Patienten darstellen kann. Eine CrF sollte daher nur dann therapiert werden,wenn der Patient sehr darunter leidet, eine effektive Behandlungsoption besteht und der Betroffene eine Behandlung wünscht.

 

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