Fatigued? You're not alone

We live in tiring times. Google "Why am I so damn tired all the time?" and you'll get over 3 million hits. However, the results of a study in the journal Cancer in 2006 indicated that the fatigue factor for ET patients, even those considered "asymptomatic," is significantly higher than in the rest of the population.

Although the study is nine years old, drug therapy and treatment protocols for ET haven't changed much, so I think the results offer some interesting insights about how patients measure their fatigue and general quality of life. Certainly the study underscores the need for palliative care that improves quality of life as much as research in pharmaceutical cures.

So here's more about that study.

Doctors have known for a long time that changes in the body caused by cancers and chemotherapy cause fatigue. Drugs designed to jack up energy levels in cancer patients haven't worked very well. (Maybe that's why the coffee just isn't doing it for me anymore.)

The 2006 study showed that those with ET reported fatigue that was higher than the general population's, and their quality of life lower. In fact, fatigue and quality of life were more in line with studies of patients with full-blown lymphomas and leukemias. That's not great news given that there's no cure for ET, and patients can live for many years.

Researchers noted that a few limited studies of patients with other cancers showed that exercise may help with fatigue. So do keep moving as much as you can within your doctor's guidelines.

Here are some other interesting tidbits from the study with my two cents thrown in:

• The median age of the ET patients was 56. Most of those surveyed (60 percent) were still working; 20 percent had retired. Only 5 percent reported they were medically disabled due to their disease. I'm still working, and, while I'm planning to cut back on my teaching load starting next term, I think my quality of life would be lower without my job, tiring as it can be. I also think that losing contact with my colleagues would make me sad. So work is probably good therapy for me right now.

• Most ET patients reported no other abnormal test results than high platelet count. In fact, the median platelet count among all ET patients was near normal, probably because most of those reporting were taking hydroxyurea (63 percent) or anagrelide, another type of oral chemo (60 percent). Many people on hydroxyurea and anagrelide report increased fatigue, so the chemo surely plays a role in energy levels. While it's good that the drugs work to reduce platelet counts as well as clot risks, it doesn't mean that patients taking those drugs feel better. 

• Some 72 percent of all ET patients reported fatigue, even among patients who had no other symptoms other than elevated platelet counts. Night sweats and bone pain were experienced by 41 percent of patients. 40 percent of patients reported itching (also known by its fancy medical name "pruritis.") I've experienced some itching and night sweats, but nothing that has been debilitating so far. I also get tingling in my hands and feet after exercise, but, again, this seems to be pretty temporary. 

For what it's worth, a study completed in 2014 by the Alliance for Clinical Trials in Oncology  and the National Cancer Institute funded through the National Institutes of Health (whew!) showed that American ginseng may help with fatigue for a variety of cancer patients. More about that for another post, but may be something to ask your hematologist about.

Would be interested in hearing from you and how your symptoms stack up. Anybody have helpful tips for coping? Let us know.

Be well!

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