Identification and management of fatigue during chemotherapy treatment in patients with gastrointestinal cancer

Keywords

fatigue - advanced practice nurse - gastrointestinal câ - ncer - clinical management

Introduction: Cancer-related fatigue is a distressing, persistent and subjective feeling of tiredness or physical, emotional and/or cognitive exhaustion. Although it is recognized that fatigue resulting from cancer treatments compromises quality of life, it is not always documented and evaluated. The Advanced Practice Nurse (EPA) promotes active listening, assessing the patient for symptoms, to develop an individualized plan and promote systematic care in all phases of treatment.

Objective: To expose the experience of the EPA in the early identification of fatigue, in the guidance and management of the event in patients revealed with gastrointestinal (GIT) tumors, undergoing venous treatment, referral for resolution or non-progression of toxicity, through telemonitoring and in-person consultations at an Oncology Clinic in Rio de Janeiro (RJ).

Methods: Quantitative, descriptive, retrospective, and longitudinal study developed by the EPA in Oncology at a private institution in RJ, from December 2023 to May 2024. The sample consisted of adult individuals with GIT exposed to treatment with intravenous chemotherapy. Epidemiological information was collected from the patients. The degree of fatigue was assessed using the CTCAE 4.0 scale (Common Terminology Criteria for Adverse Events), through anamnesis. All data were collected from the Tasy electronic datalake and transported to Excel for subsequent analysis. This project was approved by the Ethics Committee under opinion CAAE: 80441324.6.0000.0227.

Result: Fatigue was identified 122 times during the treatment of 55 patients, 26 females and 29 males. The most prevalent degree of intensity was grade 1 (69.6%), grade 2 (28.6%) and grade 3 (1.6%). Consultation and telemonitoring brought efficiency in recording symptoms and early identification, documenting intensity and frequency, facilitating interventions and allowing a low number of hospital referrals (1.6%), with its management being significantly controlled in the home environment.

Conclusion: The American Society of Clinical Oncology (ASCO) estimates that between 30% and 60% of cancer patients experience moderate to severe fatigue during the course of the disease and treatment, with the level fluctuating according to the protocol or days of treatment, impacting quality of life. The EPA's role in identifying and managing events related to fatigue brought effectiveness in recording and evolution related to the symptom, with less than 2% of hospitalizations.

Corresponding author: Dayane Lopes dos Santos (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025