With the passage of the Affordable Care Act in 2010 and most provisions due to take effect in 2014, it’s reasonable to ask what MD Anderson is doing to prepare.
Fall 2013 : Cancer-Related Fatigue Clinic
The tiredness that doesn't take a break
For Mark Navarro (left), being seen in the fatigue clinic and working with Carmen Escalante, M.D., have significantly improved his quality of life. Photo: Wyatt McSpadden
When Dolly Sumrow started her cancer treatment, she lost every ounce of energy. Finding MD Anderson’s Cancer-Related Fatigue Clinic turned out to be her salvation.
“The difference in my life was like night and day,” she says. “The counseling helped me understand how to have the energy I needed to regain my ‘normal’ routine. In fact, I feel so much better that I almost forget about treatment.”
Opened in 1998, the clinic helps patients deal with fatigue, the most common symptom of cancer and cancer treatment. An integrated team of physicians, nurse practitioners and nurse clinicians helps patients find the coping mechanisms that work best for them. For Sumrow, it’s turned out to be a combination of the drug Ritalin and exercise, including most recently, water aerobics.
Some have it, some don’t
“We think it may be possible that some people have a genetic predisposition to fatigue, but we don’t understand the exact physiology of it. It’s what we call a non-specific symptom,” says Carmen Escalante, M.D., professor and chair of General Internal Medicine, who has 25 years of experience in this field. “That means it’s not like sleep disturbance, pain, hypothyroidism or hypertension. It’s difficult to deal with, especially if a patient is expected to go back to work and can’t.”
Over the years, Escalante and her colleagues have studied exercise, stimulants like Ritalin and educating patients about behaviors that may help reduce fatigue. Limiting naps, avoiding alcohol, caffeine, chocolate and nicotine in the evening, and having a regular sleep schedule are a few other coping mechanisms they recommend.
Most important, Escalante says, is that patients talk with their doctors about their fatigue. Many people don’t report symptoms because they think they aren’t important. That can have a serious impact on quality of life, as well as physical symptoms.
For Mark Navarro, the diagnosis of multiple myeloma came so late that he had to learn to walk again to be a candidate for a stem cell transplant. But he wasn’t prepared for the fatigue that came with the procedure.
Fortunately, a low dose of Ritalin, walking and coaching his daughter’s volleyball team have helped immensely. And every Monday, Wednesday and Friday, he can be found on the court at his local YMCA, playing pickle-ball, an increasingly popular racket sport that’s a cross between badminton, tennis and ping-pong.
“I have to watch not to overexert myself and run out of energy,” he says, “but I love playing with my regular buddies. Life is good, but living it is the best.”
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