■ Hou Wanxin Li Hegen
Outpatients often encounter such a situation: tumor patients say that they are not particularly uncomfortable, but they are bored. Typical example is Aunt Wang, a physical examination found a right lung mass a year and a half ago, and the pathology after surgery was clearly lung adenocarcinoma, which belongs to the early and middle stages, and did 4 postoperative adjuvant chemotherapy, and then regular follow-up review. The results of several follow-up visits were quite good, but what bothered her was that after more than a year, she still felt weak. At first, the family was very nervous, took care of her meticulously, and did not dare to let her do any work. But after a long time, every time the blood picture was reviewed and the film was not abnormal, the family gradually felt that the old man was a little willful and a little "made"?
Aunt Wang herself also wondered, she didn't want to always be unable to eat and sleep soundly, obviously did not do any strength work, but she felt tired when she moved, listless all day, and did not want to go out dancing and traveling with her old sisters. But she looked at the patients in the same period, some people worked as usual, as if they had never been sick, and some could climb mountains and travel far away, living a more exciting life. What the hell is going on here?
Cancer-related fatigue is not uncommon
There are actually many tumor patients with symptoms like Aunt Wang, which we call cancer-induced fatigue.
It is a painful, persistent burnout or exhaustion caused by cancer and cancer treatment, which is inconsistent with recent exercise and cannot be relieved by rest. Such patients are often accompanied by cognitive impairment and low mood.
How so? Combined with the perspective of traditional Chinese medicine, after surgery, radiotherapy and chemotherapy, it can consume qi and blood, tumor patients are often nervous, afraid, anxious, these bad emotions lead to liver qi stagnation, qi and blood are not good, in addition, radiotherapy rays, chemotherapy, etc. may damage yin jin, resulting in yin deficiency and fire. This is a common but easily overlooked symptom of tumor patients, which makes patients have bitter words and greatly reduces the quality of life of patients.
Some people will ask, tumor patients often feel tired and weak, how to judge whether they have cancer-induced fatigue?
According to international guidelines, if cancer patients have experienced these symptoms every day for two or more weeks or more in the past month, they should be careful:
■At the recent level of activity, there is significant fatigue, weakness, or the need for more rest, or 5 or more of the following symptoms at the same time: 1. General weakness or heavy limbs; 2. Inability to concentrate; 3. Low mood and decreased interest; 4. Insomnia or drowsiness; 5. After sleeping, I still feel that my energy has not been restored; 6. Difficulty in activity; 7. There are emotional reactions and then feel tired such as sadness, frustration or irritability; 8. Unable to complete the daily activities that were originally competent; 9. Short-term memory loss; 10. The symptoms of fatigue cannot be relieved for several hours.
■Symptoms that occur cause significant distress and impairment to social, professional, or other important aspects.
■Have a past medical history, or medical examination report and test report indicating that symptoms are related to cancer or cancer treatment.
■The occurrence of these symptoms is not related to major depression, medical disorders, or delirium.
Dietary therapy is not a supplement
If I feel that I am tired due to cancer, do I have to go to the hospital for medication?
In fact, for mild cancer-induced fatigue, you can first start with daily diet. However, it should be noted that many cancer patients and their families have an obvious misunderstanding, that is, they think that patients are weak and need to be "supplemented".
Patients or family members often ask the doctor, "What supplements do I need?" "You know, the prolonged cancer caused by sexual fatigue is not necessarily caused by "deficiency", and it is not enough to make up for it. After the patient's tumor treatment, the digestive system is already stimulated, if you eat fat and greasy every day, it is likely to appear heavy body, loss of appetite, stomach bloating, poor sleep, etc., as a result, the body does not get too much positive energy, but there are more symptoms of cancer-induced fatigue, which can be described as making up for it incorrectly and lacked even more.
The correct dietary treatment method is to eat a light and easy to digest diet in addition to the uniform intake of various nutrients. Some dietary remedies can be selected after outpatient consultation, such as yin deficiency and fever, you can take rock sugar silver ear soup, black fungus goji berry japonica rice porridge; For those with deficiency of spleen and stomach, an appropriate amount of ginseng, yam, raw coconuts and red dates can be added to glutinous rice to boil porridge.
In addition to internal decoction, external treatment methods of Chinese medicine are also unique. External treatments such as moxibustion, acupuncture point dressing, ear points, and Chinese medicine foot baths are easy to operate, and patients can use them at home for a long time under the guidance of a physician. In addition, acupuncture, cupping, Chinese medicine hot bao, directional drug dialysis and other items that need to be operated in the hospital are stimulated by different meridian acupuncture points, which play the role of expectorant and dehumidification, blood circulation and qi, warm and yang dispersing cold, and helping yang and dampness. External treatment can be used alone or combined with internal treatment to achieve the purpose of unclogging meridians, relaxing the body and mind, and promoting the recovery of the patient's state.
Patients can also use traditional exercises to rehabilitate. Here to avoid the misunderstanding that "exercise means sweating". There are patients with perseverance, in order to recover as soon as possible, every day for a long time running, swimming, walking, think that sweat can prove that exercise is effective, which is risky for tumor patients, if the patient's bones, cardiopulmonary function is poor, or just after tumor treatment has various side reactions, at this time high-intensity exercise may appear to hurt joints or even fall and other dangers.
If the patient's physical strength allows, he can properly practice health preservation exercises and tai chi. This kind of traditional exercises are slow and slow, the range of movement is small, it is very friendly to middle-aged and elderly friends and patients, helps to unblock meridians, harmonize qi and blood, regulate the mind, enhance physical fitness, regulate the body's immune function, and is conducive to the recovery of cancer patients and improve the treatment effect.
If the cancer obviously affects daily life due to sexual fatigue and cannot be relieved by self-regulation, it is necessary to go to the hospital in time, through the differentiation and treatment of specialists, find out the cause from person to person, exclude the pathogenesis factors, and choose the treatment plan. The above-mentioned Aunt Wang came to the doctor because her normal life was affected, and after differentiation, she was given Chinese medicine to invigorate qi and strengthen the spleen, dissolve phlegm and disperse knots, combined with acupoint application and moxibustion to strengthen the spleen and dispel dampness. Two weeks later, she returned to the hospital for follow-up consultations to dispense medicine, saying that her appetite and sleep had improved, she got along with her family much more easily, and she had more mental and physical strength to go out with her sisters for recreational activities.
(The author is an oncologist at Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine)