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Suffering in Silence
Cancer patients urged to seek help for fatigue.
By Judy Jenkins - Gleaner staff

Jan knows all about the draining effects of chemotherapy. "It takes those blood cells and just rips into them," said the Henderson County resident who happened to be undergoing a chemotherapy treatment at her rural home on Wednesday.

That treatment follows many she's had since her cancer was diagnosed six years ago this month.

"Chemo definitely wears you out," she said, but she's aware that there are things her doctors can do to alleviate that extreme fatigue.  She's had several blood transfusions and also injections of a medication that stimulates the bone marrow to step up production of blood cells.

Consequently, says the usually energetic grandmother, "I do just about anything I want to do.  I don't let it get me down.."  In addition to helping care for her young granddaughter, she does her housework, hunts, fishes, and goes mushroom hunting.

But many cancer patients don't receive treatment for their fatigue - or even know there is treatment for it - and therefore miss out on a lot of living. 

Today's National Cancer Fatigue Awareness Day is intended to remedy that situation and Dr. Al Korba is all for it.  Korba, a radiation oncologist affiliated with both the Henderson and Evansville Cancer Centers, stresses that cancer patients "need to tell somebody about their fatigue and not just accept that it's OK · Some think they're not very good patients if they complain about fatigue.

I'll see somebody come into the center and they'll hardly be able to walk, but when you ask how they are they say, 'I feel great!'"  He admires that positive spin on the negative circumstance, but says patients are doing themselves a disservice by needlessly suffering from being tired all the time.

There are a number of multidisciplinary treatment approaches that can help, he said, and patients need to speak up about the problem because physicians don't always realize that fatigue is impacting them.

Korba, who has been practicing in this area 26 years, said chemotherapy tends to be more physically draining than radiation treatment.  "Chemotherapy has a wider range of effects," he said.  "There is no question there are body changes with it because of tissue destruction.  The chemo is killing both good and bad tissues."  Anemia can result, and that means oxygen levels decrease.

"Oxygen, deprivation is the main thing" in fatigue related to cancer treatment, Korba said.

The physician notes, however, that fatigue is apt to be a combination of physical and psychological factors, and that is why the Evansville Cancer Center has a psychologist on staff.

Korba said it's perfectly normal for cancer patients to be frightened and therefore go into denial about the disease and its effects, including fatigue.  Others believe that being so tired is all a part of cancer and something that must be accepted.  Still others believe they're being self-indulgent if they ask for help for fatigue.

It's a pervasive problem and there are bound to be numerous local residents dealing with it.  The tumor registry at Methodist Hospital reports the year 2000 - the latest year for which statistics are available - saw 226 cancer patients diagnosed and/or treated at the hospital here.  Of that number, 112 are females and 114 are males.

While both genders often hesitate to report fatigue, Korba noted women are more apt to say something to their doctors.  "There's a reason we have two women's hospitals in Evansville" and not hospital specifically for men, Korba said. "Men tend to be more in denial."

He hopes both sexes will stop suffering in silence. "You have to be an advocate for yourself."

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