FATIGUE AND TARGET THERAPIES IN THE ELDERLY
S. Clementi, S. Bordonaro, S. Rametta Giuliano, P Tralongo
Vol.1 (2016), issue 2, pag. 17-42
|Accepted for pubblication||29/05/2016|
Fatigue is one of the most common symptoms associated with cancer and its treatment, and it significantly disrupts normal functioning and quality of life of cancer patients especially in elderly. The National Comprehensive Cancer Network (NCCN) has defined chronic fatigue as “a distressing persistent sense of tiredness or exhaustion related to cancer that is not proportional to recent activity and interferes with usual functioning”. Cancer-related fatigue limits the ability to function, socialise and participate in daily activities, and it has also been linked to shorter recurrence-free and overall survival rates in patients with cancer. Despite its deleterious impact on patient quality of life, chronic fatigue often remains unrecognised and untreated. It is reasonable to expect that fatigue may cause functional dependence in the aged because of the increase of comorbidities, the cognitive impairmentand the limited functional reserve. Although its pathogenesis has not been yet fully understood, several factors seem be involved, such as chemotherapy and radiotherapy effects on central nervous system and muscles, alterations in sleep cycles, physical and emotional pain, inflammation, oxidative stress, immune dysregulation, premorbid functioning and illnesses, anxiety. Recently the use of target therapies in the treatment of certain cancers has been associated with the onset of fatigue. Indeed despite the more specific therapeutic effects of novel chemoterapic agents on cancer cells, chronic fatigue represents one of the most common side effects of these drugs. In this review, we will analyze the association between target therapies and chronic fatigue focusing on the impact on the elderly population.