Published by The Haworth Medical Press (2004)
The Handbook of Cancer-Related Fatigueaddresses a wide array of areas related to fatigue. The first chapter discusses definitions of fatigue and cancer-related fatigue, the relationship between certain socio-demographic factors and fatigue as well as tools that attempt to measure fatigue. The next chapter devotes many pages to the relationship between cancer related fatigue and quality of life as well as the relationship between the major cancer treatment modalities such as surgery, chemotherapy and radiotherapy and fatigue. This is followed by a description of possible causative factors such as haematological, endocrine, psychological and nutritional factors. The final chapter looks at treatment of cancer related fatigue including graded exercise, sleep therapy, cognitive-behavioural therapy, nutritional, pharmacological, complementary and alternative therapy and immunotherapy. I found the section on graded exercise particularly interesting and useful from a clinical perspective.
The second half of the book consists of 226 pages of references, which at first seems very impressive. Unfortunately when reading the text the large number of references became a distraction rather than a benefit. In some areas I read four lines of text followed by any where between 18 lines and four pages of references. I couldn’t help but think this was an example of that old adage that “more is not always better”.
While the book provides a comprehensive list of the literature related to fatigue there appears to be minimal comment on the level of evidence produced by the numerous research articles cited. Given the abundance of material written on the area this would have been useful for the clinician in terms of knowing what is worth incorporating into practice.
The promotional material on the back cover says the book has been written for patients with cancer as well as clinicians and researchers. In my clinical experience there are very few patients, without fatigue let alone those with fatigue, who would have the energy to wade through such dense text. Having said that it is important to highlight the usefulness of the summary statements in italics at the beginning of each section. I used the summary statements to decide whether or not to work through the lengthy paragraphs for further detail. When I did seek further detail or explanation on a particular area it was there.
The author, Roberto Patarca-Montero MD, PhD, currently works at the University of Miami School of Medicine. He has done a considerable amount of work in the area of chronic fatigue syndrome and has published widely in related journals. Consequently in this book he tends to draw parallels between cancer related fatigue and chronic fatigue syndrome that adds a different dimension for the cancer-focused reader and is very interesting.
Overall this book is very interesting and provides a comprehensive overview of a wide range of topics associated with fatigue. It also provides an exhaustive list of the literature published on the area of fatigue and cancer-related fatigue in particular. This book would suit the health professional, from any discipline, who wants to understand the complex nature of fatigue and its impact on patients with cancer as well as their significant others.
Peter MacCallum Cancer Centre, Melbourne, Victoria