Healthcare Providers
Regulated Health Professionals and Cancer-Related Fatigue: We All Play a Role
Regulated Health Professionals play a crucial role in helping people prevent, manage, and treat common cancer treatment-related health issues, like fatigue, throughout the trajectory of cancer survivorship (i.e., from diagnosis to end of life). A critical antecedent to providing the best possible care for patients is a solid understanding of what each practitioner does (i.e., their scope of work) and when it is most helpful to refer patients to them. This article is the first in a series that will feature the important work being done across regulated health professions and how each profession can meaningfully impact the fatigue, health, and well-being of people living with and after cancer. Here, we summarize the major Regulated Health Professions that provide essential, complementary aspects of care for people living with or trying to prevent cancer-related fatigue.
Chiropodists and Podiatrists
Chiropodists and podiatrists assess, diagnose, and treat disorders of the bones, skin and soft tissue of the feet, aiming to keep people functional, mobile, and independent.
- Fatigue Treatment and Management: Chiropodists and podiatrists can help manage foot-related issues that may exacerbate fatigue, such as providing custom orthotics to improve mobility and reduce pain. This is extremely important for individuals with cancer-related fatigue, as the most effective treatment is exercise therapy.
- Fatigue Prevention: By ensuring optimal foot health, chiropodists and podiatrists can help prevent complications that lead to decreased physical activity, thus helping to maintain energy levels and prevent fatigue.
They also play a role in screening for some cancers, including monitoring changes in nails and skin to ensure no malignancies are developing. During cancer treatment, maintaining semi-regular appointments with Chiropodists and Podiatrists can help ensure any changes that may be occurring in the feet or lower limbs that may be early signs of treatment-related complications like peripheral neuropathy or lymphedema are caught quickly. They are also integral in fall prevention and optimizing function if a lower limb surgery is needed (such as an amputation) and by fitting people for orthotics.
Dietitians
Dietitians are experts in food and nutritional sciences and are the only regulated health professionals that assess, diagnose, support, and treat health conditions with food and nutrition.
- Fatigue Treatment and Management: Dietitians offer personalized nutritional plans to address deficiencies and optimize energy levels, helping to manage fatigue in cancer patients and ensuring that patients are consuming the correct balance of nutrients required to support exercise therapy.
- Fatigue Prevention: Through balanced diet plans and proper nutrition education, dietitians can help patients maintain adequate energy levels and prevent fatigue.
Dietitians offer support to people affected by cancer throughout their care to and provide nutritional support using their understanding of the complex changes that may occur in certain types of cancer. For example, those with head and neck cancer may have problems eating, drinking, or swallowing as the structures required for those activities have been removed or they may be experiencing pain, while those experiencing gastrointestinal cancers may have difficulty with absorbing sufficient nutrients. It is important not to confuse dietitians with nutritionists who are not registered and do not receive the formal training of a dietitian.
Kinesiologists
Kinesiology is the study of human movement, performance, and function. Kinesiologists are experts in biomechanics, anatomy, and physiology and use evidence-based research to treat and prevent injury and disease and improve movement.
- Fatigue Treatment and Management: Kinesiologists design and implement exercise programs tailored to the needs of cancer patients, helping to induce the physiological remodelling required to treat cancer treatment-related injuries, reverse dysfunction, and reduce fatigue.
- Fatigue Prevention: Regular physical activity guided by kinesiologists can enhance overall fitness and energy levels, helping to prevent the onset of fatigue.
Kinesiologists are integral in managing cancer-related fatigue due to their expertise in exercise therapy. They work closely with the medical team to develop and implement individualized exercise therapy plans that address each patient’s needs to optimize their function and improve fatigue. They can also assist in improving ergonomics to decrease pain or discomfort that may be contributing to fatigue, and aid with return-to-work planning and disability management.
Naturopaths
Naturopaths are healthcare practitioners who emphasize a holistic approach to wellness. They utilize natural therapies and lifestyle interventions to support the body’s ability to heal and maintain optimal health. They are trained in various modalities, including nutrition, herbal medicine, acupuncture, and lifestyle counselling, to provide comprehensive care tailored to individual needs.
- Fatigue Treatment and Management: Naturopaths use personalized treatment plans that may include dietary recommendations, herbal supplements, and stress management techniques to address underlying causes of fatigue. Their holistic approach helps to balance the body’s systems, thereby reducing fatigue and enhancing overall vitality in cancer patients.
- Fatigue Prevention: Naturopaths help prevent fatigue by promoting a healthy lifestyle through balanced nutrition, adequate rest, and regular physical activity. Their focus on preventative care ensures that patients maintain optimal energy levels and resilience against the physical and emotional stressors associated with cancer.
Naturopaths contribute significantly to the care of cancer patients by offering natural and integrative therapies that complement conventional treatments. Their emphasis on whole-person care helps manage fatigue symptoms and improve patients’ overall well-being. Through continuous support and education, naturopaths empower patients to take proactive steps in their health journey, fostering long-term wellness and fatigue prevention.
Nurses
Nurses are critical members of the healthcare team, providing comprehensive care that encompasses medical, emotional, and educational support. Their role is pivotal in managing the complex needs of cancer patients, particularly in addressing symptoms like fatigue.
- Fatigue Treatment and Management: Nurses provide essential care in managing fatigue by administering treatments, monitoring patient progress, and educating patients on energy conservation techniques. They offer practical advice on managing daily activities and ensure patients receive appropriate medications and interventions to alleviate fatigue.
- Fatigue Prevention: Through continuous assessment and proactive care planning, nurses help prevent fatigue by addressing early signs and symptoms. They educate patients on healthy lifestyle practices, including proper nutrition, hydration, and rest, to maintain energy levels and prevent the onset of fatigue.
Nurses play a multifaceted role in supporting cancer patients, combining clinical expertise with compassionate care. They are often the first point of contact for patients, offering critical insights and interventions that help manage and prevent fatigue. By fostering a supportive environment and coordinating with other healthcare professionals, nurses ensure patients receive holistic and individualized care throughout their cancer journey.
Occupational Therapists
Occupational therapy is a very broad profession and involves linking physical health with social care and the surroundings in which people live, including their work, home, and leisure activities. Occupational therapists assess what individuals can do for themselves and support people with mental health issues, encouraging people to find practical solutions to manage their health and well-being.
- Fatigue Treatment and Management: Occupational therapists assist patients in developing energy conservation strategies and adaptive techniques to manage daily activities without excessive fatigue.
- Fatigue Prevention: They educate patients on efficient ways to perform tasks and incorporate rest breaks, helping to prevent fatigue by optimizing energy use.
More generally, occupational therapists play an important role in supporting people receiving and recovering from cancer treatments. They teach people new ways of doing things and how to adapt when function has been lost and advise on how the home environment can be changed to help people cope with physical problems caused by their cancer or treatment. Occupational therapists are also experts at prescribing and educating on assistive devices, such as wheelchairs or walkers, to keep people active and allow them to participate in their exercise therapy sessions for cancer-related fatigue.
Orthotists and Prosthetists
Orthotists assess, design and provide custom-made external devices such as splints, braces, and specialist footwear to modify the structural or functional characteristics of an individual’s limbs. Prosthetists provide the best replacements possible for individuals who have lost limbs through cancer or its treatment and help restore function and independence with artificial limbs.
- Fatigue Treatment and Management: Orthotists and prosthetists create custom devices that improve mobility and reduce physical strain, helping to manage fatigue.
- Fatigue Prevention: By providing supportive orthotic and prosthetic solutions, these professionals help patients maintain an active lifestyle and prevent fatigue.
Both allied health professionals are important for keeping people active, reducing pain, and facilitating recovery from cancer and cancer-related fatigue. Both are often hospital-based and work closely with occupational and physical therapists to optimize function after cancer and treatment.
Physical Therapists
Physical therapists are experts in the physical function of individuals and can assist people affected by cancer throughout all stages of their care. Physical therapists are critical for prehabilitation, which prepares people for their cancer treatment, and rehabilitation, which uses restoration and adaptation techniques during recovery and survivorship.
- Fatigue Treatment and Management: Physical therapists design individualized exercise programs to correct functional imbalances and improve strength, flexibility, and endurance, which helps to manage fatigue.
- Fatigue Prevention: Engaging in regular physical therapy can enhance physical fitness and energy levels, preventing the onset of fatigue.
Cancer and cancer-fatigue are associated with a wide range of physical and psychological symptoms. Using a combination of physical and psychological approaches, including movement, exercise, and manual therapy, to optimize mobility, function, cardiovascular and skeletal muscle health, pain management, and overall quality of life. Physical therapists strive to help people remain independent for as long as possible.
Psychologists/Psychotherapists
Psychologists and/or psychotherapists deliver psychosocial interventions and counselling focusing on improving quality of life, reducing distress and improving function during or after cancer and its treatments. They can also work with families and friends to support them during this difficult time.
- Fatigue Treatment and Management: Cancer and fatigue can cause immense emotional distress. Psychologists and psychotherapists offer counselling and cognitive-behavioural strategies to address emotional and psychological factors contributing to fatigue.
- Fatigue Prevention: They help patients develop coping mechanisms and stress management techniques, preventing fatigue by promoting mental well-being.
Psychosocial support can help patients feel less overwhelmed and more in control, potentially leading to better adherence to their treatment and therapy. They can also help people with managing anxiety and depression and deliver coping strategies for dealing with pain, which may also be contributing to their fatigue.
Registered Massage Therapists
Registered massage therapists (RMTs) are trained professionals who use various techniques to manipulate muscles and soft tissues in the body. They aim to improve physical function, relieve pain, and promote relaxation. Their expertise in understanding body mechanics and muscle anatomy allows them to tailor treatments to individual patient needs, especially those dealing with cancer-related symptoms.
- Fatigue Treatment and Management: RMTs employ techniques such as Swedish massage, deep tissue massage, and lymphatic drainage to alleviate muscle tension, enhance blood circulation, and promote relaxation. These methods can significantly reduce fatigue in cancer patients by easing physical discomfort and improving overall well-being.
- Fatigue Prevention: Regular massage therapy sessions can help maintain muscle health, reduce stress, and improve sleep quality, all of which are crucial in preventing the onset of fatigue. By promoting a balanced state of physical and mental relaxation, massage therapists aid in sustaining higher energy levels.
RMTs play a vital role in the comprehensive care of cancer patients by addressing the physical and emotional aspects of fatigue. Their interventions help mitigate the side effects of cancer treatments, such as pain and stress, thereby enhancing patients’ quality of life. Additionally, they work closely with other healthcare professionals to ensure a holistic approach to managing and preventing fatigue, integrating their therapies into broader care plans.
Social Workers
Social Workers help support families and patients throughout and after their cancer experience. They are trained to offer supportive counselling to help patients process their thoughts and feelings, as well as caregiver and family support.
- Fatigue Treatment and Management: Social workers provide resources and support to help patients navigate healthcare systems and access services that alleviate stress and fatigue.
- Fatigue Prevention: By offering emotional support and practical assistance, social workers help prevent fatigue by reducing the overall burden on patients and their families.
Social workers provide tools and resources to help manage cancer and cancer fatigue-related stresses, such as help with navigating personal finances during treatment and transportation. They are also experts at community resources and referrals to local programs.
Summary: The Importance of Working Collaboratively
No matter the profession, it is essential to always put the patient first and communicate openly and honestly with all other healthcare team members. Remember that no one knows their body better than the patient. As healthcare professionals, we must always give people the opportunity to talk and be listened to regarding their individual goals for living with and beyond cancer and its treatments. Involving patients in their care and allowing them to make critical decisions is essential for patients to become more independent and advocate for their health.