Episode 232: Managing Fatigue During PARP Inhibitor Maintenance Therapy

“For those without cancer or other illnesses, we often have a resolution or relief of this fatigue. ‘Oh, I’m just going to go to bed early and get a couple more hours of sleep tonight.’ Or ‘I’m going to have a cup of coffee.’ But for people with cancer, it’s not an easy fix. People with cancer describe fatigue as something much more long-lasting,” ONS member Paula Anastasia, MN, RN, AOCN®, clinical nurse specialist for UCLA Health in Los Angeles, CA, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS. Anastasia discussed fatigue in patients with cancer undergoing PARP inhibitor maintenance therapy, management strategies, and nursing considerations. This podcast episode is supported by a sponsorship from AstraZeneca. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Episode Notes

• NCPD contact hours are not available for this episode.
• Clinical Update: Ovarian Cancer Focus Group Summary
• ONS Get Up, Get Moving resources
• ONS Guidelines™ on Fatigue
• Oncology Nursing Podcast Episode 227: Biomarker Testing, PARP Inhibitors, and Oral Adherence During Ovarian Cancer Maintenance Therapy
• ONS Voice articles:
  • Symptom Assessments: Use a Team-Based Approach to Inform Care and Optimize Outcomes
  • Master the Essentials of Effective Communication
  • What the Evidence Says About Music Therapy for Cancer-Related Fatigue
  • Acupuncture for Cancer-Related Fatigue
  • Biomarkers Are Advancing Understanding of Cancer-Related Fatigue
• Clinical Journal of Oncology Nursing articles:
  • The Impact of a Nurse-Led Exercise Activity for Cancer-Related Fatigue in Patients With Leukemia
  • Exercise Intervention: A Pilot Study to Assess the Feasibility and Impact on Cancer-Related Fatigue and Quality of Life Among Patients With High-Grade Glioma
• Oncology Nursing Forum article: The Effectiveness of Yoga on Cancer-Related Fatigue: A Systemic Review and Meta-Analysis
• National Comprehensive Cancer Network
  • Guidelines > Supportive Care > Cancer-Related Fatigue
• ASCO Answers: Cancer-Related Fatigue

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

Highlights From Today’s Episode

“Fatigue is not necessarily life threatening, so I think unfortunately, it’s underplayed at how disruptive it can be in somebody’s quality of life and day-to-day life.” Timestamp (TS) 03:10

“For those without cancer or other illnesses, we often have a resolution or relief of this fatigue. ‘Oh, I’m just going to go to bed early and get a couple more hours of sleep tonight.’ Or ‘I’m going to have a cup of coffee.’ But for people with cancer, it’s not an easy fix. . . . People with cancer describe fatigue as something much more long lasting.” TS 04:02

“I think it’s really important when we educate our patients to let them know that this is a common side effect. Research tells us, and also patient experience, that fatigue does plateau after about four to eight weeks. It’s not zero, but it gets much more manageable for our patients. So, I think priming our patients with what to expect can be very helpful.” TS 07:48

“I want patients to have some sort of physical activity. It doesn’t have to be hours or marathons. Just a 10-minute walk in the morning and then maybe a 10-minute walk in the afternoon. Things like that. We try to, if possible, refer patients to a physical therapy-type setting initially, and that will help give them tools on how to be active and safe activities, and also gets them motivated. So, that’s really helpful for patients.” TS 09:41

“I think it’s important to assess the cause of the fatigue. Ruling out anemia, hypothyroidism, vitamin deficiencies, things like that. So, that is ruled out and we know what we’re doing to our poor patient with the interventions; they’ve had surgery, they’ve had chemotherapy, now we’re going to put them on a PARP inhibitor, all of these lifestyle changes.” TS 12:20

“I think since COVID-19, there’s a lot more awareness of how much people have anxiety and depression. I think we’re more in tune with that and how stressful life is, and that’s not even having cancer and all of the challenges with that. So, I think that plays into it. Depression and anxiety can contribute to fatigue.” TS 16:53

 “One of the biggest misconceptions about fatigue is that there’s nothing that you can do about it. Just accept it. And I totally disagree with that. It’s an undervalued side effect. It’s not necessarily life threatening, but it’s definitely something that can interfere with patients’ day-to-day quality of life. So, we really need to address it. We need to assess, communicate, and plan for it.” TS 28:39