肺癌病人癌因性疲憊之運動訓練

Exercise Training for Cancer-Related Fatigue in Patients with Lung Cancer

肺癌在早期並沒有什麼特殊症狀，僅為一般呼吸系統疾病所共有的症狀，早期容易被忽略。近年來儘管醫學已有相當進展，但是肺癌的治療成果還是令人失望，臺灣每年有將近6000人死於肺腺癌；因此只要談到肺癌，大家無不恐懼萬分。癌因性疲憊（cancer-related fatigue， CRF）在癌症病人的盛行率非常高，肺癌病人因癌因性疲憊造成的運動耐力不足問題，與癌症治療預後不佳有很強的相關性。本文參考相關文獻提出肺癌患者癌因性疲憊問題，如何執行運動訓練與克服其導致的呼吸困難問題之成效與治療時應注意的原則與注意事項，做詳細的分析與整理，讓臨床醫護人員有更進一步的了解，以提供較具體安全的運動指導。同時提醒在全人照護的理念中，除了注意肺癌病人癌因性疲憊與呼吸困難問題外，應同時照護病人常出現的症狀群集，特別是呼吸睡眠障礙、食慾不佳與鬱悶問題及其相關衛教，以提高病人癌因性疲憊的自我照護能力與減少疲憊的產生。期望未來能進一步的研究確認臨床上肺癌病人癌因性疲憊之運動訓練成效，並藉此研究成效鼓勵醫療人員重視並鼓勵病人參與運動的動機與意願。Lung cancer remains a major cause of death in Taiwan, which claims a toll of 6, 000 every year. Its symptoms at an early stage are usually indistinguishable from common respiratory diseases so that it is easily overlooked. Despite the advance in medicine, effects of treatment are still disappointing. Cancer-related fatigue (CRF) is a common condition of lung cancer, which has been implicated in exercise intolerance and related to the poor response to cancer treatment.In this paper we reviewed relevant medical literatures to address the cause of CRF, the execution and the principle of exercise training to overcome dyspnea and points for attention. Through a comprehensive analysis and comparison, this will provide insights into and as a guide of a safer exercising training. In addition to CRF and dyspnea, co-morbidities such as sleeping disorders, poor appetite and depression should also be paid attention to. Patients should be educated for all these conditions so that they can increase the ability of self-care to reduce the fatigue.We look forward to further confirmation of the clinical effect of exercise training on CRF. By doing so, health care providers will be encouraged to provide and increase the willing and motivation of patients to accept exercise training.