Cancer-Related Fatigue
Overview
Cancer-related fatigue (CRF) is a common and distressing symptom in patients with malignant tumors, characterized by persistent, non-exertional extreme tiredness that is not relieved by rest and is disproportionate to recent activity, severely affecting quality of life and treatment adherence. In TCM, the root cause is deficiency of healthy qi, involving insufficiency of qi, blood, yin, and yang, with dual deficiency of the spleen and kidney as the core; cancer toxin, phlegm-stasis, and qi stagnation are the branch, forming a pattern of deficiency mixed with excess. The disease is located in the spleen, kidney, and liver, and related to the heart and lung. Common clinical patterns include dual deficiency of qi and blood, yang deficiency of spleen and kidney, liver depression and spleen deficiency, and dual deficiency of qi and yin. Treatment focuses on supporting the healthy qi and consolidating the root while addressing the branch, using methods such as benefiting qi and nourishing blood, warming and supplementing the spleen and kidney, soothing the liver and strengthening the spleen, and benefiting qi and nourishing yin, combined with external therapies such as acupuncture, moxibustion, and tuina, which can significantly improve fatigue.
Pattern differentiation (clinical patterns)
Dual Deficiency of Qi and Blood
Mental fatigue and weakness, shortness of breath and reluctance to speak, pale or sallow complexion, dizziness and blurred vision, palpitations and insomnia, spontaneous sweating, poor appetite and loose stools, pale tongue with thin white coating, and a fine weak pulse.
Benefit qi and nourish blood; support the healthy qi and consolidate the root.
Yang Deficiency of Spleen and Kidney
Fatigue and somnolence, aversion to cold with cold limbs, soreness and weakness of the waist and knees, pale and shiny complexion, clear and profuse urine, loose stools or diarrhea before dawn, pale and swollen tongue with teeth marks, white slippery coating, and a deep, slow, weak pulse.
Warm and supplement the spleen and kidney; benefit qi and assist yang.
Liver Depression and Spleen Deficiency
Fatigue and weakness, depressed mood or irritability, distension and fullness in the chest and hypochondrium, frequent sighing, poor appetite and abdominal distension, loose and uncomfortable stools, pale red tongue with thin white coating, and a wiry fine pulse.
Soothe the liver and resolve depression; strengthen the spleen and benefit qi.
Connections
Daily care & prevention
Patients should arrange a reasonable daily schedule, balance work and rest, avoid overexertion, and engage in moderate aerobic exercise such as walking, taijiquan, and baduanjin, to the extent of not feeling fatigued. Diet should be light and easy to digest, with more consumption of Chinese yam, jujube, longan, lean meat, and eggs to supplement qi and blood, avoiding raw, cold, greasy foods. Maintain a cheerful mood and practice meditation and breathing exercises to regulate qi movement. Keep warm and avoid external pathogens. Regularly monitor changes in weight and physical strength, record the degree of fatigue, and communicate with the doctor promptly. Self-massage acupoints such as Zusanli (ST36) and Sanyinjiao (SP6) for 5-10 minutes each time, 1-2 times daily.
When to seek medical care
If fatigue suddenly worsens, accompanied by fever, bleeding, severe pain, dyspnea, altered consciousness, inability to eat or drink, rapid weight loss, or palpitations, chest tightness, pale complexion, and profuse sweating, it indicates deterioration of the condition or complications such as infection, anemia, or electrolyte imbalance, and immediate medical attention is required. For those undergoing chemotherapy or radiotherapy, persistent vomiting or diarrhea leading to dehydration, or abnormal blood counts, require emergency management.