I have come here at the BGICC 2019, I have given a talk on the effect of fatigue, cancer related fatigue, in patients in breast cancer. It is quite alarming to see that most of these patients, almost up to 90% of these patients, are having cancer related fatigue which is most often overlooked. It is important that we pay much more attention to the patients’ symptoms, much, much more than what we have been doing earlier as clinicians. Also we have to back it up with psychologists and psychiatrists because these patients are the ones which require a lot of emotional and psychological care. So that was the basic gist of my talk.

How can care be improved for these patients?

It has to be a multi-targeted approach. As clinicians we have to give most emphasis as to how to pick out those patients who have this problem of fatigue. Then accordingly we have to see whether this fatigue is because of the treatment, that is chemotherapy or radiotherapy or surgery, whatever we are giving, or it is because of some organic problem in the body, or it is because of certain comorbid conditions like diabetes, hypertension, coronary artery disease. Or, the most important, whether there is a psychosocial or a psychological, emotional overtone which is attached to these problems. Then accordingly whenever we find out that, yes, suppose it is a psychological problem, then we rope in the social workers, the psychologists and the psychiatrists and then you take a call as to how to proceed.

What effect does this approach have on the patient?

It is not a one stop procedure, it’s not like a patient who comes with a heart attack and you do a surgery and you do a bypass surgery and he’s fit. It is an ongoing process, you have to keep on counselling these patients over and over again over a period of time. Then definitely after some weeks or probably months of real counselling and treating them then these people start to show improvement. In fact, now in our institute what we have done is that initially when these patients come to us at inception there and then only we start assessing these patients as to what problems they have, these patients have, which can be reversed. Then accordingly we go about it. So it’s an ongoing process, it’s not a one stop shop.

Anything to add?

I would like to say that it’s a great conference going on and definitely it will help all the patients who are in the Middle East and, of course, in the South Asian belt as well.