Paul Jacobsen Discusses Survivorship Rehabilitation

Paul B. Jacobsen, PhD, professor of psychology, University of South Florida, H. Lee Moffitt Cancer Center and Research Institute, discusses ways to foster rehabilitation in cancer survivors who are experiencing fatigue or cognitive impairment, also known as chemo brain.

Jacobsen notes that for fatigue there are a number of evidence-based interventions that are effective. For instance, survivors who are off treatment can benefit from both aerobic and resistance exercise. Additionally, even modest exercise programs that may not necessarily improve fitness levels can be helpful at reducing fatigue.

In addition to exercise, psychological interventions, such as stress management, can help for severe fatigue. The use of psychostimulants, such as methylphenidate, for cancer-related fatigue can be effective and well tolerated.

Easing the burden of cognitive impairment has received less research than fatigue and as a result doesn't have evidence-based guidelines or interventions. Strategies for coping, such as creating lists, seem to be helpful, but more structured programs have not been evaluated, Jacobsen notes. Despite the lack of in-depth evidence, some studies suggest that the use of psychostimulants may be helpful in more severe cases.