Authors: Check, Diane L, Check, Jerome H, Citerone, Tammy, Cremin, Nancy.
One of the main morbidities of patients with cancer is severe fatigue. It is especially prominent in patients receiving chemotherapy or radiotherapy. Unfortunately, there is not a pharmaceutical agent that has been approved for treatment of cancer related fatigue. There are data that off-label use of dextroamphetamine sulfate has provided marked improvement in the chronic fatigue syndrome. However, the efficacy of this therapy has not been established for treating the severe fatigue of patients with cancer, especially while undergoing chemotherapy, immunotherapy, or radiotherapy. A 64-year-old woman, with stage IV breast cancer, had a good response to a combination of chemotherapy and immunotherapy and hormonal therapy. However, she suffered from incapacitating fatigue. She was treated with a small dosage of dextroamphetamine sulfate while continuing immunotherapy and hormonal therapy and demonstrated a dramatic improvement in her fatigue. She actually claimed her fatigue was completely eradicated and she resumed normal activity, which included a daily 3-mile power walk and 100 push-ups. Dextroamphetamine sulfate is very well tolerated, with no serious long-term risks. This treatment should be considered for patients with cancer related fatigue.
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