[Fatigue, anxiety and depression and their management]

Sickness behaviors such as fatigue, anxiety and depression play an important role in the body's defense mechanism. However, once these symptoms become chronic, they are harmful to patients with cancer by decreasing the immune reaction or exacerbating pain and other symptoms. It should be recalled that both medical and surgical interventions profoundly influence fatigue, anxiety and depression of cancer patients. Since latent fatigue, anxiety and depression may be overlooked behind somatic symptoms, communication skills are necessary to understand the suffering of patients. Routine assessment of these symptoms are essential for early intervention in the care of cancer patients. Communication skills such as careful listening and counselling are also useful methods in caring for patients with these symptoms. Although non-medical intervention is usually effective for these symptoms of fatigue, anxiety and depression, approximately 10 to 15% of patients require specific treatment by a psychiatrist. Above all, fatigue, anxiety and depression should be treated as part of the total pain experienced by cancer patients.