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Prevalence of Fatigue

Posted 11/9/2013

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Any list of cancer treatment side effects includes fatigue. There is fatigue after surgery, fatigue related to chemotherapy, fatigue during radiation. If you have been "lucky" enough to experience several of these, you know that they are actually quite different from one another. After surgery, most women need and want to sleep a lot (the rule of thumb is a week for every hour of surgery to achieve full recovery); during chemotherapy, many women don't want to get out of bed or off the couch some days, and during radiation, the fatigue can descend like a sudden dropping curtain.

There is huge variability in the amount of fatigue women experience, and equal variability in the time during and after treatment that it persists. Some women feel mostly back to their baseline energy level a couple of months after chemotherapy ends, and others feel that they never get there. Age and type of treatment may be related to this as well as exercise (or lack thereof), but it just seems to be different person to person. One absolute is that it will help if you force yourself to get up and exercise/move a bit. Doing less just leads to more doing less.

This is the introduction to today's study about the prevalence of fatigue in cancer patients and survivors. It found a high prevalence of moderate to severe fatigue among cancer patients and survivors of all sorts, and suggests that more attention needs to be paid to ameliorating this problem. Here is the abstract from Cancer, and a link to read more:

Prevalence and Characteristics of Moderate To Severe Fatigue

A Multicenter Study in Cancer Patients and Survivors

BACKGROUND: The effective management of fatigue in patients with cancer requires a clear delineation of what constitutes nontrivial
fatigue. The authors defined numeric cutpoints for fatigue severity based on functional interference and described the prevalence and characteristics of fatigue in patients with cancer and survivors.

METHODS: In a multicenter study, outpatients with breast, prostate, colorectal, or lung cancer rated their fatigue severity and symptom interference with functioning on the M. D. Anderson Symptom Inventory numeric scale of 0 to 10. Ratings of symptom interference guided the selection of numeric rating cutpoints between mild, moderate, and severe fatigue levels. Regression analysis identified significant factors related to reporting moderate=severe fatigue.

RESULTS: The statistically optimal cutpoints were !4 for moderate fatigue and !7 for severe fatigue. Moderate=severe fatigue was reported by 983 of 2177 patients (45%) undergoing active treatment and was more likely to occur in patients receiving treatment with strong opioids (odds ratio [OR], 3.00), those with a poor Eastern Cooperative Oncology Group performance status (OR, 2.00), those who had >5% weight loss within 6 months (OR, 1.60), those who were receiving >10 medications (OR, 1.58), those with lung cancer (OR, 1.55), and those with a history of depression (OR, 1.42). Among survivors (patients with complete remission or no evidence of disease, and not currently receiving cancer treatment), 29% of patients (150 of 515 patients) had moderate=severe fatigue that was associated with poor performance status (OR, 3.48) and a history of depression (OR, 2.21).

CONCLUSIONS: The current study statistically defined fatigue severity categories related to significantly increased symptom interference. The high prevalence of moderate=severe fatigue in both actively treated patients with cancer and survivors warrants the promoting of the routine assessment and management of patient-reported fatigue. Cancer 2013;000:000-000. VC 2013 American Cancer Society.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314239/

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