Frequency, severity, clinical course, and correlates of fatigue in 372 patients during 5 weeks of radiotherapy for cancer

Abstract

BACKGROUNDPatients often describe fatigue as the most distressing of the symptoms they experienced during their cancer treatment. Fatigue may increase from initial levels experienced during cancer treatment with the addition of radiotherapy (RT).METHODSThree hundred seventy‐two patients completed a Symptom Inventory at the initiation of RT and weekly for 4 weeks thereafter. Descriptive statistics were used to evaluate differences in fatigue at baseline by demographics and diagnosis. Changes over the course of treatment were evaluated by repeated‐measures analysis of variance and Student t tests for paired data. The effect of diagnosis, age, gender, and previous treatment on fatigue was investigated by linear and hierarchical regression.RESULTSFifty‐seven percent of patients reported some degree of fatigue at the initiation of RT. The proportion increased to 76% by Week 3 and then to 78% at Week 5. Eighty‐four percent of patients with initial fatigue remained fatigued throughout the 5‐week course. Of the 160 patients without initial fatigue, 70% subsequently developed it. By Week 5, only 13% of patients had never reported any fatigue. Severity was found to be related to diagnosis, with patients with prostate carcinoma reporting the least severe fatigue and patients with lung, alimentary, and head and neck carcinoma reporting the most severe fatigue. Neither gender, age, nor total dose of RT predicted significant variance in severity.CONCLUSIONSFatigue was a common adverse effect of RT for cancer, reported by more than three‐fourths of patients by the third to fifth weeks of treatment. Cancer diagnosis was the only factor found to be significantly related to variation in fatigue severity. Additional studies should be devised to identify other underlying causes of RT‐related fatigue. Cancer 2005. © 2005 American Cancer Society.

High-Dose Asian Ginseng (Panax Ginseng) for Cancer-Related Fatigue

“…Most of the enrolled patients (Table 2) in the study were receiving cancer therapy. As CRF varies according to the cycle and duration of cancer therapy (ie, chemotherapy or targeted therapy or radiation therapy), 67,68 the cancer therapy can be a confounder in this study. Also because this study had no placebo arm, the efficacy of PG may have been due to a placebo effect.…”

Association between Mitochondrial Bioenergetics and Radiation- Related Fatigue: A Possible Mechanism and Novel Target

“…Fatigue is one of the debilitating symptoms most often reported to nurses by cancer patients receiving XRT [23]. Cancer-related fatigue is described as pervasive, a whole body excessive tiredness that is unrelated to activity or exertion, and not relieved by rest or sleep [24].…”

Integrative Nonpharmacologic Behavioral Interventions for the Management of Cancer-Related Fatigue

“…The most common problem reported by cancer survivors is cancer-related fatigue (CRF) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Cancer survivors frequently report that CRF begins with diagnosis, worsens during the course of treatment, and per- Mustian,Morrow,Carroll et al 53 www.TheOncologist.com sists for months, and even years, after treatment is complete .…”

“…Furthermore, CRF often continues even when the survivor's cancer is undetectable or in remission [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][23][24][25]. Survivors with varying cancer diagnoses and receiving different types of treatment report a frequency of CRF in the range of 60%-100%, with 41% or more indicating severe CRF (a score >7 on an 11-point Likert scale where 0 = no CRF and 10 = CRF as bad as you can imagine) during treatment [3][4][5]16,26,27]. Moreover, as many as 81% of survivors report persistent CRF, with 17%-38% indicating persistent severe CRF 6 months or longer after completing treatment [11,[27][28][29][30][31].…”

“…1) [1][2][3][4][6][7][8][9][10][11][12][13][14][15][16][17][18][19][23][24][25]32]. The nature of CRF makes it a symptom that is difficult to define fully.…”