NEW YORK--A nationwide survey of US cancer patients, oncologists, and
caregivers documents that fatigue has profound effects on patients, including
their ability to work, meet family needs, and cope with the disease.
The survey, of 419 patients, 197 oncol-ogists, and 200 caregivers, showed
that 78% of cancer patients experience fatigue during the course of their
disease, with 53% saying they experience fatigue on most days, if not every
day (Figure 1).
While 80% of physicians surveyed said they believe that fatigue is overlooked
and undertreated, less than half reported that they discuss it with patients
or attempt to treat it.
"For many patients, fatigue is a daily reminder that they have
cancer," said Nicholas Vogelzang, MD, professor of medicine, University
of Chicago, and one of the authors of the survey. "If we can control
or lessen its effects, we go a long way toward restoring a sense of normalcy
to patients' lives."
Some Too Tired to Eat
The survey was conducted by the research organization Wirthlin Worldwide
for The Fatigue Coalition, a multidiscipli-nary group of physicians and
patient advocates from institutions including Harvard, Stanford, Memorial
Sloan-Kettering, the University of Chicago, and the National Coalition
for Cancer Survi-vorship. It was underwritten by Ortho Biotech Inc.
The majority of cancer patients reported that fatigue adversely affects
their ability to work (61%) and interferes with their usual activities
(51%), while 42% said that it negatively impacts their ability to take
care of their families (see Figure 2).
For some, fatigue makes it difficult even to get out of bed (29%) or to
eat their meals (24%).
Psychologically, fatigue also takes a tremendous toll: 57% of patients
in the study said they are unable to enjoy life fully because of fatigue,
and 31% said that fatigue affects their hope of successfully fighting their
cancer. Some 16% of patients surveyed said that treating their fatigue
was as important as treating the cancer itself, a "small although
relevant figure," Dr. Vogelzang said.
Other intriguing findings: While physicians believe that pain is more
debilitating and prevalent than fatigue, 61% of patients say that fatigue
affects their lives more than pain. And while most patients feel that fatigue
is caused by their treatment, most physicians believe that the cancer is
the cause, which may explain why most patients (75%) are resigned to living
with their fatigue.
In response to the survey, The Fatigue Coalition plans to develop a
series of educational and research initiatives designed to help patients
and physicians better understand the onset, duration, and progression of
fatigue in cancer and how to intervene successfully.