Fatigue Is Strongest Cancer-Related Side Effect, Survey Shows

Findings released from a national survey underscore what cancer patients already know: The fatigue following chemotherapy treatment has a sweeping impact on patients’ physical and emotional health, as well as their economic well-being.

Three-quarters (76%) of the 379 cancer patients surveyed consistently experienced fatigue, and nearly 9 (89%) out of 10 of those who experienced fatigue said that cancer fatigue, commonly caused by chemotherapy-induced anemia, interferes with their normal daily life.

Survey Highlights

The survey included patients who had been treated for cancers of the breast, prostate, lung, or skin, as well as those with leukemia or lymphoma. The following are highlights of the survey results from the 301 patients who experienced fatigue:

• Among fatigued patients, 60% reported that fatigue affects their lives more than any other side effect of cancer, including nausea (22%), pain (6%), and depression (10%).

• Fatigue was the longest-lasting side effect of cancer treatment. Close to half of patients (45%) experienced fatigue for at least 1 week after chemotherapy and 33% had fatigue that lasted 2 weeks or more after chemotherapy.

• Among fatigued patients, 89% said that fatigue changed the way that they go about their normal daily life, and a majority said the condition causes distress and interferes with daily activities.

• Patients said that fatigue affects their ability to earn a living: Among employed patients, 71% missed one or more days of work per month and 31% missed nearly an entire week. Similarly, their caregivers took off about the same number of days to help care for them. Another 28% said fatigue forced them to stop working altogether. Three-fourths (75%) of patients had to change their work habits, such as cutting hours at work or taking on less responsibility.

• The impact of fatigue on family/social life was equally dramatic, as 59% of respondents said that they had difficulty socializing with family or friends; 52% said that they couldn’t meet the needs of their family or loved ones; 37% cited problems maintaining interpersonal relationships; 30% had difficulty being intimate with their partner; and 25% felt distant from family members and friends.

• Fatigue also interferes with an individual’s ability to perform normal everyday tasks. A majority of respondents said that cancer fatigue interfered with daily activities, such as cleaning the house (69%), running errands (56%), climbing stairs (56%), and walking distances (69%).

• Patients are largely misinformed about cancer fatigue, and physicians do not always provide them with the information they need. Among the fatigued patients, 61% assumed that the condition would disappear on its own; 45% believed that there was nothing their physician could do to treat cancer-related fatigue; and 25% said that their physicians did not explain the causes and treatments of the condition.

• One-third (32%) of fatigued patients said that they had been diagnosed with anemia, a common cause of fatigue. Despite this, only 9% of fatigued patients were treated with prescription drugs or transfusions to correct the condition.

Common Causes of Fatigue

“The survey results confirm that the debilitating fatigue during cancer treatment is seriously underrecognized and undertreated,” said Gregory A. Curt, MD, of the National Cancer Institute and a member of the Fatigue Coalition. “The physical, emotional and economic stress of fatigue on cancer patients has a serious impact on their ability to get back to the business of living.”

The most common cause of cancer-related fatigue is anemia.

Treatment Options

“The real message of the survey findings is that many patients with fatigue are suffering alone when treatment options are available. Clearly, based on these results, fatigue may jeopardize patients’ careers and their ability to take care of themselves and their families. The treatment community and patients need to recognize this fact and actively seek and request more treatment options,” said Susan L. Scherr, a cancer survivor who is a member of the Fatigue Coalition and serves as director of community and strategic alliances for the National Coalition for Cancer Survivorship (NCCS), a national advocacy group for cancer patients.

“Now, when our patients describe the way fatigue is impacting their ability to go about their daily lives, we need to evaluate each individual’s condition and treat fatigue aggressively when needed,” added Dr. Curt.