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.