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Fatigue Difficult to Isolate From Related Cancer Symptoms

August 1, 2001
Publication
Article
Oncology NEWS InternationalOncology NEWS International Vol 10 No 8
Volume 10
Issue 8

PHILADELPHIA-A study presented at the Oncology Nursing Society’s 26th Annual Congress in San Diego underscores the challenge of managing cancer-related fatigue: Fatigue frequently is part of a cluster of interrelated symptoms, such as pain, depression, and poor sleep quality.

PHILADELPHIA—A study presented at the Oncology Nursing Society’s 26th Annual Congress in San Diego underscores the challenge of managing cancer-related fatigue: Fatigue frequently is part of a cluster of interrelated symptoms, such as pain, depression, and poor sleep quality.

Andrea M. Barsevick, DNSc, RN, director of nursing research and education, Fox Chase Cancer Center, and her colleagues examined the effects of symptom clustering in a group of 101 patients who were drawn from the control group of a larger study of fatigue management.

The study group was composed of 89 women and 12 men, with a mean age of 57 (range, 30 to 78). The majority of patients had breast cancer, but other diagnoses included cervical cancer, lymphoma, and lung cancer. All disease stages were represented in the group.

The investigators measured fatigue, pain, depression, and sleep quality at baseline and at a time of expected high fatigue (at the end of 5 weeks of radiation therapy or 48 hours after the second cycle of chemotherapy).

Fatigue was measured with the Profile of Mood States (fatigue scale), the Schwartz Cancer Fatigue Scale, and the General Fatigue Scale.

Sleep quality was assessed with the Pittsburgh Sleep Quality Scale; depression, with the Profile of Mood States (depression scale); and pain, with a Side Effects Checklist item (pain).

When the symptoms were considered individually, 36% of the study participants experienced pain; 82% had sleep disturbances; 22% experienced depression; and 81% experienced fatigue.

When the symptoms were grouped as triads, 7% of the patients had fatigue-pain-depression; 21% had fatigue-pain-sleep disturbance; 7% experienced pain-sleep disturbance-depression; and 21% had fatigue-sleep disturbance-depression. Seven percent of the patients experienced all four symptoms.

The investigators concluded that symptom clustering is common among patients undergoing cancer treatment and that fatigue is significantly correlated with depression. Poor sleep quality also was associated with fatigue, but the relationship did not reach statistical significance.

The study did not find a correlation between fatigue and pain, but the researchers noted that the pain measurement may not have been sensitive enough.

Articles in this issue

Amifostine Can Reduce Xerostomia, Loss of Taste, Fibrosis, and Pain
Three-Dimensional Conformal Radiation Therapy Reduces Rectal Damage in Prostate Cancer Treatment
Can Concurrent Amifostine and 5-FU Permit Delivery of Higher Boost Doses of Radiation?
Preventing Severe Esophagitis Critical in Chemoradiotherapy for Lung Cancer
Upcoming Trial to Test Ability of Amifostine to Reduce Radiation-Induced Hypothyroidism
Amifostine Offers Little Advantage in Small Trial of Twice-Daily Radiation Plus Chemotherapy
Subcutaneous Amifostine Provides Protection Against Radiation-Induced Acute Xerostomia
Study to Test Amifostine in Cervical Cancer Patients Treated With Combined-Modality Therapy
Radioprotectants May Extend Use of Combined Chemotherapy and Radiation
Amifostine Ameliorates Pneumonitis and Esophagitis During Radiochemotherapy
Potentially Useful Predictors of Risk for Developing Postradiation Pneumonitis
Amifostine Trial Represents First FDA Approval of Treatment Interacting With Radiation
Amifostine Reduces Side Effects During Treatment for Advanced Lung Cancer
Intrarectal Amifostine Prevents Late Rectal Complications of Radiotherapy for Prostate Cancer
Experts Consider Statistical Issues in Designing Studies of Toxicity Modifiers

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