Fatigue After Chemo Has Major Impact on Patients’ Lives

WASHINGTON--Results of a new national survey underscore what cancer patients already know: The fatigue that commonly follows chemotherapy has a sweeping impact on patients’ physical and emotional health, as well as their economic well being.

The survey, released by the Fatigue Coalition, a multidisciplinary group of medical practitioners, researchers, and patient advocates, included 379 cancer patients who had received chemotherapy. Three-quarters (76% or 301 patients) said they had consistently experienced fatigue. And of these, 89% said the fatigue interfered with their normal daily life.

For example, 69% of the patients with fatigue said they found it harder to clean house and to walk distances, and 56% said they had difficulty running errands and climbing stairs.

Among the patients who had experienced fatigue, 60% said that fatigue impacted their daily lives more than any other side effect of their cancer treatment--considerably outweighing the effects of nausea (22%), depression (10%), and pain (6%) (see figure).

Not only was fatigue the most prevalent cancer side effect, it also lasted the longest. Nearly half (45%) of patients with fatigue said the condition lasted at least 1 week after chemotherapy, and 33% said it lasted 2 weeks or more.

Fatigue also affected patients’ ability to earn a living: 71% said they missed 1 or more workdays a month because of fatigue, and 31% missed nearly an entire week. Caregivers were also affected, with 13% missing about the same number of workdays as patients. More than one-quarter of the fatigue patients (28%) said they were forced to stop working altogether, and 75% had to change their work habits, such as cutting hours or reducing their responsibility.

The impact of fatigue on family/social life was equally dramatic: 59% said they had difficulty socializing with family or friends; 52% said they could not meet the needs of their family or loved ones; 37% had problems maintaining interpersonal relationships; 30% had problems with intimacy; and 25% felt distant from family and friends.

One Third Had Anemia

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

Finally, patients were often misinformed about cancer fatigue: 61% assumed the condition would disappear on its own; 45% said there was nothing their physician could do to treat the fatigue; and 25% said their physician did not explain the causes of the condition or possible treatments.

"The survey results confirm that the debilitating fatigue that often occurs during cancer treatment is seriously under-recognized and undertreated," said

Gregory A. Curt, MD, clinical director at 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," he added.

Susan L. Scherr, a member of the Fatigue Coalition and director of community and strategic alliances for the National Coalition for Cancer Survivorship, said that "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."

Added Dr. Curt, "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."

The survey, funded by a grant from Ortho Biotech Inc, was conducted last summer by Wirthlin Worldwide, a research organization.