Poll Shows Incidence, Adverse Effects of Cancer-Related Fatigue

NEW YORK--A nationwide survey of US cancer patients, oncologists, andcaregivers documents that fatigue has profound effects on patients, includingtheir ability to work, meet family needs, and cope with the disease.

The survey, of 419 patients, 197 oncol-ogists, and 200 caregivers, showedthat 78% of cancer patients experience fatigue during the course of theirdisease, with 53% saying they experience fatigue on most days, if not everyday (Figure 1).

While 80% of physicians surveyed said they believe that fatigue is overlookedand undertreated, less than half reported that they discuss it with patientsor attempt to treat it.

"For many patients, fatigue is a daily reminder that they havecancer," said Nicholas Vogelzang, MD, professor of medicine, Universityof Chicago, and one of the authors of the survey. "If we can controlor lessen its effects, we go a long way toward restoring a sense of normalcyto patients' lives."

Some Too Tired to Eat

The survey was conducted by the research organization Wirthlin Worldwidefor The Fatigue Coalition, a multidiscipli-nary group of physicians andpatient advocates from institutions including Harvard, Stanford, MemorialSloan-Kettering, the University of Chicago, and the National Coalitionfor Cancer Survi-vorship. It was underwritten by Ortho Biotech Inc.

The majority of cancer patients reported that fatigue adversely affectstheir ability to work (61%) and interferes with their usual activities(51%), while 42% said that it negatively impacts their ability to takecare of their families (see Figure 2).For some, fatigue makes it difficult even to get out of bed (29%) or toeat their meals (24%).

Psychologically, fatigue also takes a tremendous toll: 57% of patientsin the study said they are unable to enjoy life fully because of fatigue,and 31% said that fatigue affects their hope of successfully fighting theircancer. Some 16% of patients surveyed said that treating their fatiguewas as important as treating the cancer itself, a "small althoughrelevant figure," Dr. Vogelzang said.

Other intriguing findings: While physicians believe that pain is moredebilitating and prevalent than fatigue, 61% of patients say that fatigueaffects their lives more than pain. And while most patients feel that fatigueis caused by their treatment, most physicians believe that the cancer isthe cause, which may explain why most patients (75%) are resigned to livingwith their fatigue.

In response to the survey, The Fatigue Coalition plans to develop aseries of educational and research initiatives designed to help patientsand physicians better understand the onset, duration, and progression offatigue in cancer and how to intervene successfully.