Fatigue affects broad range of activities among patients with cancer

Cancer-related fatigue significantly interferes with patients' quality of life, and some areas often affected among thesepatients are not normally included on standard quality-of-life assessments, said Karen M. Mustian, PhD, University ofRochester School of Medicine, NY. More randomized, controlled trials are needed to identify these areas, she said.

Dr Mustian designed a study to determine the scope of impairment caused by cancer-related fatigue in 753 patients with mixedcancer diagnoses. Specific areas evaluated were activities of daily living (ADL) such as performing household chores, cooking,bathing, dressing, working, socializing, engaging in sexual activity, and running errands. The patients were assessed 7 daysafter their first 2 chemotherapy infusions using the Multidimensional Assessment of Fatigue and a 10-point Likertscale.

Of the 753 patients, 533 reported fatigue with a median severity of 5.99 points after Cycle 1 and a median severity of 5.73after Cycle 2. The fatigue experienced after the first chemotherapy cycle interfered with household chores in 488 patients(severity, 4.89), with cooking in 459 patients (severity, 4.52), bathing in 545 patients (severity, 4.21), and dressing in 548patients (severity, 4.22). Difficulty socializing because of fatigue was reported by 541 patients (severity, 4.55). Runningerrands was difficult for 513 patients (severity, 4.59). Difficulties in working and engaging in sexual activity were reportedby fewer patients (n=322; severity, 4.46; and n=368; severity, 4.64, respectively).

Cancer-related fatigue was significantly correlated with ADL interferences after both Cycle 1 and Cycle 2, with each itemreported achieving significance of pp<.05). Patients undergoingchemotherapy in a metastatic setting rather than an adjuvant setting also experienced more ADL interference, as did nonwhitepatients (p<.05).