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Fatigue in Advanced Cancer: A Prospective Study

R. Horvitz Center for Palliative Medicine, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center

Declan Walsh, MSc, FACP, FRCP, Edin

R. Horvitz Center for Palliative Medicine, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center, walsht{at}ccf.org, The Harry R. Horvitz Chair for Palliative Medicine, Department of Solid Tumor Oncology Cleveland Clinic Taussig Cancer Center

Lisa A. Rybicki, MS

Department of Quantitative Health Sciences, Cleveland Clinic Cleveland, Ohio.[Q1]

Mellar P. Davis, MD, FCCP

R. Horvitz Center for Palliative Medicine, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center

Dilara Seyidova-Khoshknabi, MD

R. Horvitz Center for Palliative Medicine, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center

Fatigue is a common advanced cancer symptom. Clinical features are not well known. The authors surveyed consecutive patients admitted to a palliative medicine program to identify clinical correlates of fatigue. Data collected included age, sex, performance status, primary site, prior chemotherapy/radiation therapy, and blood transfusions. Visual analogue scales assessed fatigue, quality of life, and ability to perform daily activities. Weight change was estimated. Laboratory results including lactate dehydrogenase and hemoglobin were recorded. Fatigue severity was associated with brain metastases, poor performance status, poor quality of life, and reduced ability to perform activities. Prior radiation therapy was associated with less severe fatigue. Age, sex, and hemoglobin level were not associated with fatigue. Fatigue was universal on referral. Brain metastases and poor quality of life independently predicted severity. Hemoglobin level did not predict fatigue. Further studies are necessary to define the clinical features and relationships of fatigue.

Key Words: cancer-related fatigue • advanced cancer • palliative medicine

This version was published on October 1, 2008

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 5, 372-378 (2008)
DOI: 10.1177/1049909108319267


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